Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation.

Abstract

The classical criteria for the evaluation of clinical trials in cancer reflect alterations in physical well-being, but are insensitive to other important factors, such as psychosocial state, sociability, and somatic sensation that may play a critical role in determining the patients' functional response to their illness and its treatment. The Functional Living Index-Cancer is designed for easy, repeated patient self-administration. It is a 22-item questionnaire that has been validated on 837 patients in two cities over a three-year period. Criteria for validity include stability of factor analysis, concurrent validation studies against the Karnofsky, Beck Depression, Spielberger State and Trait Anxiety, and Katz Activities of Daily Living scales, as well as the scaled version of The General Health Questionnaire and The McGill/ Melzack Pain Index. The index is uncontaminated by social desirability issues. The validation studies demonstrate the lack of correlation between traditional measures of patient response and other significant functional factors such as depression and anxiety (r = 0.33), sociability and family interaction, and nausea. These findings elucidate the frequently observed discrepancies between traditional assessments of clinical response and overall functional patient outcome. The index is proposed as an adjunct to clinical trials assessment and may provide additional patient functional information on which to analyse the outcome of clinical trials or offer specific advice to individual patients.

Quality of life among long‐term survivors of breast cancer: different types of antecedents predict different classes of outcomes

“…If so, the associations with optimism would have been uniform. This divergence in prediction also attests once again to the importance of distinguishing among the various facets of QOL (Avis et al, 2005;Cella et al, 1993;Osoba et al, 1997;Ringdal and Ringdal, 1993;Schag and Heinrich, 1990;Schag et al, 1991;Schipper et al, 1984).…”

“…Deciding how to measure QOL is not as easy as it might seem. After a period when QOL was viewed almost entirely in functional terms, several multiscale inventories were developed to assess QOL after treatment (Borghede and Sullivan, 1996;Cella et al, 1993;Osoba et al, 1997;Ringdal and Ringdal, 1993;Schag et al, 1991;Schag and Heinrich, 1990;Schipper et al, 1984). A key principle behind those measures is that QOL is manifest in diverse ways, all of which may matter.…”

Treatment of AIDS-associated Kaposi's sarcoma in Zimbabwe: Results of a randomized quality of life focused clinical trial

“…The development and validation of the FLI-C was previously reported 16 as was its validation in Shona and other cultures. [17][18][19] The translation of the FLI-C into the Shona language as well as the development, translation and validation of KSM will be the subject of a separate communication.…”

Multiattribute utility assessment of outcomes of treatment for head and neck cancer

“…If a scale is to be useful then it should grade outcomes with both accuracy and reliability. Assessment of psychological function and social function is difficult but multiattribute techniques can facilitate the incorporation of such subjective values into a clinically useful scale (Schipper et al, 1984).…”

“…Traditionally, utility assessment techniques also require that respondents integrate all components of health into a single value. There is evidence that people have difficulty in doing this (Schipper et al, 1984).…”