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Vogt KS, Hughes J, Wilkinson A, Mahmoodi N, Skull J, Wood H, McDougall S, Slade P, Greenfield DM, Pacey A, Ledger W, Jones GL. Preserving fertility in women with cancer (PreFer): Decision-making and patient-reported outcomes in women offered egg and embryo freezing prior to cancer treatment. Psychooncology 2018; 27:2725-2732. [DOI: 10.1002/pon.4866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/03/2018] [Accepted: 07/30/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Katharina S. Vogt
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
| | - Jane Hughes
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
| | | | - Neda Mahmoodi
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
| | - Jonathan Skull
- Reproductive Medicine and Surgery, Assisted Conception; Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - Hilary Wood
- School of Health and Related Research; University of Sheffield; Sheffield UK
| | | | - Pauline Slade
- Institute of Psychology Health and Society; University of Liverpool; Liverpool UK
| | - Diana M. Greenfield
- Late Effects, Sheffield Teaching Hospitals NHS Trust and Honorary Professor, Department of Oncology and Metabolism; University of Sheffield. Weston Park Hospital; Sheffield UK
| | - Allan Pacey
- Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism; University of Sheffield; Sheffield UK
| | | | - Georgina L. Jones
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
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Tax C, Steenbergen ME, Zusterzeel PLM, Bekkers RLM, Rovers MM. Measuring health-related quality of life in cervical cancer patients: a systematic review of the most used questionnaires and their validity. BMC Med Res Methodol 2017; 17:15. [PMID: 28125962 PMCID: PMC5270308 DOI: 10.1186/s12874-016-0289-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 12/26/2016] [Indexed: 01/24/2023] Open
Abstract
Background Data on health-related quality of life (HRQoL) is paramount for shared and evidence based decision-making. Since an overview of cervical cancer HRQoL tools and their validity appears to be lacking, we performed a systematic review on usage of disease specific HRQoL instruments in cervical cancer patients and their psychometric properties to identify the most suitable cervical cancer specific HRQoL tool. Methods We searched Pubmed, EMBASE and PsycINFO from inception up to 18 October 2016 for studies on quality of life in cervical cancer patients. Data extraction and HRQoL identification was performed by two independent reviewers. Validation studies of the identified cervical cancer specific HRQoL tools were retrieved and assessed on psychometric properties using the COSMIN checklist. All used cervical cancer specific HRQoL instruments were scored and ranked according to their psychometric properties. Results We included 156 studies (20,690 patients) and identified 31 HRQoL tools. The EORTC QLQ-CX24 (35 studies; 5,556 patients) and FACT-Cx (22 studies; 4,224 patients) were the only cervical cancer specific tools. The EORTC QLQ-CX24 had 4 out of 9 positive rated psychometric properties; internal consistency, content and construct validity, and agreement. Criterion validity, reliability, and interpretability scored doubtful. Responsiveness and floor- and ceiling effects were not reported. The FACT-Cx had 2 out of 9 positive rated psychometric properties; internal consistency and agreement. Content validity, reliability, and interpretability scored doubtful while criterion and construct validity scored negative. Responsiveness and floor- and ceiling effects were not reported. Conclusion The validity of the often used EORTC QLQ-CX24 questionnaire for cervical cancer patients remains uncertain as 5 out of 9 psychometric properties were doubtful or not reported in current literature. Cervical cancer specific HRQoL tools should therefore always be used in conjunction with validated generic cancer HRQoL tools until proper validity has been proven, or a more valid tool has been developed. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0289-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Casper Tax
- Department of Operating Rooms, Radboud University Medical Centre, Radboudumc Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | | | - Petra L M Zusterzeel
- Department of Gynaecology, Radboud University Medical Centre, Radboudumc Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Ruud L M Bekkers
- Department of Gynaecology, Radboud University Medical Centre, Radboudumc Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Maroeska M Rovers
- Department of Operating Rooms, Radboud University Medical Centre, Radboudumc Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Department of Health Evidence, Radboud University Medical Centre, Radboudumc Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Trutnovsky G, Nagele E, Ulrich D, Aigmüller T, Dörfler D, Geiss I, Reinstadler E, Angleitner-Flotzinger J, Ries JJ, Bjelic-Radisic V. German translation and validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA revised (PISQ-IR). Int Urogynecol J 2016; 27:1235-44. [PMID: 26883366 PMCID: PMC4947097 DOI: 10.1007/s00192-016-2969-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/28/2016] [Indexed: 11/02/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Condition-specific sexual questionnaires are essential for clinical trials and important patient-reported outcome measures. The aim of the study was to translate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into German and to clinically validate it in a German-speaking population. METHODS The translated PISQ-IR was linguistically validated in two rounds of cognitive interviews. The final instrument was psychometrically validated in women presenting to urogynecological clinics with pelvic floor dysfunction. For analysis of criterion validity, three related self-reported measures were administered: the Female Sexual Function Index (FSFI), the Kings Health Questionnaire (KHQ), and the 36-Item Short Form Health Survey (SF-36). For external validity, PISQ-IR subscales were compared to the clinical-measures Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale. Descriptive statistics, floor and ceiling effects, internal consistency using Cronbach's alpha coefficient, and Pearson correlations were calculated for all PISQ-IR subscales. RESULTS The PISQ-IR was completed by 197 women, out of whom 66 (33.5 %) considered themselves not sexually active (NSA) and 131 (66.5 %) as sexually active (SA). Participants' mean age was 57 ± 12 years; 50 % were diagnosed with symptomatic POP, 74 % with urinary incontinence (UI) and 4 % with anal incontinence (AI). The PISQ-IR subscales were analyzed separately for SA and NSA women with Cronbach's alpha coefficients ranging from 0.64 to 0.94. Moderate to high correlations were observed between PISQ-IR subscales and related quality of life (QoL) scales and corresponding FSFI scales. CONCLUSION Initial testing of the German PISQ-IR suggests it is an internally consistent and valid tool for use in clinical practice and research.
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Affiliation(s)
- Gerda Trutnovsky
- Department of Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Eva Nagele
- Department of Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Daniela Ulrich
- Department of Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.
| | - Thomas Aigmüller
- Department of Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
| | - Daniela Dörfler
- Department of Gynecology, Vienna General Hospital, Währinger Gürtel 18-20, 1090, Wien, Austria
| | - Ingrid Geiss
- Department of Gynecology, Hospital Lilienfeld, Im Tal 2, 3180, Lilienfeld, Austria
| | - Evi Reinstadler
- Department of Gynecology, Hospital Dornbirn, Lustenauerstraße 4, 6850, Dornbirn, Austria
| | | | - Jean-Jacques Ries
- Department of Gynecology, Hospital Aarau, Tellstrasse, 5001, Aarau, Switzerland
| | - Vesna Bjelic-Radisic
- Department of Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria
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Fregnani CMS, Fregnani JHTG, Dias de Oliveira Latorre MDR, de Almeida AM. Evaluation of the psychometric properties of the Functional Assessment of Cancer Therapy-Cervix questionnaire in Brazil. PLoS One 2013; 8:e77947. [PMID: 24147102 PMCID: PMC3797824 DOI: 10.1371/journal.pone.0077947] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/06/2013] [Indexed: 11/20/2022] Open
Abstract
Background Although cervical cancer is the second most common tumor among Brazilian women, studies that evaluate the quality of life of these women are still scarce. This situation is explained by the lack of specific and validated tools for this purpose in Portuguese (Brazil). The aim of this study was to evaluate the psychometric properties of the Portuguese version of the FACT-CX (Functional Assessment of Cancer Therapy-Cervix) questionnaire in a population of Brazilian women with cervical cancer. Methods The psychometric properties of the FACT-CX questionnaire were tested in a sample of 100 women diagnosed with cervical cancer who were previously treated in the Barretos Cancer Hospital. We analyzed the internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient - ICC), confirmatory factor analysis, convergent validity (correlation with the SF-36 questionnaire), and discriminant validity by disease stage and two questions related to self-perception of health was also performed. Results The scales had Cronbach´s alpha coefficients ranging from 0.61 to 0.80. However, three scales did not have a statistically significant coefficient greater than 0.70. The ICC ranged from 0.68 to 0.82 and all considered satisfactory. Factor analysis did not generate consistent components. The FACT-G and FACT-CX total scores had good internal consistency and reproducibility, and also correlated well with the General Health and Vitality scales of the SF-36. However, only two FACT-CX scales had a significant correlation with SF-36. Discriminant analysis showed that FACT-CX failed to discriminate groups according to clinical stage but was able to divide the women according to the self-perception of health. Conclusion FATC-CX total score had good internal consistency, reproducibility and discriminant validity. In addition, it correlated well with General Health and Vitality scales of SF-36. However, three scales had questionable internal consistency and only two had significant correlation with SF-36.
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Affiliation(s)
- Cristiane Menezes Sirna Fregnani
- Graduation Program in Public Health Nursing, College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
- Research and Teaching Institute, Barretos Cancer Hospital (IEP-HCB), Barretos, Brazil
- * E-mail:
| | | | | | - Ana Maria de Almeida
- Department of Maternal-Infant and Public Health Nursing, College of Nursing, University of São Paulo, Ribeirão Preto, Ribeirão Preto, Brazil
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Ding Y, Hu Y, Hallberg IR. Psychometric properties of the Chinese version of the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) measuring health-related quality of life. Health Qual Life Outcomes 2012; 10:124. [PMID: 23031680 PMCID: PMC3503601 DOI: 10.1186/1477-7525-10-124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 09/28/2012] [Indexed: 12/04/2022] Open
Abstract
Background The Functional Assessment of Cancer Therapy (FACT) is one of the most commonly used self-report instruments for evaluation of health-related quality of life in oncology patients. However, cultural considerations necessitate testing of the subscales in different populations. We sought to qualitatively and quantitatively investigate the applicability and psychometric properties of the Chinese version of the FACT-Cervix (FACT-Cx) in Chinese women with cervical cancer. Methods Ten personal interviews were conducted in order to explore patients’ opinions about the scale and its items in depth. In addition the questionnaire was administered to 400 women with cervical cancer to test its psychometric properties. Reliability was assessed using Cronbach’s alpha coefficient and item-subscale correlation while validity was evaluated using factor analysis and known-group validity. Results Some items related to sex and the ability to give birth were questioned in the personal interviews, mostly regarding their significance and acceptance in the Chinese cultural context. The Cronbach’s alphas of FACT-Cx and the subscales were greater than 0.7, except for the cervical-cancer-specific subscale which was 0.57. Factor analysis demonstrated that the FACT-G construct generally paralleled the original. There were significant differences in the FACT-Cx and some subscales between those receiving and not receiving treatment and among the patients with different performance status. Conclusions In general, psychometric properties of the Chinese version supported its use with cervical cancer patients in Mainland China. Further work is needed to improve the psychometric adequacy of the cervical-cancer-specific subscale and adjust it to cultural considerations.
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Affiliation(s)
- Yan Ding
- Nursing Department, Obstetrics and Gynecology Hospital of Fudan University, No, 419 Fang Xie Road, Shanghai, 200011, China.
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Buys TPH, Cantor SB, Guillaud M, Adler-Storthz K, Cox DD, Okolo C, Arulogon O, Oladepo O, Basen-Engquist K, Shinn E, Yamal JM, Beck JR, Scheurer ME, van Niekerk D, Malpica A, Matisic J, Staerkel G, Atkinson EN, Bidaut L, Lane P, Benedet JL, Miller D, Ehlen T, Price R, Adewole IF, MacAulay C, Follen M. Optical technologies and molecular imaging for cervical neoplasia: a program project update. ACTA ACUST UNITED AC 2011; 9:S7-24. [PMID: 21944317 DOI: 10.1016/j.genm.2011.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 08/02/2011] [Indexed: 12/23/2022]
Abstract
There is an urgent global need for effective and affordable approaches to cervical cancer screening and diagnosis. In developing nations, cervical malignancies remain the leading cause of cancer-related deaths in women. This reality may be difficult to accept given that these deaths are largely preventable; where cervical screening programs have been implemented, cervical cancer-related deaths have decreased dramatically. In developed countries, the challenges of cervical disease stem from high costs and overtreatment. The National Cancer Institute-funded Program Project is evaluating the applicability of optical technologies in cervical cancer. The mandate of the project is to create tools for disease detection and diagnosis that are inexpensive, require minimal expertise, are more accurate than existing modalities, and can be feasibly implemented in a variety of clinical settings. This article presents the status and long-term goals of the project.
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Affiliation(s)
- Timon P H Buys
- Imaging Unit, Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, British Columbia, Canada.
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Luckett T, King M, Butow P, Friedlander M, Paris T. Assessing health-related quality of life in gynecologic oncology: a systematic review of questionnaires and their ability to detect clinically important differences and change. Int J Gynecol Cancer 2010; 20:664-84. [PMID: 20442592 DOI: 10.1111/igc.0b013e3181dad379] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Researchers wishing to assess the health-related quality of life (HRQoL) of women with gynecologic cancers have a range of questionnaires to choose from. In general, disease-, treatment-, or symptom-specific questionnaires are assumed to be better able to identify between-group differences (sensitivity) and changes over time (responsiveness) than are cancer-specific or generic questionnaires. However, little work has tested this assumption in oncology. We set out to (a) identify all multidimensional HRQoL questionnaires used in studies with women with gynecologic cancer and (b) evaluate their track records in identifying minimal clinically important differences (MCIDs), with a view to making recommendations. METHODS We searched MEDLINE using the term quality of life and each gynecologic cancer type, as well as the names of identified questionnaires. We used 10% of the scale range as the threshold for an MCID. RESULTS We identified 1 generic (SF-36/SF-12), 3 cancer-specific (European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ] C30, Functional Assessment of Cancer Therapy-General [FACT-G], and short-form Cancer Rehabilitation Evaluation System [CARES-SF]), and 1 disease-specific (QOL-Ovarian Cancer Patient Version) HRQoL questionnaires and 5 disease-specific (QLQ-OV28, FACT-O for ovarian, QLQ-CX24, FACT-Cx for cervical and FACT-V for vulvar), 1 treatment-specific (FACT and Gynecologic Oncology Group-Ntx for neurotoxicity), and 2 symptom-specific (FACT-Anemia and Functional Assessment of Chronic Illness and Therapy [FACIT]-Fatigue) modules. Twenty-seven articles reported results from 26 studies in which an MCID had been identified. The FACIT's anemia and fatigue subscales were more sensitive, and the neurotoxicity subscale more sensitive and responsive than the FACT-G on at least 1 comparison. However, we found no evidence for superior performance by the FACT-G compared with the SF-36 or EORTC and FACIT disease-specific modules versus the QLQ-C30 and FACT-G. There was also little evidence to favor EORTC versus FACIT questionnaires or vice versa. CONCLUSIONS The evidence we reviewed offered little support for the hypothesis that disease-, symptom-, or treatment-specific instruments are more sensitive and responsive than cancer-specific or generic questionnaires. However, conclusions were limited by the small number of head-to-head comparisons available. We summarize the clinical contexts in which each instrument identified an MCID to inform choice of questionnaire(s), sample size calculations, and interpretation of results in future studies.
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Affiliation(s)
- Tim Luckett
- Psycho-oncology Co-operative Research Group, School of Psychology, University of Sydney, Sydney, New South Wales, Australia.
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Zeng YC, Ching SSY, Loke AY. Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors. Health Qual Life Outcomes 2010; 8:30. [PMID: 20302624 PMCID: PMC2852383 DOI: 10.1186/1477-7525-8-30] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Accepted: 03/19/2010] [Indexed: 12/01/2022] Open
Abstract
Background Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly paramount for healthcare professionals. The purposes of this review were to describe existing validated quality of life instruments used in cervical cancer survivors, and to reveal the implications of quality of life measurement for Chinese cervical cancer survivors. Methods A literature search of five electronic databases was conducted using the terms cervical/cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles published in either English or Chinese from January 2000 to June 2009 were searched. Only those adopting an established quality of life instrument for use in cervical cancer survivors were included. Results A total of 11 validated multidimensional quality of life instruments were identified from 41 articles. These instruments could be classified into four categories: generic, cancer-specific, cancer site-specific and cancer survivor-specific instruments. With internal consistency varying from 0.68-0.99, the test-retest reliability ranged from 0.60-0.95 based on the test of the Pearson coefficient. One or more types of validity supported the construct validity. Although all these instruments met the minimum requirements of reliability and validity, the original versions of these instruments were mainly in English. Conclusion Selection of an instrument should consider the purpose of investigation, take its psychometric properties into account, and consider the instrument's origin and comprehensiveness. As quality of life can be affected by culture, studies assessing the quality of life of cervical cancer survivors in China or other non-English speaking countries should choose or develop instruments relevant to their own cultural context. There is a need to develop a comprehensive quality of life instrument for Chinese cervical cancer survivors across the whole survivorship, including immediately after diagnosis and for short- (less than 5 years) and long-term (more than 5 years) survivorship.
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Affiliation(s)
- Ying Chun Zeng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, PR China.
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Bjelic-Radisic V, Dorfer M, Greimel E, Frudinger A, Tamussino K, Winter R. Quality of life and continence 1 year after the tension-free vaginal tape operation. Am J Obstet Gynecol 2006; 195:1784-8. [PMID: 17132481 DOI: 10.1016/j.ajog.2006.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Revised: 06/29/2006] [Accepted: 07/05/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate changes in condition-specific and generic quality of life (QOL) and continence rates 1 year after the tension-free vaginal tape (TVT) operation for stress urinary incontinence. STUDY DESIGN A total of 99 patients undergoing the TVT operation underwent clinical and urodynamic assessment and completed the German language King's Health Questionnaire (KHQ) and the Short Form 36 (SF-36) before and 3 and 12 months after surgery. Overall, 72 TVTs were performed as isolated procedure and 27 in combination with other operations. Data were analyzed with the Chi-square test, analyses of variance, and the Tukey test. RESULTS Overall, the objective continence rate was 80% at 1 year and did not differ significantly between patients with or without concomitant surgery. Significant and clinically relevant (>10 points) improvements were seen in all domains of the KHQ except General Health perception. The SF-36 showed statistically significant but not clinically significant improvement. CONCLUSION The TVT operation is associated with improved condition-specific QOL in women with stress urinary incontinence. The condition-specific KHQ is more appropriate than the generic SF-36 for evaluating treatment results in women treated for incontinence.
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Affiliation(s)
- Vesna Bjelic-Radisic
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
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Vistad I, Fosså SD, Dahl AA. A critical review of patient-rated quality of life studies of long-term survivors of cervical cancer. Gynecol Oncol 2006; 102:563-72. [PMID: 16716379 DOI: 10.1016/j.ygyno.2006.03.050] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 03/23/2006] [Accepted: 03/30/2006] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Increasing survival rates of cervical cancer (CC) patients and the trend towards more toxic multimodal therapy have led to focus on the quality of life (QOL) of cervical cancer survivors (CCSs). The aim of this critical review was to summarize and discuss the research findings of QOL in CCSs based on self-report measures in terms of physical, psychosocial, and sexual well-being. METHODS Electronic databases were used to identify studies published between 1966 and August 2005. A quality assessment using methodological and treatment-related criteria was performed to distinguish between studies with good and less good methodology. RESULTS Twenty-three studies were included, whereof eight had a good methodology. Eight studies used at least one questionnaire that had not been validated previously, and only one of the validated questionnaires had been tested in former studies of CCSs. The studies with good methodology focused primarily on sexual and social function after treatment, and less on physical and psychological well-being. The trend is that radiotherapy is more associated with reduced QOL dimensions than surgery or chemotherapy. In earlier stages of CC and following surgery alone, there seem to be minor differences between CCSs and control groups concerning various QOL domains. CONCLUSIONS Reviewed studies indicate that quality of life in cervical cancer survivors is reduced compared to the general female population following radiotherapy, but less so following surgery and earlier stages of cervical cancer. Shortcomings of both methodology and content of the studies reviewed preclude definite conclusions concerning QOL for the moment.
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Affiliation(s)
- Ingvild Vistad
- Department of Gynecology, Sorlandet Hospital HF, Kristiansand, Norway.
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Jones GL, Ledger W, Bonnett TJ, Radley S, Parkinson N, Kennedy SH. The impact of treatment for gynecological cancer on health-related quality of life (HRQoL): a systematic review. Am J Obstet Gynecol 2006; 194:26-42. [PMID: 16389007 DOI: 10.1016/j.ajog.2005.04.060] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2004] [Revised: 03/31/2005] [Accepted: 04/20/2005] [Indexed: 11/12/2022]
Abstract
Gynecologic cancers are major sources of mortality and morbidity. Although many review articles have reported on the impact of these diseases on health-related quality of life (HRQoL), none have reviewed the evidence in specific relation to the effect of treatment on HRQoL. Consequently, we systematically searched 4 electronic databases and hand-searched relevant reference lists and bibliographies to identify literature on this subject. Only 47 studies used a validated questionnaire to measure HRQoL. Although a meta-analysis was not possible, we found HRQoL rarely included as a treatment outcome, and when included assessment was often methodologically flawed. Seldom were pretreatment and posttreatment data collected or treatment regimes documented. Except for a few studies, analysis of HRQoL was conducted on small samples, excluding the cancer site and stage. Consequently, no definitive conclusions could be drawn and therefore we conclude with recommendations for the future reporting of HRQoL in gynecologic oncology studies.
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Affiliation(s)
- Georgina L Jones
- The Institute of General Practice and Primary Care, ScHARR, Sheffield, United Kingdom.
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Bjelic-Radisic V, Dorfer M, Tamussino K, Greimel E. Psychometric properties and validation of the German-language King's Health Questionnaire in women with stress urinary incontinence. Neurourol Urodyn 2005; 24:63-8. [PMID: 15578627 DOI: 10.1002/nau.20092] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
AIMS The purpose of this study was to evaluate the psychometric properties of and validate the German-language version of the King's Health Questionnaire (KHQ) in women with stress urinary incontinence (SUI). METHODS A total of 145 women treated for stress incontinence with surgery or physiotherapy completed the the KHQ and the SF-36 before and after treatment. Psychometric analyses of the quality of life (QoL) instruments determined the reliability (Cronbach's alpha), internal and external validity, and responsiveness of the KHQ subscales. RESULTS The KHQ showed good internal consistency, content validity, and criterion validity as measured by correlation with scores on the SF-36. Cronbach's alpha coefficient ranged from 0.76 to 0.86, indicating a high internal consistency of the subscales. Concerning criterion validity, correlations between the KHQ subscales and the SF-36 were low to moderate. The highest correlation was found between the general health perception subscales of both questionnaires. CONCLUSIONS The results indicate good psychometric properties for the German-language KHQ.
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Affiliation(s)
- Vesna Bjelic-Radisic
- Department of Obstetrics & Gynecology, Medical University of Graz, Graz, Austria.
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Gil KM, Frasure HE, Hopkins MP, Jenison EL, von Gruenigen VE. Effect of method of administration on longitudinal assessment of quality of life in gynecologic cancer: an exploratory study. Health Qual Life Outcomes 2005; 3:6. [PMID: 15655074 PMCID: PMC546223 DOI: 10.1186/1477-7525-3-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2004] [Accepted: 01/17/2005] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Longitudinal assessments of quality of life are needed to measure changes over the course of a disease and treatment. Computer versions of quality of life instruments have increased the feasibility of obtaining longitudinal measurements. However, there remain occasions when patients are not able to complete these questionnaires. This study examined whether changes measured using a computer version of the Functional Assessment of Cancer Therapy - General (FACT-G) on two occasions would be obtained if patients completed a paper version on one of the two occasions. METHODS Gynecologic oncology patients completed a computer version of the FACT-G pre-operatively and at six months. Patients were given the option of using the paper version instead of the computer at either time point. Repeated measures analysis of variance was used. RESULTS One hundred nineteen patients completed the FACT-G at both time points. Seventy-one (60%) patients used the computer at both visits, 26 (21.8%) used the computer followed by the paper version, 17 (14.3%) used the paper version followed by the computer version, and five patients (4.2%) used the paper version at both visits. Significant effects over time were obtained in the physical, functional, and emotional well-being domains, and in total scores, but there were no effects of method of administration of the questionnaires and no interaction between method of administration and changes over time. CONCLUSIONS These data indicate that women are responding to the content of the questionnaire and not method of data collection. Although using the same method of administration of instruments over time is desirable, using alternate methods is preferable to forgoing data collection entirely. Large scale studies should be conducted to determine if the multiple methods of data collection that are becoming increasingly available are producing interchangeable information.
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Affiliation(s)
- Karen M Gil
- Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, Ohio, USA
- Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, USA
| | - Heidi E Frasure
- Department of Obstetrics and Gynecology, University Hospitals of Cleveland, Cleveland, Ohio, USA
| | - Michael P Hopkins
- Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, USA
| | - Eric L Jenison
- Department of Obstetrics and Gynecology, Akron General Medical Center, Akron, Ohio, USA
- Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, USA
| | - Vivian E von Gruenigen
- Northeastern Ohio Universities College of Medicine, Rootstown, Ohio, USA
- Department of Obstetrics and Gynecology, University Hospitals of Cleveland, Cleveland, Ohio, USA
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