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Bujang MA, Lai WH, Ratnasingam S, Tiong XT, Hon YK, Yap EPP, Jee YYH, Ahmad NFD, Kim ARJ, Husin M. Health-SigQOLM is a versatile scale for measuring various aspects of health-related quality of life. BMC Res Notes 2024; 17:162. [PMID: 38872199 PMCID: PMC11170794 DOI: 10.1186/s13104-024-06823-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVE The "Health" element is one of the elements in Significant Quality of Life Measure (SigQOLM) that measures quality of life and well-being of people. This study aims to evaluate the Health element (Health-SigQOLM) as a generic and dynamic scale to measure health-related quality of life (HRQOL) with a broader spectrum of coverage. This study used a secondary data that developed SigQOLM. Only the "Health" element with 33 items is used for analysis. RESULTS The construct of Health-SigQOLM has a minimum factor loading of 0.425 with excellent model fit. The health status among healthcare workers is significantly associated with the Health-SigQOLM (p < 0.001). The Health-SigQOLM score can clearly distinguish between healthy people and those who have been afflicted with some diseases but have never been hospitalized due to disease progression or other associated complications (p = 0.002). The Health-SigQOLM is a generic and dynamic tool for assessing various aspects of health-related quality of life.
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Affiliation(s)
- Mohamad Adam Bujang
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.
- Institute for Clinical Research, Ministry of Health Malaysia, Shah Alam, Malaysia.
- Clinical Research Centre, Sarawak General Hospital, Jalan Hospital, Level 5, 93586, Kuching, Sarawak, Malaysia.
| | - Wei Hong Lai
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
- Institute for Clinical Research, Ministry of Health Malaysia, Shah Alam, Malaysia
- Clinical Research Centre, Sarawak General Hospital, Jalan Hospital, Level 5, 93586, Kuching, Sarawak, Malaysia
| | | | - Xun Ting Tiong
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
- Institute for Clinical Research, Ministry of Health Malaysia, Shah Alam, Malaysia
- Clinical Research Centre, Sarawak General Hospital, Jalan Hospital, Level 5, 93586, Kuching, Sarawak, Malaysia
| | - Yoon Khee Hon
- Institute for Clinical Research, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Eileen Pin Pin Yap
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
- Clinical Research Centre, Sarawak General Hospital, Jalan Hospital, Level 5, 93586, Kuching, Sarawak, Malaysia
| | | | | | - Alex Ren Jye Kim
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
| | - Masliyana Husin
- Institute for Clinical Research, Ministry of Health Malaysia, Shah Alam, Malaysia
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Kang KA, Lee MN. Cross-Cultural Validation of the McGill Quality of Life Questionnaire-Revised (MQOL-R), Korean Version; A Focus on People at the End of Life. JOURNAL OF HOSPICE AND PALLIATIVE CARE 2022; 25:110-120. [PMID: 37674909 PMCID: PMC10179989 DOI: 10.14475/jhpc.2022.25.3.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 09/08/2023]
Abstract
Purpose The purpose of this study was to confirm the factor structure of the McGill Quality of Life Questionnaire-Revised (MQOL-R) in the context of Korean culture and to verify its reliability and validity. Methods The participants comprised terminal cancer patients aged 25 or older, and data from 164 participants were analyzed. The study was conducted in the following order translation, expert review, reverse translation, preliminary investigation and interviews, and completion of the final version. Confirmatory factor analysis was applied to evaluate the validity of the instrument, and the Beck Depression Inventory, Korean version (K-BDI) was applied to confirm the criterion validity of the MQOL-R Korean version. The Cronbach's alpha coefficient, representing internal consistency, was measured to evaluate reliability. Results Cronbach's alpha for all 14 questions was 0.862. The model fit indices for confirmatory factor analysis were within the acceptance criteria. The factor loadings of all four factors were over 0.50, and convergent validity and discriminant validity were confirmed. Regarding criterion validity, a negative correlation was found between the four factors of MQOL-R Korean version and the K-BDI. Conclusion The MQOL-R Korean version, the reliability and validity of which were verified in this study, is a 15-item tool consisting of 14 items dealing with four physical, psychological, existential, and social factors and a single item evaluating the overall quality of life. The MQOL-R Korean version is an instrument that can more concisely and effectively measure the quality of life of patients with life-threatening diseases.
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Affiliation(s)
- Kyung-Ah Kang
- College of Nursing, Sahmyook University, Seoul, Korea
| | - Myung-Nam Lee
- College of Nursing, Department of Nursing, Kangwon National University, Samcheok, Korea
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Montagut-Martínez P, Pérez-Cruzado D, Gutiérrez-Sánchez D. Cancer-related fatigue measures in palliative care: A psychometric systematic review. Eur J Cancer Care (Engl) 2022; 31:e13642. [PMID: 35822246 DOI: 10.1111/ecc.13642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/26/2022] [Accepted: 06/06/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION In palliative care, the prevention and relief of fatigue are regarded as crucial goals in patients with cancer. METHODS A systematic review was carried out according to the COnsensus-based Standards for the selection of health status Measurement INstruments methodology. Searches were conducted in Medline (through PubMed), Web of Science, Open Gray, Scielo, Cochrane, CINAHL and EMBASE. All instruments found in each study were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS A total of 5598 articles were identified in the different databases. In total, 57 studies describing 19 instruments were included in this study. The main properties evaluated were internal consistency, cross-cultural validity, hypotheses testing and responsiveness. All studies were evaluated with the Strobe scale with a score greater than 6 points. CONCLUSIONS According to the quality methodological results, Edmonton Symptom Assessment System, Problems and Needs in Palliative Care Questionnaire, European Organisation for Research and Treatment of Cancer Quality of Life 15-item Questionnaire for Palliative Care and Palliative Care Quality of Life Instrument are the recommended instruments used for assessing cancer-related fatigue in palliative care. PROPESRO registration number: CRD42020206783.
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Affiliation(s)
| | - David Pérez-Cruzado
- Department of Occupational Therapy, Universidad Catolica de Murcia UCAM, Murcia, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Daniel Gutiérrez-Sánchez
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain.,Department of Nursing and Podiatry, University of Málaga, Málaga, Spain
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Viola RA, Wells GA, Peterson J. The Effects of Fluid Status and Fluid Therapy on the Dying: A Systematic Review. J Palliat Care 2019. [DOI: 10.1177/082585979701300407] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Raymond A. Viola
- University of Ottawa Institute of Palliative Care, Sisters of Charity of Ottawa Health Service, Ottawa, Ontario
| | - George A. Wells
- Clinical Epidemiology Unit, Ottawa Civic Hospital, Ottawa, Ontario, Canada
| | - Joan Peterson
- Clinical Epidemiology Unit, Ottawa Civic Hospital, Ottawa, Ontario, Canada
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Kim KU, Yoon SJ, Lee J, Ahn HS, Park HJ, Lee SI, Jo MW. Validation of the Korean Version of the McMaster Quality of Life Scale in Terminal Cancer Patients. J Palliat Care 2019. [DOI: 10.1177/082585970602200107] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to develop and validate a Korean version of McMaster Quality of Life Scale (K-MQLS) suitable for evaluating clinical hospice and palliative care. The McMaster Quality of Life Scale (MQLS) is a brief and comprehensive scale that is used to assess cancer patients receiving palliative care due to poor physical condition. To further develop the K-MQLS, we followed rigorous international translation steps and performed validity, reliability, and sensitivity analyses. The results of our study show that the K-MQLS is an efficient tool in terms of its validity, reliability, and sensitivity for the measurement of the health-related quality of life during the palliative phase. This developed tool could be used in research or clinical settings to assess health-related quality of life in Korean palliative care patients.
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Affiliation(s)
| | - Seok-Jun Yoon
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul
| | - Juneyoung Lee
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul
| | - Hyeong-Sik Ahn
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul
| | - Hye-Ja Park
- Department of Nursing, Medical College, Pochon CHA University, SeongNam City
| | - Sang-Il Lee
- Department of Preventive Medicine, University of Ulsan, College of Medicine, Seoul, South Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan, College of Medicine, Seoul, South Korea
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Aslakson RA, Dy SM, Wilson RF, Waldfogel J, Zhang A, Isenberg SR, Blair A, Sixon J, Lorenz KA, Robinson KA. Patient- and Caregiver-Reported Assessment Tools for Palliative Care: Summary of the 2017 Agency for Healthcare Research and Quality Technical Brief. J Pain Symptom Manage 2017; 54:961-972.e16. [PMID: 28818633 DOI: 10.1016/j.jpainsymman.2017.04.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/11/2017] [Accepted: 04/13/2017] [Indexed: 12/21/2022]
Abstract
CONTEXT Assessment tools are data collection instruments that are completed by or with patients or caregivers and which collect data at the individual patient or caregiver level. OBJECTIVES The objectives of this study are to 1) summarize palliative care assessment tools completed by or with patients or caregivers and 2) identify needs for future tool development and evaluation. METHODS We completed 1) a systematic review of systematic reviews; 2) a supplemental search of previous reviews and Web sites, and/or 3) a targeted search for primary articles when no tools existed in a domain. Paired investigators screened search results, assessed risk of bias, and abstracted data. We organized tools by domains from the National Consensus Project Clinical Practice Guidelines for Palliative Care and selected the most relevant, recent, and highest quality systematic review for each domain. RESULTS We included 10 systematic reviews and identified 152 tools (97 from systematic reviews and 55 from supplemental sources). Key gaps included no systematic review for pain and few tools assessing structural, cultural, spiritual, or ethical/legal domains, or patient-reported experience with end-of-life care. Psychometric information was available for many tools, but few studies evaluated responsiveness (sensitivity to change) and no studies compared tools. CONCLUSION Few to no tools address the spiritual, ethical, or cultural domains or patient-reported experience with end-of-life care. While some data exist on psychometric properties of tools, the responsiveness of different tools to change and/or comparisons between tools have not been evaluated. Future research should focus on developing or testing tools that address domains for which few tools exist, evaluating responsiveness, and comparing tools.
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Affiliation(s)
- Rebecca A Aslakson
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Department of Oncology, Palliative Care Program, Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA.
| | - Sydney M Dy
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Renee F Wilson
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Julie Waldfogel
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Allen Zhang
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Sarina R Isenberg
- Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alex Blair
- Department of Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Joshua Sixon
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Karl A Lorenz
- VA Palo Alto Health Care System, Palo Alto, California; Stanford School of Medicine, Department of Medicine, Palo Alto, California
| | - Karen A Robinson
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland, USA; Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Panza F, Solfrizzi V, Lozupone M, Barulli MR, D'Urso F, Stallone R, Dibello V, Noia A, Di Dio C, Daniele A, Bellomo A, Seripa D, Greco A, Logroscino G. An Old Challenge with New Promises: A Systematic Review on Comprehensive Geriatric Assessment in Long-Term Care Facilities. Rejuvenation Res 2017. [PMID: 28635539 DOI: 10.1089/rej.2017.1964] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by settings where the CGA is performed [i.e., hospital, posthospital discharge/long-term care facilities (LTCFs), or community/home] as well as the specific clinical conditions of older frail individuals. In this scenario, CGA and quality of care in LTCFs have been a challenge for decades. In the present article, we systematically reviewed evidence from the last three decades of clinical research devoted to systematic implementation of CGA programs in LTCFs, that is, nursing homes, care homes, residential homes, and rehabilitation facilities. In the United States, all LTC residents must undergo a CGA on a regular basis on admission to a facility, prompting the development of the Resident Assessment Instrument (RAI) Minimum Data Set, a specific CGA-based assessment tool in this population. In the LTCF setting, the present reviewed evidence suggested that most complex older subjects may benefit from a CGA in terms of improved quality of care and reduced hospitalization events and that CGA must be standardized across healthcare settings to promote greater health system integration and coordination. In the LTCF setting, particularly in nursing homes, other new and promising CGA programs have also been proposed to develop rapid screening CGA-based tools to enhance in the future the ability of primary care physicians to recognize and treat geriatric syndromes in this setting. However, at present, the interRAI suite of instruments represented an integrated health information system that has the potential to provide person-centered information transcending healthcare settings.
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Affiliation(s)
- Francesco Panza
- 1 Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari, Italy .,2 Unit of Neurodegenerative Disease, Department of Clinical Research in Neurology, University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico," Tricase, Lecce, Italy .,3 Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza , San Giovanni Rotondo, Foggia, Italy
| | - Vincenzo Solfrizzi
- 4 Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro , Bari, Italy
| | - Madia Lozupone
- 1 Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari, Italy
| | - Maria Rosaria Barulli
- 2 Unit of Neurodegenerative Disease, Department of Clinical Research in Neurology, University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico," Tricase, Lecce, Italy
| | - Francesca D'Urso
- 5 Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia , Foggia, Italy
| | - Roberta Stallone
- 1 Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari, Italy
| | - Vittorio Dibello
- 6 Interdisciplinary Department of Medicine (DIM), Section of Dentistry, University of Bari Aldo Moro , Bari, Italy
| | - Alessia Noia
- 4 Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro , Bari, Italy
| | - Cristina Di Dio
- 2 Unit of Neurodegenerative Disease, Department of Clinical Research in Neurology, University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico," Tricase, Lecce, Italy
| | - Antonio Daniele
- 7 Institute of Neurology, Catholic University of Sacred Heart , Rome, Italy
| | - Antonello Bellomo
- 5 Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia , Foggia, Italy
| | - Davide Seripa
- 3 Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza , San Giovanni Rotondo, Foggia, Italy
| | - Antonio Greco
- 3 Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza , San Giovanni Rotondo, Foggia, Italy
| | - Giancarlo Logroscino
- 1 Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro , Bari, Italy .,2 Unit of Neurodegenerative Disease, Department of Clinical Research in Neurology, University of Bari "Aldo Moro" at "Pia Fondazione Card. G. Panico," Tricase, Lecce, Italy
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Further Reading. J Telemed Telecare 2016. [DOI: 10.1258/135763307782213598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Díaz-Prieto C, García-Sánchez JN. Psychological profiles of older adult Web 2.0 tool users. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Understanding domains of health-related quality of life concerns of Singapore Chinese patients with advanced cancer: a qualitative analysis. Support Care Cancer 2015; 24:1107-18. [PMID: 26266660 DOI: 10.1007/s00520-015-2886-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/02/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Quality of life concerns in patients with advanced diseases might be different from other patients and are shaped by sociocultural context. The objective of this qualitative study was to identify domains and themes of health-related quality of life (HRQoL) that Chinese patients with advanced cancer in Singapore considered relevant and important. METHODS English- and Chinese-speaking patients with advanced solid cancer were recruited from a tertiary cancer center and a community-based hospice for in-depth interview or focused group discussion. Thematic analysis was used to identify subthemes, themes, and domains from the transcripts. RESULTS Forty-six ethnic Chinese (aged 26-86, 48% male) participated in the study. Six domains of HRQoL concerns were identified: pain and suffering, physical health, social health, mental health, financial well-being, and spiritual health. Pain and suffering are not limited to the physical domain, reflecting the multidimensional nature of this concept. Pain and suffering must also be understood within the cultural context. Healthcare relations (i.e., social health), existential well-being and religious well-being (i.e., spiritual health), and suffering (i.e., pain and suffering) are not fully captured in the existing HRQoL instruments. In addition, financial issues and the practice of secrecy in interpersonal relationships emerged as unique features possibly arising from our sociocultural context and healthcare financing landscape. CONCLUSION Socioculturally specific issues not measured by the existing HRQoL instruments for use in patients with advanced cancers or terminal diseases were found in our study. These are non-physical pain and suffering, meaning of illness, meaning of death, financial issues, and practice of secrecy in interpersonal relationships.
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Hermans K, De Almeida Mello J, Spruytte N, Cohen J, Van Audenhove C, Declercq A. A Comparative Analysis of Comprehensive Geriatric Assessments for Nursing Home Residents Receiving Palliative Care: A Systematic Review. J Am Med Dir Assoc 2014; 15:467-476. [DOI: 10.1016/j.jamda.2014.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/05/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022]
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Paiva CE, Barroso EM, Carneseca EC, de Pádua Souza C, dos Santos FT, Mendoza López RV, Ribeiro Paiva SB. A critical analysis of test-retest reliability in instrument validation studies of cancer patients under palliative care: a systematic review. BMC Med Res Methodol 2014; 14:8. [PMID: 24447633 PMCID: PMC3899385 DOI: 10.1186/1471-2288-14-8] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 01/13/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Patient-reported outcome validation needs to achieve validity and reliability standards. Among reliability analysis parameters, test-retest reliability is an important psychometric property. Retested patients must be in a clinically stable condition. This is particularly problematic in palliative care (PC) settings because advanced cancer patients are prone to a faster rate of clinical deterioration. The aim of this study was to evaluate the methods by which multi-symptom and health-related qualities of life (HRQoL) based on patient-reported outcomes (PROs) have been validated in oncological PC settings with regards to test-retest reliability. METHODS A systematic search of PubMed (1966 to June 2013), EMBASE (1980 to June 2013), PsychInfo (1806 to June 2013), CINAHL (1980 to June 2013), and SCIELO (1998 to June 2013), and specific PRO databases was performed. Studies were included if they described a set of validation studies. Studies were included if they described a set of validation studies for an instrument developed to measure multi-symptom or multidimensional HRQoL in advanced cancer patients under PC. The COSMIN checklist was used to rate the methodological quality of the study designs. RESULTS We identified 89 validation studies from 746 potentially relevant articles. From those 89 articles, 31 measured test-retest reliability and were included in this review. Upon critical analysis of the overall quality of the criteria used to determine the test-retest reliability, 6 (19.4%), 17 (54.8%), and 8 (25.8%) of these articles were rated as good, fair, or poor, respectively, and no article was classified as excellent. Multi-symptom instruments were retested over a shortened interval when compared to the HRQoL instruments (median values 24 hours and 168 hours, respectively; p = 0.001). Validation studies that included objective confirmation of clinical stability in their design yielded better results for the test-retest analysis with regard to both pain and global HRQoL scores (p < 0.05). The quality of the statistical analysis and its description were of great concern. CONCLUSION Test-retest reliability has been infrequently and poorly evaluated. The confirmation of clinical stability was an important factor in our analysis, and we suggest that special attention be focused on clinical stability when designing a PRO validation study that includes advanced cancer patients under PC.
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Affiliation(s)
- Carlos Eduardo Paiva
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, São Paulo CEP 14784-400, Brazil
- Palliative Care and Quality of Life Research Group, Post-Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Eliane Marçon Barroso
- Palliative Care and Quality of Life Research Group, Post-Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Estela Cristina Carneseca
- Palliative Care and Quality of Life Research Group, Post-Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Cristiano de Pádua Souza
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, São Paulo CEP 14784-400, Brazil
| | - Felipe Thomé dos Santos
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, São Paulo CEP 14784-400, Brazil
| | | | - Sakamoto Bianca Ribeiro Paiva
- Palliative Care and Quality of Life Research Group, Post-Graduate Program, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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Sizoo EM, Dirven L, Reijneveld JC, Postma TJ, Heimans JJ, Deliens L, Pasman HRW, Taphoorn MJB. Measuring health-related quality of life in high-grade glioma patients at the end of life using a proxy-reported retrospective questionnaire. J Neurooncol 2013; 116:283-90. [DOI: 10.1007/s11060-013-1289-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/21/2013] [Indexed: 11/12/2022]
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Hladschik-Kermer B, Kierner KA, Heck U, Miksovsky A, Reiter B, Zoidl H, Medicus E, Masel EK, Watzke HH. Patients and staff perceptions of cancer patients' quality of life. Eur J Oncol Nurs 2013; 17:70-4. [DOI: 10.1016/j.ejon.2012.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Revised: 12/29/2011] [Accepted: 01/24/2012] [Indexed: 11/29/2022]
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Abstract
Nausea and vomiting are distressing and debilitating symptoms frequently reported in advanced disease. They are also complex and multifactorial in nature, which can make palliation difficult. The primary method of treatment is pharmacological, with current recommendations based on the presumed cause, knowledge of the emetogenic pathways, and matching of the emetogenic stimulus with the drug most likely to act on the relevant receptors. This is often complicated by the difficulty in identifying the cause(s) and the fact that many antiemetics work on multiple receptors. This article offers an overview of the physiology of the emetogenic pathways, the pathophysiology of common aetiologies, the clinical assessment required and tools available, and the pharmacological and non-pharmacological management of these symptoms.
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Miyazaki K, Suzukamo Y, Shimozuma K, Nakayama T. Verification of the psychometric properties of the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 palliative (EORTCQLQ-C15-PAL). Qual Life Res 2011; 21:335-40. [DOI: 10.1007/s11136-011-9939-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2011] [Indexed: 11/12/2022]
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Richards CT, Gisondi MA, Chang CH, Courtney DM, Engel KG, Emanuel L, Quest T. Palliative care symptom assessment for patients with cancer in the emergency department: validation of the Screen for Palliative and End-of-life care needs in the Emergency Department instrument. J Palliat Med 2011; 14:757-64. [PMID: 21548790 DOI: 10.1089/jpm.2010.0456] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE We sought to develop and validate a novel palliative medicine needs assessment tool for patients with cancer in the emergency department. METHODS An expert panel trained in palliative medicine and emergency medicine reviewed and adapted a general palliative medicine symptom assessment tool, the Needs at the End-of-Life Screening Tool. From this adaptation a new 13-question instrument was derived, collectively referred to as the Screen for Palliative and End-of-life care needs in the Emergency Department (SPEED). A database of 86 validated symptom assessment tools available from the palliative medicine literature, totaling 3011 questions, were then reviewed to identify validated test items most similar to the 13 items of SPEED; a total of 107 related questions from the database were identified. Minor adaptations of questions were made for standardization to a uniform 10-point Likert scale. The 107 items, along with the 13 SPEED items were randomly ordered to create a single survey of 120 items. The 120-item survey was administered by trained staff to all patients with cancer who met inclusion criteria (age over 21 years, English-speaking, capacity to provide informed consent) who presented to a large urban academic emergency department between 8:00 am and 11:00 pm over a 10-week period. Data were analyzed to determine the degree of correlation between SPEED items and the related 107 selected items from previously validated tools. RESULTS A total of 53 subjects were enrolled, of which 49 (92%) completed the survey in its entirety. Fifty-three percent of subjects were male, age range was 24-88 years, and the most common cancer diagnoses were breast, colon, and lung. Cronbach coefficient α for the SPEED items ranged from 0.716 to 0.991, indicating their high scale reliability. Correlations between the SPEED scales and related assessment tools previously validated in other settings were high and statistically significant. CONCLUSION The SPEED instrument demonstrates reliability and validity for screening for palliative care needs of patients with cancer presenting to the emergency department.
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Selman L, Harding R, Gysels M, Speck P, Higginson IJ. The measurement of spirituality in palliative care and the content of tools validated cross-culturally: a systematic review. J Pain Symptom Manage 2011; 41:728-53. [PMID: 21306866 DOI: 10.1016/j.jpainsymman.2010.06.023] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 06/23/2010] [Accepted: 07/08/2010] [Indexed: 11/19/2022]
Abstract
CONTEXT Despite the need to assess spiritual outcomes in palliative care, little is known about the properties of the tools currently used to do so. In addition, measures of spirituality have been criticized in the literature for cultural bias, and it is unclear which tools have been validated cross-culturally. OBJECTIVES This systematic review aimed to identify and categorize spiritual outcome measures validated in advanced cancer, human immunodeficiency virus (HIV), or palliative care populations; to assess the tools' cross-cultural applicability; and for those measures validated cross-culturally, to determine and categorize the concepts used to measure spirituality. METHODS Eight databases were searched to identify relevant validation and research studies. An extensive search strategy included search terms in three categories: palliative care, spirituality, and outcome measurement. Tools were evaluated according to two criteria: 1) validation in advanced cancer, HIV, or palliative care and 2) validation in an ethnically diverse context. Tools that met Criterion 1 were categorized by type; tools that also met Criterion 2 were subjected to content analysis to identify and categorize the spiritual concepts they use. RESULTS One hundred ninety-one articles were identified, yielding 85 tools. Fifty different tools had been reported in research studies; however, 30 of these had not been validated in palliative care populations. Thirty-eight tools met Criterion 1: general multidimensional measures (n=21), functional measures (n=11), and substantive measures (n=6). Nine measures met Criterion 2; these used spiritual concepts relating to six themes: Beliefs, practices, and experiences; Relationships; Spiritual resources; Outlook on life/self; Outlook on death/dying; and Indicators of spiritual well-being. A conceptual model of spirituality is presented on the basis of the content analysis. Recommendations include consideration of both the clinical and cultural population in which spiritual instruments have been validated when selecting an appropriate measure for research purposes. Areas in need of further research are identified. CONCLUSION The nine tools identified in this review are those that have currently been validated in cross-cultural palliative care populations and, subject to appraisal of their psychometric properties, may be suitable for cross-cultural research.
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Affiliation(s)
- Lucy Selman
- Department of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom.
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Cummings G, Biondo PD, Campbell D, Stiles C, Fainsinger R, Muise M, Hagen N. Can the global uptake of palliative care innovations be improved? Insights from a bibliometric analysis of the Edmonton Symptom Assessment System. Palliat Med 2011; 25:71-82. [PMID: 20847088 DOI: 10.1177/0269216310381449] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Clinical research is undertaken to improve care for palliative patients, but little is known about how to support the broad uptake of resultant innovations. The objectives of this paper are to: (1) explore the uptake of the Edmonton Symptom Assessment System throughout the global palliative care community through the lens of a bibliometric review - a research method that maps out the journey of new knowledge uptake by evaluating where key articles are cited in published literature; (2) construct hypotheses on attributes of the global community of palliative care learners; and (3) make inferences on approaches that could improve knowledge transfer. While preliminary, results of the study suggest several specific approaches that could support widespread uptake of innovations in palliative care: targeting publication in high impact, international journals; explicitly focusing on how the innovation is applied to best practice; encouraging additional research to expand on early studies; consciously targeting key professional groups and organizations to promote discussion in the grey literature; and early translation and promotion within multiple languages.
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Henoch I, Axelsson B, Bergman B. The Assessment of Quality of life at the End of Life (AQEL) questionnaire: a brief but comprehensive instrument for use in patients with cancer in palliative care. Qual Life Res 2010; 19:739-50. [DOI: 10.1007/s11136-010-9623-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2010] [Indexed: 11/28/2022]
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Albers G, Echteld MA, de Vet HCW, Onwuteaka-Philipsen BD, van der Linden MHM, Deliens L. Evaluation of quality-of-life measures for use in palliative care: a systematic review. Palliat Med 2010; 24:17-37. [PMID: 19843620 DOI: 10.1177/0269216309346593] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE In this literature review we evaluated the feasibility and clinimetric quality of quality-of-life (QoL) measurement instruments suitable for use in palliative care. METHODS We conducted a systematic literature review to identify instruments measuring (at least one domain of) QoL. We selected articles that present data on patients receiving palliative care and at least one measurement property. A checklist was used to describe the characteristics of the instruments, and a widely accepted rating list was used to evaluate the clinimetric aspects. RESULTS 29 instruments were identified and evaluated, most of which were targeted at palliative patients in general. None of the instruments demonstrated satisfactory results for all measurement properties. Fourteen instruments received positive ratings for construct validity. Thirteen instruments were tested for reliability, but only two were tested adequately and had positive results (ICC>0.70). Responsiveness was not tested adequately for any of the instruments. Very few of the studies provided information on the interpretation of the scores. Overall, the MQOL, followed by the QUAL-E and the QODD, received the best ratings for their measurement properties. CONCLUSIONS Many measurement instruments were identified, but most had not yet been adequately evaluated. The evaluation of existing instruments with good content validity should have priority over the development of new instruments.
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Affiliation(s)
- Gwenda Albers
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
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Petersen MA, Pedersen L, Groenvold M. Does Nonparticipation in Studies of Advanced Cancer Lead to Biased Quality-of-Life Scores? J Palliat Med 2009; 12:1023-8. [PMID: 19715452 DOI: 10.1089/jpm.2009.0108] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Morten A. Petersen
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Lise Pedersen
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Mogens Groenvold
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
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Abstract
AbstractPalliative care aims at improving the patient’s quality of life. The assessment of this quality of life (QoL) is crucial for the evaluation of palliative care outcome. Many patients require hospital admissions for symptom control during their cancer journey and most of them die in hospitals, although they would like to stay at home until the end of their lives. In 1986, the European Organization for Research and Treatment (EORTC) initiated a research programme to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. This questionnaire measures cancer patients’ physical, psychological and social functions and was used in a wide range of clinical cancer trials with large numbers of research groups and also in various other non-trial studies. The aim of this study was to evaluate the psychometric properties, especially the reliability, validity and applicability of the EORTC QLQ-C30 in a German sample of terminally ill cancer patients receiving palliative care in different settings. The questionnaire was well accepted in the present patient population. Scale reliability was good (pre-treatment 0.80) especially for the functional scale. The results support the reliability and validity of the QLQ-C30 (version 3.0) as a measure of the health-related quality of life in German cancer patients receiving palliative care treatment.
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Long-Term Quality of Life After Hepatic Resection: Health Is not Simply the Absence of Disease. World J Surg 2009; 33:1473-80. [DOI: 10.1007/s00268-009-0032-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Jocham HR, Dassen T, Widdershoven G, Middel B, Halfens R. The Effect of Palliative Care in Home Care and Hospital on Quality of Life. J Hosp Palliat Nurs 2009. [DOI: 10.1097/njh.0b013e31819985d9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Kim SH, Choi YS, Lee J, Oh SC, Yeom CH, Lee MA, Kim DG, Moon DH, Kim DY, Koh SJ. Reliability and validity of the Hospice Quality of Life Scale for Korean cancer patients. J Pain Symptom Manage 2009; 37:156-67. [PMID: 18687571 DOI: 10.1016/j.jpainsymman.2008.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2007] [Revised: 02/15/2008] [Accepted: 02/18/2008] [Indexed: 11/26/2022]
Abstract
The Hospice Quality of Life Scale (HQLS) for Korean cancer patients was developed as follows: 1) item generation by semi-structured interviews and review of existing scales, 2) item reduction by the Delphi method, and 3) reliability and validity test. The final HQLS consisted of 40 questions within 13 domains and the internal consistency was 0.41-0.93. The domain "Family and Economy" was uniquely separated from the general social issues, which reflects the family-oriented Asian culture. For construct validity, the HQLS scores differed significantly according to their Eastern Cooperative Oncology Group Performance Status (known-group validity). Convergent and discriminant success rates were optimal in nine and four subscales, respectively. Total and subscale scores were significantly correlated with the related subscales in the European Organization for Research and Treatment of Cancer QLQ-C30 and the McMaster Quality of Life Scale, which supported the concurrent validity. HQLS was approved as an efficient tool for assessing the quality of life of Korean cancer patients who were receiving hospice and palliative care.
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Affiliation(s)
- Su Hyun Kim
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea
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JY Fergus C, S Nicol J, B Russell P. Is a STAS-based tool valid to triage patients at a specialist palliative care inpatient unit? Int J Palliat Nurs 2008. [DOI: 10.12968/ijpn.2008.14.1.28151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Jordhoy MS, Inger Ringdal G, Helbostad JL, Oldervoll L, Loge JH, Kaasa S. Assessing physical functioning: a systematic review of quality of life measures developed for use in palliative care. Palliat Med 2007; 21:673-82. [PMID: 18073253 DOI: 10.1177/0269216307083386] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Physical decline is experienced by all palliative care patients and affects most aspects of life. Physical functioning (PF) is therefore a crucial domain for quality of life (Qol) assessments. The purpose of this study was to review how PF assessments are performed in Qol instruments developed for palliative care METHODS For identification of instruments, Medline searches up to April 2005 were performed using the terms (palliative care OR end of life care OR terminal care) AND quality of life AND (assessment OR instrument OR questionnaire). A total of 1326 hits were screened. Named QoL instruments were extracted from 240 abstracts and 46 relevant reports. Items assessing PF were then identified and classified according to activity domains as described by the WHO International Classification of Functioning Disability and Health. RESULTS Of 224 different instruments detected, 39 were identified as developed for palliative care. Of these, 11 included original PF assessments. Two were comprehensive performance status measures made for staff assessment, 9 were multidimensional tools including 2-7 PF items. The content and phrasing of items varied considerably. All instruments included some aspects of self-care, whereas the coverage of mobility, domestic, work--and leisure activities was inconsistent. INTERPRETATION Despite its importance, PF assessment seems to be a minor part of palliative care QoL instruments. Clear definitions and conceptualization of PF are needed, as well as a consensus on relevant aspects to include in improved instruments. Performance scales already developed should be further explored with regard to content, validity and psychometric properties.
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Affiliation(s)
- Marit S Jordhoy
- Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Tu MS, Chiou CP. Perceptual consistency of pain and quality of life between hospice cancer patients and family caregivers: a pilot study. Int J Clin Pract 2007; 61:1686-91. [PMID: 17537189 DOI: 10.1111/j.1742-1241.2007.01347.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS Clinicians usually adjust medical management based on caregivers' observation when caring for seriously ill or cognitive-impaired patients. The purpose of this study is to research the differences in perceptual congruence of patients and caregivers when assessing patients' global pain (GP) and quality of life (QOL) in a hospice ward. METHODS From July 2002 to June 2004, hospice inpatients and their family caregivers were invited to participate in this study at a medical centre in Southern Taiwan. The survey was cross-sectional, incorporating patients' bio-psycho-social factors so as to understand their impacts on patients' pain perception and QOL. The bio-psycho-social factors included biological pain, physical dependence, financial difficulty, anxiety over family, existential meaning of life, uncontrolled outcome of disease and insufficient emotional support. RESULTS Fifty-eight patient/caregiver dyads were recruited in the study. The mean of patients' self-reported GP was higher than caregivers' rating (5.9 +/- 1.7 vs. 5.1 +/- 1.9, p < 0.05); however, the score of patients' QOL was lower in the patients than in the caregivers (6.9 +/- 1.6 vs. 7.9 +/- 1.4, p < 0.001). The result of regression analyses showed that 'biological pain', 'religion' and 'gender' were independent variables for patients' GP; however, 'biological pain' and 'gender' were factors for patients' QOL. No psychosocial factor was revealed as a factor in patient's perception of GP or QOL in this survey. CONCLUSION This study indicates that caregivers have the propensity to under-rate patients' pain and overvalue QOL; moreover, 'religion' and 'gender' influence patients' perception near the end-of-life. Therefore, reassessment and proper holistic approach are important in hospice care.
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Affiliation(s)
- M-S Tu
- Division of Palliative Care, Department of Family Medicine, Kaohsiung Veterans General Hospital, and School of Nursing, I-shou University, Kaohsiung, Taiwan.
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Mularski RA, Dy SM, Shugarman LR, Wilkinson AM, Lynn J, Shekelle PG, Morton SC, Sun VC, Hughes RG, Hilton LK, Maglione M, Rhodes SL, Rolon C, Lorenz KA. A systematic review of measures of end-of-life care and its outcomes. Health Serv Res 2007; 42:1848-70. [PMID: 17850523 PMCID: PMC2254566 DOI: 10.1111/j.1475-6773.2007.00721.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To identify psychometrically sound measures of outcomes in end-of-life care and to characterize their use in intervention studies. DATA SOURCES English language articles from 1990 to November 2005 describing measures with published psychometric data and intervention studies of end-of-life care. STUDY DESIGN Systematic review of end-of-life care literature. EXTRACTION METHODS Two reviewers organized identified measures into 10 major domains. Eight reviewers extracted and characterized measures from intervention studies. PRINCIPAL FINDINGS Of 24,423 citations, we extracted 200 articles that described 261 measures, accepting 99 measures. In addition to 35 measures recommended in a prior systematic review, we identified an additional 64 measures of the end-of-life experience. The most robust measures were in the areas of symptoms, quality of life, and satisfaction; significant gaps existed in continuity of care, advance care planning, spirituality, and caregiver well-being. We also reviewed 84 intervention studies in which 135 patient-centered outcomes were assessed by 97 separate measures. Of these, 80 were used only once and only eight measures were used in more than two studies. CONCLUSIONS In general, most measures have not undergone rigorous development and testing. Measure development in end-of-life care should focus on areas with identified gaps, and testing should be done to facilitate comparability across the care settings, populations, and clinical conditions. Intervention research should use robust measures that adhere to these standards.
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Affiliation(s)
- Richard A Mularski
- Center for Health Research, Kaiser Permanente Northwest, Oregon Health & Science University, 3800 N. Interstate, WIN 1060, Portland, OR 97227, USA
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Abstract
The objective of this paper is to identify an outcome measure for occupational therapy interventions with palliative clients, in particular Home Assessments. Several possibilities beyond traditional functional measures are considered, and the notion of quality of life (QoL) as a potential measure and routine part of assessment is discussed.A systematic literature search resulted in 45 QoL tools that might be suitable for palliative care. The validation or development papers for these tools were closely examined. Twenty-four instruments met the inclusion criteria for further consideration for use by occupational therapists. The research found that it may be feasible for occupational therapists to use a QoL tool as a routine part of assessing each palliative patient, with the objective of focusing interventions to priority areas identified by the patient. Further work in this area will identify a range of established and validated methods of assessing QoL, suitable for different stages within the palliative phase of illness for purposes including assessment, support and targeted interventions.
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Affiliation(s)
- Elizabeth J M Pearson
- Occupational Therapy Department, Peter MacCallum Cancer Centre, Victoria, Australia.
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Abstract
There are many assessment tools available to measure emesis. This Association for Palliative Medicine Science Committee Task Group undertook a review of the validity and suitability of the assessment tools available to measure nausea, vomiting and retching within a palliative care population. Electronic databases were searched from 1970 to 2004. Both specific and global tools were identified and reviewed for their validity, reliability and suitability for our patient population where coexisting cognitive impairment and significant co-morbidities may make accurate assessment of symptoms difficult. Within specific palliative care scenarios namely daily clinical assessment, prevalence surveys and randomized controlled trial settings, the team reached a consensus on which tools had the greatest evidence to recommend them, either for immediate use or for further validation studies. An ideal measurement tool for the assessment of nausea, vomiting and retching has not yet been developed.
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Affiliation(s)
- Carina Saxby
- Palliative Medicine, Yorkshire Deanery, Leeds, UK
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Aa Petersen M, Pedersen L, Groenvold M. Does the agreement of patient and physician assessments of health related quality of life in palliative care depend on patient characteristics? Palliat Med 2007; 21:289-94. [PMID: 17656405 DOI: 10.1177/0269216307077694] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Using physician assessments of patients' health related quality of life may improve the feasibility of studies in palliative care. However, poor agreement between patients and physicians has been found. We investigated whether subgroups of patients with good agreement existed. STUDY DESIGN AND SETTING Patient and physician assessments of twelve European Organisation for Research and Treatment of Cancer Quality of Life Care Questionnaire 30 domains were obtained once a week for up to 13 weeks. The association between agreement and patient characteristics at the first assessment (n = 115) was investigated using multivariate logistic regression. Significant associations were verified using the follow-up time-points combined (total n = 263). RESULTS Significant associations between patient characteristics and agreement were found for most domains. However, few subgroups had good agreement. The evaluations on follow-up data did not confirm the findings of subgroups with good agreement. CONCLUSION Based on our findings physician assessments cannot be recommended as a substitute for patient self-assessment for any subgroups of palliative care patients.
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Affiliation(s)
- Morten Aa Petersen
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen NV, Denmark.
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Elliott TE, Reiner CM, Palcher JA. The Prognostic Value of Measuring Health-Related Quality of Life in Hospice Patients. J Palliat Med 2007; 10:696-704. [PMID: 17592981 DOI: 10.1089/jpm.2006.0227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Better prognostic instruments are sorely needed for patients near the end of life. Health-related quality of life instruments designed for hospice patients have not been previously studied for their prognostic properties. This study evaluated the prognostic property of the Missoula-Vitas Quality of Life Index (MVQOLI) with hospice patients. METHODS A prospective, cross-sectional cohort design included all consecutive patients admitted to a hospice over a 19-month period. At admission to hospice, patients were asked to complete an MVQOLI. In addition, hospice nurses completed three functional status instruments. All patients were followed until death, study closure, or loss to follow-up. RESULTS The sample included 1047 patients, but only 231 (22%) were able to complete an MVQOLI at admission. Functional status data were collected on nearly all of the patients. The Karnofsky performance score, modified activity of daily living score, and descriptive symptom score were significantly associated with survival time. Using Cox regression models these functional status assessments were strongly associated with survival time (p<0.001). However, the MVQOLI scores were not significantly associated with survival time, except for the function subscale (p=0.045). CONCLUSION The MVQOLI global, total, and four of the five weighted-domain baseline scores were not associated with survival time in hospice patients. Other methods for prognostication at the end of life are needed.
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Affiliation(s)
- Thomas E Elliott
- Division of Education and Research, Duluth Clinic, University of Minnesota Medical School Duluth, Duluth, Minnesota 55805, USA.
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Petersen MA, Larsen H, Pedersen L, Sonne N, Groenvold M. Assessing health-related quality of life in palliative care: comparing patient and physician assessments. Eur J Cancer 2006; 42:1159-66. [PMID: 16624553 DOI: 10.1016/j.ejca.2006.01.032] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2005] [Revised: 01/04/2006] [Accepted: 01/06/2006] [Indexed: 01/22/2023]
Abstract
It is often difficult to recruit patients for palliative care studies and severe attrition must be expected resulting in biased findings. This may be avoided if equivalent information could be obtained from sources other than the patients. Therefore, we investigated whether physician assessments can be used to evaluate the patients' health-related quality of life (HRQOL). Patient and physician assessments of the patients' HRQOL were obtained once a week for up to 13 weeks using EORTC QLQ-C30 items. The agreement between patients and physicians at first contact (N=115) and for the following 13 weeks combined (total N=263) was investigated. Significant differences between patient and physician assessments were observed for all HRQOL domains assessed. Physicians reported patients to have fewer problems/symptoms than patients did for all HRQOL domains except for physical and social functioning. The agreement between patients and physicians was poor. Using physician assessments may bias findings and cannot be recommended as a substitute for patient self-assessment in palliative care.
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Affiliation(s)
- Morten Aa Petersen
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Bispebjerg bakke 23, Opgang 20d, DK-2400 Copenhagen NV, Denmark.
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Abstract
This paper discusses the state of the science in prospective measurement in end-of-life research and identifies particular areas for focused attention. Topics include defining the scope of inquiry, evaluating experiences of patients too ill to communicate, the role of proxy and family response, measurement sensitivity to change, the role of theory in guiding measurement efforts, evaluating relationships between domains of end-of-life experience, and measurement of cultural comprehensiveness. The state of the sciences calls for future research to (1) conduct longitudinal studies to capture transitions in end-of-life trajectories; (2) evaluate the quality of proxy reporting as it varies by rater relationship, domain, and over time; (3) use state-of-the art psychometric and longitudinal techniques to validate measures and to assess sensitivity to change; (4) develop further and test conceptual models of the experience of dying; (5) study the inter-relatedness of multiple dimensions of end-of-life trajectories; (6) compile updated information evaluating available measurement tools; and (7) conduct population- based research with attention to ethnic and age diversity.
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Affiliation(s)
- Karen E Steinhauser
- Center for Palliative Care, Center for Health Services Research in Primary Care, Durham VA Medical Center, and the Department of Medicine, Duke University, Durham, North Carolina 27705, USA.
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Bausewein C, Fegg M, Radbruch L, Nauck F, von Mackensen S, Borasio GD, Higginson IJ. Validation and clinical application of the german version of the palliative care outcome scale. J Pain Symptom Manage 2005; 30:51-62. [PMID: 16043007 DOI: 10.1016/j.jpainsymman.2005.01.017] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2005] [Indexed: 11/12/2022]
Abstract
The Palliative Care Outcome Scale (POS) is a multidimensional instrument covering physical, psychosocial, spiritual, organizational, and practical concerns. This study validated the German version of the POS and used the tool in different palliative care settings in Germany and Austria. Patients and staff were asked to complete the POS three times and evaluate the questionnaire and the translation afterwards. One hundred eighteen patients (44 male, 74 female, mean age 63 years, all suffering from advanced cancer) completed the POS one time, 55 patients two times, and 36 patients three times. Spearman's rho was highly significant for pain, other symptoms, anxiety, and life worthwhile in the first two assessments. The third assessment showed significant correlations for pain, other symptoms, anxiety, and family anxiety. Seventy-seven of 87 patients answered questions regarding the scale and the translation. All questions other than "Over the past 3 days, have you felt good about yourself?" were understandable for patients. Almost half of the staff was undecided whether the tool was reflecting the patients' condition. In contrast, the majority of patients liked it. Thus, the German version of the POS is well accepted by patients and staff and appears to be valid, although there are some areas where the scale would benefit from expansion to more closely capture staff and patient concerns.
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Affiliation(s)
- Claudia Bausewein
- Interdisciplinary Center for Palliative Medicine, University of Munich, Munich, Germany
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Affiliation(s)
- Bruce P Himelstein
- Pediatric Palliative Care Program, Children's Hospital of Wisconsin, Milwaukee, USA.
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McPherson CJ, Addington-Hall JM. Judging the quality of care at the end of life: can proxies provide reliable information? Soc Sci Med 2003; 56:95-109. [PMID: 12435554 DOI: 10.1016/s0277-9536(02)00011-4] [Citation(s) in RCA: 263] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A major challenge in research into care at the end of life is the difficulty of obtaining the views and experiences of representative samples of patients. Studies relying on patients' accounts prior to death are potentially biased, as they only represent that proportion of patients with an identifiable terminal illness, who are relatively well and therefore able to participate, and who are willing to take part. An alternative approach that overcomes many of these problems is the retrospective or 'after death' approach. Here, observations are gathered from proxies, usually the patient's next of kin, following the patient's death. However, questions have been raised about the validity of proxies' responses. This paper provides a comprehensive review of studies that have compared patient and proxy views. The evidence suggests that proxies can reliably report on the quality of services, and on observable symptoms. Agreement is poorest for subjective aspects of the patient's experience, such as pain, anxiety and depression. The findings are discussed in relation to literature drawn from survey methodology, psychology, health and palliative care. In addition to this, factors likely to affect levels of agreement are identified. Amongst these are factors associated with the patient and proxy, the measures used to assess palliative care and the quality of the research evaluating the validity of proxies' reports. As proxies are a vital source of information, and for some patients the only source, the paper highlights the need for further research to improve the validity of proxies' reports.
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Affiliation(s)
- C J McPherson
- Department of Palliative Care and Policy, Guy's King's and St. Thomas' School of Medicine, King's College London, Weston Education Centre, Cutcombe Road, London, UK.
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Abstract
In healthcare, most researchers and clinicians agree that quality of life (QOL) is related to symptoms, functioning, psychological and social wellbeing, and probably to a lesser extent to meaning and fulfillment. This multidimensional health-oriented concept has been named health-related quality of life (HRQOL). However, during end-of-life care spirituality and existential issues become more prominent, as well as family members' perception of quality of care. Outcome measures in palliative care require constructs that reflect the specific goals of palliative care, such as improving QOL before death, symptom control, family support and satisfaction, as well as patients' perceptions of 'purpose' and 'meaning of life'. It is generally recommended that internationally developed and validated patient-rated multidimensional questionnaires should be used when assessing HRQOL in research. However, 'multidimensionality', with often more than 10 possible outcomes, is a threat both to statistical analysis and clinical interpretation of data. Preferentially, a more limited number of outcomes based upon the research question(s) should be defined prior to data collection in the study protocol. The researcher needs to carefully evaluate the content of the questionnaire, in addition to other properties, such as the validity and reliability, before the final decision is made with regards to which instrument to use in a given study.
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Affiliation(s)
- Stein Kaasa
- Department of Oncology and Radiotherapy, Palliative Medicine Unit, Trondheim University Hospital, Trondheim, Norway.
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Steinhauser KE, Bosworth HB, Clipp EC, McNeilly M, Christakis NA, Parker J, Tulsky JA. Initial assessment of a new instrument to measure quality of life at the end of life. J Palliat Med 2002; 5:829-41. [PMID: 12685529 DOI: 10.1089/10966210260499014] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE We conducted this study to pilot a new multidimensional instrument to assess the quality of life at the end of life. METHODS Items were derived from focus groups and a national survey identifying attributes of the quality of dying. Fifty-four items measured on a five-point Likert scale covered six domains. We administered the instrument to equal numbers of Veteran's Administration (VA) and university medical center outpatients with advanced serious illness. We assessed psychometric properties using factor analysis. RESULTS Two hundred patients completed the instrument (response rate, 85%). Diagnoses included cancer (64%), congenital heart failure (CHF) (19.5%), end-stage renal disease (ESRD) (10%) and chronic obstructive pulmonary disease (COPD) (6.5%). Seventy-four percent were male, 64% were caucasian, and 34% African American. Item reduction and factor analysis yielded a final instrument with 24 items in 5 distinct domains (overall Cronbach a = 0.83). The first factor (6 items; a = 0.84) measured a sense of completion, particularly through contributions to others. The second factor (7 items; alpha = 0.77) measured relations with the health care system. The third factor (6 items; alpha = 0.77) measured preparation. The fourth factor (4 items; alpha = 0.77) measured symptom severity, and the final factor (2 items; alpha = 0.60) measured affective social support. CONCLUSIONS We have developed a new instrument to measure the quality of life at the end of life that assesses empirically derived domains that are of demonstrated importance to dying patients, is acceptable to a seriously ill population, and exhibits excellent psychometric properties. Some items related to completion and preparation represent particularly new contributions to quality-of-life measurement.
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Affiliation(s)
- Karen E Steinhauser
- Program on the Medical Encounter and Palliative Care, Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina 27705, USA.
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Strömgren AS, Groenvold M, Pedersen L, Olsen AK, Sjogren P. Symptomatology of cancer patients in palliative care: content validation of self-assessment questionnaires against medical records. Eur J Cancer 2002; 38:788-94. [PMID: 11937313 DOI: 10.1016/s0959-8049(01)00470-1] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
To elucidate which symptoms or problems to measure when evaluating palliative care, we assessed the content validity of selected patient self-assessment questionnaires used to evaluate palliative care: the European Organization for Research and Treatment of Cancer-Quality of Life-Core 30 (EORTC QLQ-C30), the Edmonton Symptom Assessment System (ESAS), the Palliative Care Outcome Scale (POS), the McGill Quality of Life Questionnaire (MQOL) and the Memorial Symptom Assessment Scale (MSAS). The content of the questionnaires was compared against the symptoms and problems noted in the medical records of 171 consecutive cancer patients on their first admission to a department of palliative medicine. From the records, 63 different symptoms were listed. Two questionnaires covered almost all of the prevalent symptoms/problems: the EORTC QLQ-C30 covered 10 and the MSAS 11 of the 12 most frequent problems. Researchers selecting instruments for evaluating palliative care may use the present study and other reviews to examine to what degree a given selection of instruments cover the symptoms/problems targeted by palliative care physicians.
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Affiliation(s)
- A S Strömgren
- Department of Palliative Medicine, Bispebjerg Hospital, DK-2400 Copenhagen, Denmark.
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Abstract
The increasing number of palliative care patients necessitates a simple, reliable instrument to routinely measure outcomes among hospice patients. We tested the utility of the Brief Hospice Inventory (BHI) to assess outcomes of hospice patients and estimations of patients' outcomes by nurse caregivers. In a prospective study, 145 home-based hospice patients were enrolled in the study from VistaCare Hospice. During the first week of admission, patients and nurse caregivers completed the BHI, which assessed patients' symptoms, satisfaction with care, and quality of life. Factor analysis supported a two-factor structure for the BHI for patients and caregivers, including a symptom subscale and quality of life subscale. Patients with severe symptoms showed improvement on the symptom subscale, but not the quality of life subscale, during the first 2 weeks after admission. The BHI shows utility in measuring hospice patients' symptom severity and quality of life over time.
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Affiliation(s)
- H Guo
- Pain Research Group, The University of Texas M. D. Anderson Cancer Center, 1100 Holcombe Blvd. Houston, TX 77030, USA
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Cohen SR, Mount BM. Living with cancer: "good" days and "bad" days--what produces them? Can the McGill quality of life questionnaire distinguish between them? Cancer 2000; 89:1854-65. [PMID: 11042583 DOI: 10.1002/1097-0142(20001015)89:8<1854::aid-cncr28>3.0.co;2-c] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND To determine the impact of care on quality of life (QOL), or to detect a change in QOL over time, measures of QOL must remain stable when QOL is stable (test-retest reliability) and change when QOL changes (responsiveness). This study addresses these issues for the McGill Quality of Life Questionnaire (MQOL). Unlike other studies that use disease status to indicate whether QOL has remained stable or changed, in this study the patient determines QOL stability or change. The authors also sought to clarify the determinants of "good" and "bad" days for oncology patients. METHODS Patients attending an oncology outpatient clinic or who were being treated by a palliative care service were asked to complete MQOL 4 times: on days they judged to be "good," "average," and "bad" and 2 days after the first completion. They also were asked to directly rate the change in their QOL during the intervals between MQOL completion and to report the most important determinants of their good and bad days. RESULTS The test-retest reliability of MQOL as measured by an intraclass correlation coefficient ranged from 0.69 to 0.78. All MQOL scores were significantly different on good, average, and bad days, except for the support subscale, in both clinical settings. Five domains were determinants of QOL: physical symptoms, physical functioning, psychologic well-being, existential well-being, and relationships. CONCLUSIONS MQOL's reliability and responsiveness suggest it can be used to determine changes in the QOL of groups. The results allow interpretation of changes in MQOL scores with respect to meaning of the change to oncology patients. This in turn is helpful to determine the sample size required in future studies. Some of the domains important to the QOL of oncology patients are not included in widely used measures of QOL.
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Affiliation(s)
- S R Cohen
- Department of Oncology, McGill University Montreal, Quebec, Canada.
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Abstract
In the past 5 years, quality-of-life (QOL) assessment measures such as the McGill, McMaster, Global Visual Analogue Scale, Assessment of QOL at the End of Life, Life Evaluation Questionnaire, and Hospice QOL Index have been devised specifically for patients with advanced cancer. The developers of these instruments have tried to respond to the changing needs of this specific population, taking into account characteristics including poor performance status, difficulty with longitudinal study, rapidly deteriorating physical condition, and change in relevant issues. Emphasis has been placed on patient report, ease and speed of completion, and the existential domain or meaning of life. Novel techniques in QOL measurement have also been adapted for palliative care, such as judgment analysis in the Schedule for the Evaluation of Individual Quality of Life. It is generally agreed that a single tool will not cover all QOL assessment needs.
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Affiliation(s)
- S Donnelly
- Milford Care Centre, Plassey Park Road, Castletroy, Limerick, Ireland.
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Affiliation(s)
- M J Brady
- Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, IL 60201, USA
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Hardy JR, Edmonds P, Turner R, Rees E, A'Hern R. The use of the Rotterdam Symptom Checklist in palliative care. J Pain Symptom Manage 1999; 18:79-84. [PMID: 10484854 DOI: 10.1016/s0885-3924(99)00050-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Rotterdam Symptom Checklist (RSCL), which measures both physical and psychological aspects of quality of life (QOL), was given to all new patients admitted to a palliative care unit who were thought capable of filling out a questionnaire as an outcome measure of symptom control. Assessments were obtained from 52 patients at baseline (week 1). This represented only 53% of the new patients admitted to the unit. Thirty-one patients completed a second questionnaire at week 2, and only 28 patients completed a third (week 3). In these selected patients, the median overall RSCL scores were 57, 52, and 49 at weeks 1, 2, and 3. There was a significant improvement in QOL scores across the three measurements with a significant difference between weeks 1 and 3 (P = 0.05) but not between weeks 1 and 2. Primarily because of the inability of many patients to complete the questionnaire and the high attrition rate, the appropriateness of this tool as a symptom control measure in palliative care patients is questioned.
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Affiliation(s)
- J R Hardy
- Department of Palliative Medicine, Royal Marsden NHS Trust, London and Surrey, United Kingdom
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Pratheepawanit N, Salek MS, Finlay IG. The applicability of quality-of-life assessment in palliative care: comparing two quality-of-life measures. Palliat Med 1999; 13:325-34. [PMID: 10659101 DOI: 10.1191/026921699670560921] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Two self-administered quality-of-life measures, the McGill Quality of Life Questionnaire (MQOL) and the Patient Evaluated Problem Scores (PEPS) were compared in patients receiving palliative care. The MQOL is a multidimensional questionnaire consisting of 16 items in five quality-of-life (QOL) domains: physical symptoms, physical well-being, psychological, existential and support domains. The PEPS is an individualized questionnaire asking patients to identify and rate major problems affecting their QOL. Both questionnaires were completed by 36 patients during outpatient clinic visits in three palliative care settings in Wales. Of those patients who stated their questionnaire preference 60% favoured MQOL due to its comprehensiveness, while others (28%) preferred PEPS due to its simplicity. The MQOL showed excellent internal consistency (alpha = 0.90). The intrapatient analysis of answers from both questionnaires showed that MQOL was better than PEPS in reporting physical symptoms and support domain, while PEPS detected more psychosocial issues. The MQOL overall QOL score correlated highly with its existential domain (rs = 0.57, P < 0.0005) and the PEPS overall quality of life (rs = 0.77, P < 0.0005). Similarly, the PEPS overall QOL correlated well with MQOL total score (rs = 0.76, P < 0.0005) and existential domain of the MQOL (rs = 0.63, P < 0.0005). The findings support the importance of an existential domain in assessing the QOL of this population. Both MQOL and PEPS were found to be relevant and acceptable in advanced cancer patients receiving palliative care. However, with its favourable psychometric properties MQOL may be more suitable for QOL assessment in this population.
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Axelsson B, Sjödén PO. Assessment of quality of life in palliative care--psychometric properties of a short questionnaire. Acta Oncol 1999; 38:229-37. [PMID: 10227446 DOI: 10.1080/028418699431663] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The psychometric properties of a short but comprehensive quality-of-life instrument, developed especially for cancer patients in the palliative care setting are presented. Items from physical, psychological, social and existential domains are included. The findings suggest that the AQEL (Assessment of Quality of Life at the End of Life) instrument is both valid and reliable, but further trials with more patients are needed.
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Affiliation(s)
- B Axelsson
- Department of General Surgery, Ostersund Hospital, Sweden
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