Catchlove BR Measuring the quality life cancer patients a concise QL index use physicians Journal Chronic Diseases




    Appendix A. Characteristics of generic and breast cancer-specific quality of life instruments (Instruments are listed alphabetically). 
     

  Measure Purpose Domains Scale  
Time frame
 
No. of items
 
Administered by and

(completion time)

Reliability  
Validity
 
1
 
Beck Depression Inventory (BDI) [1]
 
Designed to measure Depression
 
One domain:

Depression

 
Inventory produces a total score and is scaled on a four point Likert scale
 
Past two weeks
 
21
 
Self-administered

(5 minutes)

 
Reliabilities ranged from .48 to .86
 
Correlation coefficients between the BDI and clinical ratings yield correlations from .55 to .96 [2]
 
2
 
Breast Cancer Chemotherapy Questionnaire

(BCQ) [3]

 
Developed to measure outcomes of women with stage II breast cancer receiving adjuvant chemotherapy
 
Seven domains:

Consequences of hair loss; emotional dysfunction; physical symptoms; trouble and inconvenience associated with treatment; fatigue; nausea; positive well-being

 
Seven point Likert scale ranging in responses
 
Past two weeks
 
30
 
Interviewer- administered

(10-15 minutes)

 
Internal consistency ranging from .89 to .91
 
Correlation coefficients between BCQ and Spitzer QL-Index was .62
 
3
 
Breast Cancer Prevention Trial Symptom Checklist

(BCPT) [4, 5]

 
Designed to examine the physical and psychological symptoms associated with menopause and Tamoxifen usage
 
Eight domains: 

Hot flashes; nausea; bladder control; vaginal problems; musculoskeletal pain; cognitive problems; weight problems; arm problems

 
Five point Likert scale ranging from 0 (Not at all) to 4 (Extremely)
 
Past four weeks
 
43
 
Self-report

(estimated 30 minutes)

 
Reliability was .81
 
Correlation coefficients between BCPT and SF-36 were -.40 and -.36
 
4
 
Cancer Needs Questionnaire – Short Form

(CNQ-SF) [6]

 
Developed to assess cancer patients’ needs
 
Five domains:  Psychological; health information; physical and daily living; patient care and support; interpersonal communication
 
Five point Likert scale ranging from 1 (No need/not applicable) to 5 (High need for help)
 
Unspecified
 
32
 
Self-administered

(estimated 15-20 minutes)

 
Reliability ranged from .77 to .94
 
Correlation coefficients between CNQ-SF and EORTC QLQ-C30 and BDI ranged from .23 to .58 [7]
 
5
 
Cancer Rehabilitation Evaluation System

(CARES-SF) [8]

 
Developed to assess patients’ cancer-related problems
 
Six domains:

Physical; psychosocial; Medical interaction; marital; sexual; global

 
Five point Likert scale ranging from 0 (Not at all) to 4 (Very much)
 
Past month
 
59
 
Self-administered

(average 20 minutes; Range of 10-34 minutes)

 
Reliabilities ranged from .39 to .82
 
Correlation coefficients between the CARES-SF and the Memorial Symptom Assessment Scale (MSAS)  ranged between .53 to .73 [9]
 
6
 
Center for Epidemiologic Studies Depression Scale-10

(CES-D)

 
Designed to measure Depression
 
One domain:

Depression

 
Four point Likert scale ranging from 0 (Rarely) to 3 (Most of the time) and summed across the ten items to provide a total score.
 
Past week
 
10
 
Self-administered

(estimated 5 minutes)

 
Reliability of .92[10];  Reliability for CES-D 20 item scale is .86 [11]
 
Correctly identifies 98% of depressed patients as having major Depression [10]
 
7
 
European Organization for Research and Treatment of Cancer QOL Breast Cancer Specific Version

(EORTC QLQ-BR23) [12]

 
Designed to measure QOL in the breast cancer population at various stages and with patients with differing modalities
 
Five domains:

Therapy side effects; arm symptoms; breast symptoms; body image; sexual functioning

 
Four point Likert scale ranging from 1 (Not at all) to 4 (Very much)
 
Past week
 
23
 
Self-report

(10 minutes)

 
Reliabilities ranged from .70 to .91
 
Discriminant validity of mutually exclusive groups based on their initial performance status scores produced medium to large effect sizes ranging from .43 to 1.1
 
8
 
European Organization for Research and Treatment of Cancer QOL Cancer Specific Version

(EORTC QLQ-C30) [13]

 
Cancer specific questionnaire designed to measure QOL in the cancer population
 
Nine domains:

Physical; role, cognitive; emotional; social; fatigue; pain; nausea and vomiting; global health status and quality of life

 
Four point Likert scale ranging from 1 (Not at all) to 4 (Very much); 1 (Very poor) to 7 (Excellent)
 
Past week
 
30
 
Self-administered

(Under 10 minutes)

 
Reliabilities ranged from .69 to .90.[14]  Test-retest reliabilities ranged from .63 to .87 [15]
 
Correlation coefficient between the QLQ-C30 and the Profile of Mood States (POMS) was .56 [16]44].
 
9
 
Edmonton Symptom Assessment System

(ESAS) [17]

 
Designed to measure a variety of symptoms
 
Nine domains:

Pain; tiredness; nausea; Depression; anxiety; drowsiness; appetite; well-being; shortness of breath

 
Scaled using a visual analog scale
 
At the time of assessment
 
9
 
Self-administered

(estimated 5 minutes)

 
Internal consistency reliability of .39 to .86
 
Correlation coefficient between the ESAS and the FACT was .85 [18]
 
10
 
Functional Assessment of Cancer Therapy – Breast Symptom Index (FACT-B) [19]
 
Specific to breast cancer patients
 
Six domains:  Physical well-being; social/family well-being; emotional well-being; functional well-being; relationship with doctor; additional concerns
 
Five point Likert scale ranging from 0 (Not at all) to 4 (Very much)
 
Past week
 
37
 
Self-report or interviewer- administered

(estimated 25 minutes)

 
Internal consistency was .90
 
Spearman correlations between FBSI and FACT ranged from .34 to .84
 
11
 
Functional Assessment of Cancer Therapy – Endocrine System

(FACT-ES) [20]

 
Focus on endocrine concerns experienced during breast cancer treatment
 
One domain:

Endocrine concerns

 
Five point Likert scale ranging from 0 (Not at all) to 4 (Very much) and comprises a total score
 
Past week
 
18
 
Self-report or interviewer-administered

(estimated 10 minutes)

 
Internal consistency was .79

Test-retest reliability was .93

 
Discriminant validity of known groups comparing adjuvant chemotherapy and those without any endocrine therapy produced a significant t score with the adjuvant chemotherapy group experiencing more endocrine symptoms than the non-endocrine therapy group
 
12
 
Functional Living Index – Cancer

(FLIC) [21]

 
Designed to assess the effect that cancer treatment and symptoms have on functional ability in all areas of life
 
Five domains:

Physical functioning; mental functioning; social functioning; general health/well-being; gastrointestinal symptoms

 
Seven point Likert-type linear analog scale. Patients are instructed to answer the questions by placing a vertical line at the point in the scale that best represents their response based on various Likert points along the scale
 
Past two weeks;

Past month;

Today

 
22
 
Self-administered

(Under 10 minutes)

 
Reliability ranged from .64 to .87.[21]
 
Correlation coefficients between FLIC and SF-36 ranged from .50 to .62 [22]
 
13
 
Geriatric Depression Scale – Short Form

(GDS-SF) [23]

 
Designed to assess depression in the elderly
 
Four domains:

Positive mood; sad mood; boredom, memory problems, and energy level; staying home

 
Scaled in a yes/no format
 
Past week
 
15
 
Self-administered

(estimated 5 minutes)

 
Internal consistency ranged from .60 to .77 [24]
 
Cut off score of greater than or equal to 7 in correctly diagnosing depression 79% of the time [25]
 
14
 
Hospital Anxiety and Depression Scale

(HADS) [26]

 
Developed to measure anxiety and depression
 
Two domains: 

Anxiety and depression

 
Four point Likert scale
 
Past week
 
14
 
Self-administered

(estimated 5-10 minutes)

 
Reliabilities of .98 for total score, .85 for anxiety subscale, and .80 for depression subscale. Test-retest reliability has produced coefficients over a two month period for the total score, anxiety subscale, and depression subscale (.79, .79, and .63 respectively).[27]
 
Correlation coefficients between the HADS and Symptom Checklist 90 scale were .73 (anxiety subscale) and .67 (depression subscale [28]).
 
15
 
Life Satisfaction Questionnaire

(LSQ) [14]

 
Developed to measure one’s general sense of satisfaction with life as it relates to school, relationships, leisure time, religious practices, and overall health, specifically for women with breast cancer
 
Six domains:

Quality of family relation; physical symptoms; socioeconomic situation; quality of daily activities; sickness impact; and quality of close friend relation

 
Seven point Likert scale ranging from 1 (very much) to 7 (Not at all)
 
Past week
 
32
 
Self-report

(estimated 20 minutes)

 
Reliabilities ranged from .62 to .92
 
Correlation coefficients between LSQ and EORTC QLQ-C30 were -.68 to .54
 
16
 
Medical Outcome Short Form Health Survey

(SF-36) [29]

 
Developed to assess health-related QOL
 
Eight domains: 

Physical functioning; role limitations due to physical health; role limitations due to emotional problems; energy/fatigue; emotional well-being; social functioning; bodily pain; general health

 
Scaled using various scales
 
  Unspecified
 
36
 
Self-administered

(5 minutes)

 
Reliability ranged from .74 to .98 [30]
 
Correlation coefficients between the SF-36 and the General health Questionnaire (GHQ-29) were -.35 to =.61 (correlations are negative because the two scales run in opposite directions) [31]
 
17
 
Quality of Life Index

(QL-Index) [32]

 
Designed to assess health outcomes of those with cancer and other chronic diseases
 
Five domains:

Activity; daily living; health; support; outlook

 
Three point Likert Scale
 
Past two weeks
 
5
 
Interviewer-administered or self-administered

(Under 10 minutes)

 
Internal consistency of .78
 
Correlation coefficients ranged from .40 to .63 .[32]
 
18
 
Rotterdam Symptoms Checklist – Modified [33]
 
Developed to assess symptom-related distress among cancer patients
 
Two domains:

Physical distress and miscellaneous variables

 
Four point Likert scale ranging from 1 (Not at all) to 4 (Very much)
 
Past week
 
28
 
Self-administered

(8 minutes)

 
Reliability of .88
 
Correlation coefficients ranged from -.59 to -.61 when the Rotterdam Symptoms Checklist-Modified was compared with the SF-36 (correlations are negative because the two scales run in opposite directions) [33]
 
19
 
Satisfaction with Life Domains Scale for Breast Cancer

(SLDS-BC) [34]

 
Developed to measure satifaction with life among breast cancer patients
 
Five domains:

Social functioning; appearance; physical functioning; communication with Medical providers; spirituality

 
Seven point Likert-type scale ranging from 1 (A “delighted” face) to 7 (A “very unhappy” face
 
Unspecified
 
32
 
Self-report

(estimated 20 minutes)

 
Reliabilities ranged from .90 to .93
 
Correlation coefficient between SLDS-BC and FACT-B was .59
 
20
 
World Health Organization Quality of Life – Brief Version

(WHOQOL-BREF) [35]

 
Designed to examine domain level profiles assessing quality of life
 
Four domains: 

Physical health; psychological; social relationships; environment

 
Five point Likert scale with varying anchors
 
Past two weeks
 
26
 
Self-administered

(estimated 15-20 minutes)

 
Reliability ranged from .66 to .84. Similar alphas have been shown for test-retest reliability ranging from .66 to .87
 
Correlation coefficients between the WHOQOL-BREF and SF-36 ranged from .36 to .78 [36]
 
 
21
 
Zung self-rating depression scale [37]
 
Designed to measure Depression
 
Depression
 
Four point Likert scale ranging from 1 (A little of the time) to 4 (Most of the time)
 
Last 5 days
 
20
 
Self-administered

(estimated 10 minutes)

 
Internal consistency of .58[38]
 
Scale has produced good discriminant validity as it was found to be the primary discriminating variable in distinguishing depressed from nondepressed participants.

[39]

 
 

References:

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    3. Levine MN, Guyatt GH, Gent M, De Pauw S, Goodyear MD, Hryniuk WM, Arnold A, Findlay B, Skillings JR, Bramwell VH, et al.: Quality of life in stage II breast cancer: an instrument for clinical trials. Journal of Clinical Oncology 1988, 6:1798-1810.

    4. Ganz PA, Day R, Ware JE, Jr., Redmond C, Fisher B: Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. J Natl Cancer Inst 1995, 87:1372-1382.

    5. Day R, Ganz PA, Costantino JP, Cronin WM, Wickerham DL, Fisher B: Health-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Adjuvant Breast and Bowel Project P-1 Study. Journal of Clinical Oncology 1999, 17:2659-2669.

    6. Lattimore-Foot GG: Needs assessment in tertiary and secondary oncology practice: a conceptual and methodological exposition. PhD thesis. University of Newcastle, Newcastle; 1996.

    7. Cossich T, Schofield P, McLachlan SA: Validation of the cancer needs questionnaire (CNQ) short-form version in an ambulatory cancer setting. Qual Life Res 2004, 13:1225-1233.

    8. Heinrich RL, Schag CC, Ganz PA: Living with cancer: the Cancer Inventory of Problem Situations. Journal of Clinical Psychology 1984, 40:972-980.

    9. Turner J, Kelly B, Swanson C, Allison R, Wetzig N: Psychosocial impact of newly diagnosed advanced breast cancer. Psycho-Oncology 2005, 14:396-407.

    10. Irwin M, Artin KH, Oxman MN: Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Archives of Internal Medicine 1999, 159:1701-1704.

    11. Kohout FJ, Berkman LF, Evans DA, Cornoni-Huntley J: Two shorter forms of the CES-D (Center for Epidemiological Studies Depression) depression symptoms index. Journal of Aging and Health 1993, 5:179-193.

    12. Sprangers MAG, Groenvold M, Arraras JI, Franklin J, teVelde A, Muller M, Franzini L, Wiliams A, deHaes H, Hopwood P, et al: The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: First results from a three-country field study. Journal of Clinical Oncology 1996, 14:2756-2768.

    13. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, Dehaes J, et al: The European-Organization-for-Research-and-Treatment-of-Cancer QLQ-C30 - a Quality-of-Life Instrument for Use in International Clinical-Trials in Oncology. Journal of the National Cancer Institute 1993, 85:365-376.

    14. Carlsson M, Hamrin E: Measurement of quality of life in women with breast cancer. Development of a Life Satisfaction Questionnaire (LSQ-32) and a comparison with the EORTC QLQ-C30. Quality of Life Research 1996, 5:265-274.

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    16. McLachlan SA, Devins GM, Goodwin PJ: Validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) as a measure of psychosocial function in breast cancer patients. European Journal of Cancer 1998, 34:510-517.

    17. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K: The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. Journal of Palliative Care 1991, 7:6-9.

    18. Chang VT, Hwang SS, Feuerman M: Validation of the Edmonton Symptom Assessment Scale. Cancer 2000, 88:2164-2171.

    19. Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S, Cobleigh M, Shiomoto G: Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. Journal of Clinical Oncology 1997, 15:974-986.

    20. Fallowfield LJ, Leaity SK, Howell A, Benson S, Cella D: Assessment of quality of life in women undergoing hormonal therapy for breast cancer: validation of an endocrine symptom subscale for the FACT-B. Breast Cancer Research and Treatment 1999, 55:189-199.

    21. Morrow GR, Lindke J, Black P: Measurement of quality of life in patients: psychometric analyses of the Functional Living Index-Cancer (FLIC). Quality of Life Research 1992, 1:287-296.

    22. Wilson RW, Hutson LM, Vanstry D: Comparison of 2 quality-of-life questionnaires in women treated for breast cancer: the RAND 36-Item Health Survey and the Functional Living Index-Cancer. Physical Therapy 2005, 85:851-860.

    23. Sheikh J, Yesavage J: Geriatric Depression Scale: Recent evidence and development of a shorter version. Clinical Gerontologist 1986, 5:165-173.

    24. Jang Y, Borenstein AR, Chiriboga DA, Mortimer JA: Depressive symptoms among African American and White older adults. Journals of Gerontology Series B-Psychological Sciences and Social Sciences 2005, 60:P313-P319.

    25. Lesher EL, Berryhill JS: Validation of the Geriatric Depression Scale--Short Form among inpatients. Journal of Clinical Psychology 1994, 50:256-260.

    26. Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 1983, 67:361-370.

    27. Roberts SB, Bonnici DM, Mackinnon AJ, Worcester MC: Psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) among female cardiac patients. Br J Health Psychol 2001, 6:373-383.

    28. Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research 2002, 52:69-77.

    29. Ware J, Snow K, Kosinski M: SF-36 Health Survey: Manual and Interpretation Guide. Lincoln, RI: Quality-Metric Incorporated; 1993.

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    32. Spitzer WO, Dobson AJ, Hall J, Chesterman E, Levi J, Shepherd R, Battista RN, Catchlove BR: Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. Journal of Chronic Diseases 1981, 34:585-597.

    33. Stein KD, Denniston M, Baker F, Dent M, Hann DM, Bushhouse S, West M: Validation of a modified Rotterdam Symptom Checklist for use with cancer patients in the united states. Journal of Pain and Symptom Management 2003, 26:975-989.

    34. Spagnola S, Zabora J, BrintzenhofeSzoc K, Hooker C, Cohen G, Baker F: The Satisfaction with Life Domains Scale for Breast Cancer (SLDS-BC). Breast J 2003, 9:463-471.

    35. Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med 1998, 28:551-558.

    36. da Silva Lima AF, Fleck M, Pechansky F, de Boni R, Sukop P: Psychometric properties of the World Health Organization quality of life instrument (WHOQoL-BREF) in alcoholic males: a pilot study. Quality of Life Research 2005, 14:473-478.

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    Catchlove BR Measuring the quality life cancer patients a concise QL index use physicians Journal Chronic Diseases

      Appendix A. Characteristics of generic and breast cancer-specific quality of life instruments (Instruments are listed alphabetically). 
       

      Measure Purpose Domains Scale  
    Time frame
     
    No. of items
     
    Administered by and

    (completion time)

    Reliability  
    Validity
     
    1
     
    Beck Depression Inventory (BDI) [1]
     
    Designed to measure Depression
     
    One domain:

    Depression

     
    Inventory produces a total score and is scaled on a four point Likert scale
     
    Past two weeks
     
    21
     
    Self-administered

    (5 minutes)

     
    Reliabilities ranged from .48 to .86
     
    Correlation coefficients between the BDI and clinical ratings yield correlations from .55 to .96 [2]
     
    2
     
    Breast Cancer Chemotherapy Questionnaire

    (BCQ) [3]

     
    Developed to measure outcomes of women with stage II breast cancer receiving adjuvant chemotherapy
     
    Seven domains:

    Consequences of hair loss; emotional dysfunction; physical symptoms; trouble and inconvenience associated with treatment; fatigue; nausea; positive well-being

     
    Seven point Likert scale ranging in responses
     
    Past two weeks
     
    30
     
    Interviewer- administered

    (10-15 minutes)

     
    Internal consistency ranging from .89 to .91
     
    Correlation coefficients between BCQ and Spitzer QL-Index was .62
     
    3
     
    Breast Cancer Prevention Trial Symptom Checklist

    (BCPT) [4, 5]

     
    Designed to examine the physical and psychological symptoms associated with menopause and Tamoxifen usage
     
    Eight domains: 

    Hot flashes; nausea; bladder control; vaginal problems; musculoskeletal pain; cognitive problems; weight problems; arm problems

     
    Five point Likert scale ranging from 0 (Not at all) to 4 (Extremely)
     
    Past four weeks
     
    43
     
    Self-report

    (estimated 30 minutes)

     
    Reliability was .81
     
    Correlation coefficients between BCPT and SF-36 were -.40 and -.36
     
    4
     
    Cancer Needs Questionnaire – Short Form

    (CNQ-SF) [6]

     
    Developed to assess cancer patients’ needs
     
    Five domains:  Psychological; health information; physical and daily living; patient care and support; interpersonal communication
     
    Five point Likert scale ranging from 1 (No need/not applicable) to 5 (High need for help)
     
    Unspecified
     
    32
     
    Self-administered

    (estimated 15-20 minutes)

     
    Reliability ranged from .77 to .94
     
    Correlation coefficients between CNQ-SF and EORTC QLQ-C30 and BDI ranged from .23 to .58 [7]
     
    5
     
    Cancer Rehabilitation Evaluation System

    (CARES-SF) [8]

     
    Developed to assess patients’ cancer-related problems
     
    Six domains:

    Physical; psychosocial; Medical interaction; marital; sexual; global

     
    Five point Likert scale ranging from 0 (Not at all) to 4 (Very much)
     
    Past month
     
    59
     
    Self-administered

    (average 20 minutes; Range of 10-34 minutes)

     
    Reliabilities ranged from .39 to .82
     
    Correlation coefficients between the CARES-SF and the Memorial Symptom Assessment Scale (MSAS)  ranged between .53 to .73 [9]
     
    6
     
    Center for Epidemiologic Studies Depression Scale-10

    (CES-D)

     
    Designed to measure Depression
     
    One domain:

    Depression

     
    Four point Likert scale ranging from 0 (Rarely) to 3 (Most of the time) and summed across the ten items to provide a total score.
     
    Past week
     
    10
     
    Self-administered

    (estimated 5 minutes)

     
    Reliability of .92[10];  Reliability for CES-D 20 item scale is .86 [11]
     
    Correctly identifies 98% of depressed patients as having major Depression [10]
     
    7
     
    European Organization for Research and Treatment of Cancer QOL Breast Cancer Specific Version

    (EORTC QLQ-BR23) [12]

     
    Designed to measure QOL in the breast cancer population at various stages and with patients with differing modalities
     
    Five domains:

    Therapy side effects; arm symptoms; breast symptoms; body image; sexual functioning

     
    Four point Likert scale ranging from 1 (Not at all) to 4 (Very much)
     
    Past week
     
    23
     
    Self-report

    (10 minutes)

     
    Reliabilities ranged from .70 to .91
     
    Discriminant validity of mutually exclusive groups based on their initial performance status scores produced medium to large effect sizes ranging from .43 to 1.1
     
    8
     
    European Organization for Research and Treatment of Cancer QOL Cancer Specific Version

    (EORTC QLQ-C30) [13]

     
    Cancer specific questionnaire designed to measure QOL in the cancer population
     
    Nine domains:

    Physical; role, cognitive; emotional; social; fatigue; pain; nausea and vomiting; global health status and quality of life

     
    Four point Likert scale ranging from 1 (Not at all) to 4 (Very much); 1 (Very poor) to 7 (Excellent)
     
    Past week
     
    30
     
    Self-administered

    (Under 10 minutes)

     
    Reliabilities ranged from .69 to .90.[14]  Test-retest reliabilities ranged from .63 to .87 [15]
     
    Correlation coefficient between the QLQ-C30 and the Profile of Mood States (POMS) was .56 [16]44].
     
    9
     
    Edmonton Symptom Assessment System

    (ESAS) [17]

     
    Designed to measure a variety of symptoms
     
    Nine domains:

    Pain; tiredness; nausea; Depression; anxiety; drowsiness; appetite; well-being; shortness of breath

     
    Scaled using a visual analog scale
     
    At the time of assessment
     
    9
     
    Self-administered

    (estimated 5 minutes)

     
    Internal consistency reliability of .39 to .86
     
    Correlation coefficient between the ESAS and the FACT was .85 [18]
     
    10
     
    Functional Assessment of Cancer Therapy – Breast Symptom Index (FACT-B) [19]
     
    Specific to breast cancer patients
     
    Six domains:  Physical well-being; social/family well-being; emotional well-being; functional well-being; relationship with doctor; additional concerns
     
    Five point Likert scale ranging from 0 (Not at all) to 4 (Very much)
     
    Past week
     
    37
     
    Self-report or interviewer- administered

    (estimated 25 minutes)

     
    Internal consistency was .90
     
    Spearman correlations between FBSI and FACT ranged from .34 to .84
     
    11
     
    Functional Assessment of Cancer Therapy – Endocrine System

    (FACT-ES) [20]

     
    Focus on endocrine concerns experienced during breast cancer treatment
     
    One domain:

    Endocrine concerns

     
    Five point Likert scale ranging from 0 (Not at all) to 4 (Very much) and comprises a total score
     
    Past week
     
    18
     
    Self-report or interviewer-administered

    (estimated 10 minutes)

     
    Internal consistency was .79

    Test-retest reliability was .93

     
    Discriminant validity of known groups comparing adjuvant chemotherapy and those without any endocrine therapy produced a significant t score with the adjuvant chemotherapy group experiencing more endocrine symptoms than the non-endocrine therapy group
     
    12
     
    Functional Living Index – Cancer

    (FLIC) [21]

     
    Designed to assess the effect that cancer treatment and symptoms have on functional ability in all areas of life
     
    Five domains:

    Physical functioning; mental functioning; social functioning; general health/well-being; gastrointestinal symptoms

     
    Seven point Likert-type linear analog scale. Patients are instructed to answer the questions by placing a vertical line at the point in the scale that best represents their response based on various Likert points along the scale
     
    Past two weeks;

    Past month;

    Today

     
    22
     
    Self-administered

    (Under 10 minutes)

     
    Reliability ranged from .64 to .87.[21]
     
    Correlation coefficients between FLIC and SF-36 ranged from .50 to .62 [22]
     
    13
     
    Geriatric Depression Scale – Short Form

    (GDS-SF) [23]

     
    Designed to assess depression in the elderly
     
    Four domains:

    Positive mood; sad mood; boredom, memory problems, and energy level; staying home

     
    Scaled in a yes/no format
     
    Past week
     
    15
     
    Self-administered

    (estimated 5 minutes)

     
    Internal consistency ranged from .60 to .77 [24]
     
    Cut off score of greater than or equal to 7 in correctly diagnosing depression 79% of the time [25]
     
    14
     
    Hospital Anxiety and Depression Scale

    (HADS) [26]

     
    Developed to measure anxiety and depression
     
    Two domains: 

    Anxiety and depression

     
    Four point Likert scale
     
    Past week
     
    14
     
    Self-administered

    (estimated 5-10 minutes)

     
    Reliabilities of .98 for total score, .85 for anxiety subscale, and .80 for depression subscale. Test-retest reliability has produced coefficients over a two month period for the total score, anxiety subscale, and depression subscale (.79, .79, and .63 respectively).[27]
     
    Correlation coefficients between the HADS and Symptom Checklist 90 scale were .73 (anxiety subscale) and .67 (depression subscale [28]).
     
    15
     
    Life Satisfaction Questionnaire

    (LSQ) [14]

     
    Developed to measure one’s general sense of satisfaction with life as it relates to school, relationships, leisure time, religious practices, and overall health, specifically for women with breast cancer
     
    Six domains:

    Quality of family relation; physical symptoms; socioeconomic situation; quality of daily activities; sickness impact; and quality of close friend relation

     
    Seven point Likert scale ranging from 1 (very much) to 7 (Not at all)
     
    Past week
     
    32
     
    Self-report

    (estimated 20 minutes)

     
    Reliabilities ranged from .62 to .92
     
    Correlation coefficients between LSQ and EORTC QLQ-C30 were -.68 to .54
     
    16
     
    Medical Outcome Short Form Health Survey

    (SF-36) [29]

     
    Developed to assess health-related QOL
     
    Eight domains: 

    Physical functioning; role limitations due to physical health; role limitations due to emotional problems; energy/fatigue; emotional well-being; social functioning; bodily pain; general health

     
    Scaled using various scales
     
      Unspecified
     
    36
     
    Self-administered

    (5 minutes)

     
    Reliability ranged from .74 to .98 [30]
     
    Correlation coefficients between the SF-36 and the General health Questionnaire (GHQ-29) were -.35 to =.61 (correlations are negative because the two scales run in opposite directions) [31]
     
    17
     
    Quality of Life Index

    (QL-Index) [32]

     
    Designed to assess health outcomes of those with cancer and other chronic diseases
     
    Five domains:

    Activity; daily living; health; support; outlook

     
    Three point Likert Scale
     
    Past two weeks
     
    5
     
    Interviewer-administered or self-administered

    (Under 10 minutes)

     
    Internal consistency of .78
     
    Correlation coefficients ranged from .40 to .63 .[32]
     
    18
     
    Rotterdam Symptoms Checklist – Modified [33]
     
    Developed to assess symptom-related distress among cancer patients
     
    Two domains:

    Physical distress and miscellaneous variables

     
    Four point Likert scale ranging from 1 (Not at all) to 4 (Very much)
     
    Past week
     
    28
     
    Self-administered

    (8 minutes)

     
    Reliability of .88
     
    Correlation coefficients ranged from -.59 to -.61 when the Rotterdam Symptoms Checklist-Modified was compared with the SF-36 (correlations are negative because the two scales run in opposite directions) [33]
     
    19
     
    Satisfaction with Life Domains Scale for Breast Cancer

    (SLDS-BC) [34]

     
    Developed to measure satifaction with life among breast cancer patients
     
    Five domains:

    Social functioning; appearance; physical functioning; communication with Medical providers; spirituality

     
    Seven point Likert-type scale ranging from 1 (A “delighted” face) to 7 (A “very unhappy” face
     
    Unspecified
     
    32
     
    Self-report

    (estimated 20 minutes)

     
    Reliabilities ranged from .90 to .93
     
    Correlation coefficient between SLDS-BC and FACT-B was .59
     
    20
     
    World Health Organization Quality of Life – Brief Version

    (WHOQOL-BREF) [35]

     
    Designed to examine domain level profiles assessing quality of life
     
    Four domains: 

    Physical health; psychological; social relationships; environment

     
    Five point Likert scale with varying anchors
     
    Past two weeks
     
    26
     
    Self-administered

    (estimated 15-20 minutes)

     
    Reliability ranged from .66 to .84. Similar alphas have been shown for test-retest reliability ranging from .66 to .87
     
    Correlation coefficients between the WHOQOL-BREF and SF-36 ranged from .36 to .78 [36]
     
     
    21
     
    Zung self-rating depression scale [37]
     
    Designed to measure Depression
     
    Depression
     
    Four point Likert scale ranging from 1 (A little of the time) to 4 (Most of the time)
     
    Last 5 days
     
    20
     
    Self-administered

    (estimated 10 minutes)

     
    Internal consistency of .58[38]
     
    Scale has produced good discriminant validity as it was found to be the primary discriminating variable in distinguishing depressed from nondepressed participants.

    [39]

     
     

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