Little research has been conducted documenting the reliability and validity of the Karnofsky Performance Status (KPS) scale, and guidelines based on empirical data do not exist to govern its use. Two hundred ninety-three cancer patients completed a questionnaire that assesses their physical and psychosocial difficulties. Physicians rated patients on the KPS and a subsample of 75 patients was used to evaluate interrater reliability. Analyses were conducted to evaluate the interrater reliability and construct validity of the KPS. The KPS was shown to have good reliability and validity. Detailed examination of the reliability data suggested areas in which physicians err in their judgments. Multiple regression techniques were used to empirically identify seven behaviorally based questions that would be helpful in predicting KPS scores. The seven variables included weight loss, weight gain, reduced energy, difficulty walking, driving, grooming, and working part time. An interview approach with behaviorally based guidelines is presented using these variables to obtain relevant data and make more accurate KPS ratings. With the approach suggested and the guidelines presented, oncologists may train themselves to use the KPS in a standard way, which should increase reliability and validity of the KPS and has implications for patients and research studies that use KPS as a stratifying variable.

The CAncer Rehabilitation Evaluation System (CARES) (CARES Consultants, Santa Monica, CA) a rehabilitation and quality of life instrument with well‐documented reliability and validity, has been shortened. This report describes the development and psychometric properties of the new instrument, the CAncer Rehabilitation Evaluation System—Short Form (CARES‐SF). The data from four existing samples of cancer patients demonstrate that the CARES‐SF is highly related to the CARES (r = 0.98), has excellent test‐retest reliability (86% agreement), concurrent validity with related measures, and acceptable internal consistency of summary scales (alpha = 0.85 to 0.61). In a new sample of breast cancer patients evaluated at three points in time (1 month, 7 months, and 13 months after diagnosis) the instrument appears to be sensitive to change and is highly related to the Functional Living Index—Cancer (FLIC), an existing quality of life instrument. The authors conclude that the CARES‐SF has excellent potential as a quality of life instrument for use in clinical trials.

Poor mental health places staff at risk for burnout and likely contributes to staff leaving hospice care; this is a critical issue as the profession attempts to attract new staff to meet the expanding demands for hospice care.

Fifty-one ambulatory patients with commonly occurring cancers and 25 of their spouses participated in a study to evaluate a stress and activity management treatment program (SAM) conducted in a group. Twenty-six patients participated in the SAM treatment condition, and 25 patients participated in the current available care (CAC) control condition. SAM patients and spouses were expected to improve more than the CAC patients and spouses in three important areas: (a) fund of information, (b) psychosocial adjustment, and (c) daily activities. Patients and spouses were evaluated at four points in time: pretreatment, posttreatment, 2-month follow-up, and 4-month follow-up. There was some support for unique effects of the treatment intervention, but there was also support for improvement in psychosocial adjustment that occurs for patients and spouses with the passage of time. The SAM patients and spouses reported high satisfaction with the group program, used the techniques that they learned in the group, and said that they would recommend it to other patients.