The OVIS study: health related quality of life measured by the EORTC QLQ-C30 and -BR23 in German female patients with breast cancer from Schleswig-Holstein

The OVIS study is a population-based study that aims at evaluating medical care in Schleswig-Holstein (Germany). In this paper, the health related quality of life (QoL, EORTC QLQ-C30 and -BR23) of 1,927 women with breast cancer is reported. The global health status/QoL score was comparable to reference data of the age-adjusted German general population, but clinical meaningful differences (≥ 10 points) were found for all functioning scales (with the exception of physical functioning) and for three of the symptom scales/items (fatigue, dyspnoe, insomnia) with OVIS patients showing more deficits. Furthermore, OVIS patients scored higher on the item financial difficulties. Logistic regression analyses revealed that coming from an urban surrounding, having a higher social status and attendance to a regular aftercare predicted a good overall QoL, while factors that were related to perceived complications in the course of the therapy raised the risk for a low QoL rating. It is of interest, that attendance to a rehabilitation and interest in self-help groups independently predicted an increased risk for a low quality of life. Overall, we assume the global QoL is rating slightly too optimistic since major deficits were reported on the specific physical and functional scales/items.     

The EORTC breast cancer-specific quality of life questionnaire (EORTC QLQ-BR23): Translation and validation study of the Iranian version

The objective of this study was to test the reliability and validity of the Iranian version of the European Organization for Research and Treatment of Cancer (EORTC) Breast Cancer-Specific Quality of Life Questionnaire (QLQ-BR23). The English-language version of the questionnaire was translated into Persian (Iranian language) and its final form was approved by the EORTC Study Group on Quality of Life and then it was used in this study. The questionnaire was administered at two points in time to a consecutive sample of 168 newly diagnosed breast cancer patients and almost all of them (99%) found the questions easy to understand and acceptable. Cronbach's coefficient for multi-item scales (to test reliability) ranged from 0.63 to 0.95 at baseline and from 0.75 to 0.92 at follow-up administration of the questionnaire. Validity analysis was performed using known-groups' comparison analysis. The results showed that all functional and symptom scales discriminated between sub-groups of patients differing in clinical status as defined by their performance status and disease stage. In addition, all functional and symptoms scales detected change over time, as a function of changes in patients' performance status. In general, the findings of this study indicated that the Iranian version of the EORTC QLQ-BR23 is a reliable and valid supplementary measure of the quality of life in breast cancer patients and can be used in clinical trials and studies of outcome research in oncology.     

Psychometric properties and responsiveness of the EORTC Quality of Life Questionnaire (QLQ-C30) in patients with breast,ovarian and lung cancer

The QLQ-C30, a health-related quality of life questionnaire developed for use in patients with cancer, has been previously validated in patients with lung cancer and head and neck cancer. In this study, further validation was carried out for 535 patients, including patients with breast cancer (n=143) and ovarian cancer (n=111) for whom there is no previously published validation, as well as patients with lung cancer (n=121). All patients were entered in one of two trials of anti-emetics to prevent chemotherapy-induced emesis. The QLQ-C30 was completed before chemotherapy and on day 8 after chemotherapy. The factor structure in patients with breast and ovarian cancer was similar to that previously described. Interdomain correlations, in the entire group, were strongest for the physical and role function domains and the fatigue, pain and global quality of life.domains before and after chemotherapy. In addition, after chemotherapy, social function was also strongly correlated with fatigue and global quality of life. These correlations were not always of equal strength in the breast, ovarian and lung groups, suggesting that there may be differences between these groups. The responsiveness of the QLQ-C30 in the presence of widely metastatic, as compared with locoregional, disease showed changes in the expected directions (i.e., diminished function in physical and social role functions and in global quality of life, with greater fatigue and pain in patients with metastatic disease). Eight days after chemotherapy, decreases were seen in physical, role and social functioning and in global quality of life, and there was greater fatigue, nausea and vomiting compared with before chemotherapy. Patients with breast cancer had better physical, role and social functioning, and less fatigue and pain than patients with ovarian cancer. This result is expected, since many of the patients with breast cancer had early stage disease, whereas those with ovarian cancer had advanced stage disease. Mean scores for patients with lung cancer were between the other two groups, in keeping with the mixture of early and advanced stage disease in these patients. There was a strong correlation between ECOG performance status scores and several domains of the QLQ-C30; these were all in the expected directions. The results of this study confirm those in earlier studies on patients with lung cancer, and provide new information on patients with breast and ovarian cancer. In addition, the QLQ-C30 is responsive to the effects of chemotherapy and of metastatic disease.     

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

The purpose was to develop and validate a new instrument suitable for measuring perceived quality of life in women with breast cancer. The instrument is to be used within conventional cancer therapy as well as in complementary care, and is called the LSQ-32 (Life Satisfaction Questionnaire). The subjects were 362 women with breast cancer in all cancer stages. Cronbach's reliability coefficient of the LSQ was 0.89. The construct validity was estimated by a principal component analysis. Six orthogonal factors were identified: (1) Quality of family relation, (2) Physical symptoms, (3) Socioeconomic situation, (4) Quality of daily activities, (5) Sickness impact and (6) Quality of close friend relation. The criterion-related validity was estimated by comparing the LSQ-32 and the EORTC QLQ-C30. The scales/items of the EORTC QLQ-C30 were represented in the LSQ-32, but the factors Quality of family relation and Quality of close friend relation were not found in the EORTC QLQ-C30. It was concluded that the LSQ-32 as well as the EORTC QLQ-C30 are valuable tools in the measurement of quality of life in women with breast cancer. The LSQ-32, however, also contains an existential factor.The study was approved on 1992 04 08 by the Research Ethical Committee, Faculty of Health Sciences, University of Linköping.     

Quality of life of lung cancer patients: Validation of the Taiwan Chinese version of the EORTC QLQ-C30 and QLQ-LC13

The purpose of this study was to test the validity and reliability of the Taiwan Chinese translation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30, version 3) and Quality of Life Questionnaire Lung Cancer-13 (QLQ-LC13) questionnaires. Consecutively 51 patients with lung cancer undergoing active chemotherapy and 48 such patients undergoing regular follow-up completed the questionnaires. The intraclass correlation between test and retest ranged from 0.46 to 0.85 for the QLQ-C30 and was 0.76 for dyspnea for the QLQ-LC13. The kappa coefficients between test and retest ranged from 0.51 to 0.73 for single items of the QLQ-C30 and 0.49-0.68 for five of the nine items in the QLQ-LC13. The Cronbach's alpha coefficients were > or = 0.70 for all scales of the two questionnaires apart from that of cognitive functioning. The correlation coefficients between indices measuring similar dimensions of the EORTC QLQ-C30 and the SF-36 questionnaires ranged from 0.43 to 0.73, and that between the dyspnea scales of the two EORTC questionnaires was 0.70. Patients in the follow-up group revealed higher scores of global status/quality of life, and lower scores of nausea/vomiting, as also physical functioning. The questionnaires could also detect expected adverse effects of radiotherapy, cisplatin, and paclitaxel.     

Translation and validation of the Standard Chinese version of the EORTC QLQ-C30

The majority of quality of life (QOL) questionnaires have been developed and used in English-speaking or Western European countries. The aims of this study were to provide the Standard Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30 version 2.0), and evaluate its psychometric properties. The translation process included independent translation, back translation, a pilot test with gynecological cancer patients, and a review and approval by the original developers. Participants in the major study included gestational trophoblastic disease patients (n = 68), ovarian cancer patients (n = 105), and other types of gynecological cancer patients (n = 18). The average completion time of the Standard Chinese version was 8.1 ± 2.9 min. All item-subscale correlation coefficients exceeded the criterion of item-convergent validity (r > 0.40) except item 1, 5, 20, and 25, and all items correlated significantly higher with their own subscale than with other subscales except item 1, 20, and 25. The correlation coefficients among all subscales were significant but modest (r = 0.40–0.70). Seven out of nine subscales met the minimal standards of reliability (Cronbach's > 0.70). In conclusion, the Standard Chinese version of the EORTC QLQ-C30 is a valid instrument overall in assessing the QOL of Chinese gynecological cancer patients.     

Validity,reliability and clinical relevance of EORTC QLQ-C30 and LC13 in patients with chest malignancies in a palliative setting

Aims To evaluate the reliability and validity of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and LC13 questionnaire in a palliative setting, and to undertake a broad clinical evaluation of the questionnaire. Patients One hundred and twelve patients with advanced lung cancer or pleural mesothelioma, not amenable to curative or life-prolonging treatment, were consecutively included. Methods Construct validity and reliability of the EORTC questionnaire were examined by multitrait analysis and internal consistency. Criterion validity was examined by variance by and correlation with an array of clinical measures, including tumour stage, performance status, 6-min walk test, spirometry, and blood tests. Concurrent validity was evaluated by established scales for emotional distress and pain. Results With the exception of cognitive functioning, reliability and construct validity of the QLQ-C30 was confirmed. Criterion and concurrent validity was supported for most of the functioning and symptom scales. In a multivariate stepwise regression analysis, EORTC physical functioning was predicted by performance status and 6-min walk distance (r ² = .70), emotional functioning by HADS anxiety ratings (r ² = .59), and global quality of life by performance status, HADS depression ratings, and FEV1 %predicted (r ² = .50). Conclusion The results support the validity and clinical relevance and of the EORTC questionnaire in a palliative setting.     

乳腺癌患者综合社会支持干预效果评价

目的探讨综合社会支持干预对提高乳腺癌患者术后应对能力和生命质量的效果。方法按病区将98例乳腺癌术后患者分为实验组和对照组各49例,实验组接受综合社会支持干预,对照组接受常规护理。分别在术后1~5天内及术后1个月、3个月进行社会支持、应对和生命质量各指标的测量。结果干预后,实验组和对照组的社会支持得分、应对量表8个方面得分和生命质量的生理维度、心理维度、和医务人员关系维度的得分及生命质量总分均的差异均存在统计学意义（P〈0.05）,社会支持得分、应对量表得分和生命质量得分均随干预时间推移而变化,干预方法与干预时间存在交互作用。结论综合社会支持干预可以提升患者对社会支持的感知度,增强正性应对,提高患者的生命质量。     

Mapping the cancer-specific EORTC QLQ-C30 and EORTC QLQ-BR23 to the generic EQ-5D in metastatic breast cancer patients

Purpose

To develop a mapping algorithm for a conversion of the EORTC QLQ-C30 and EORTC QLQ BR-23 into the EQ-5D-derived utilities in metastatic breast cancer (MBC) patients.

Methods

We enrolled 199 patients with MBC from four leading Korean hospitals in 2009. EQ-5D utility, cancer-specific (QLQ-C30) and breast cancer-specific quality of life data (QLQ-BR23) and selected clinical and demographic information were collected from the study participants. Ordinary least squares regression models were used to model the EQ-5D using QLQ-C30 and QLQ-BR23 scale scores. To select the best model specification, six different sets of explanatory variables were compared.

Result

Regression analysis with the multiitem scale scores of QLQ-C30 was the best-performing model, explaining for 48.7% of the observed EQ-5D variation. Its mean absolute error between the observed and predicted EQ-5D utilities (0.092) and relative prediction error (2.784%) was among the smallest. Also, this mapping model showed the least systematic errors according to disease severity.

Conclusions

The mapping algorithms developed have good predictive validity, and therefore, they enable researchers to translate cancer-specific health-related quality of life measures to the preference-adjusted health status of MBC patients.     

Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer

A revision of the Quality of Life Questionnaire (QLQ-C30) of the European Organization for Research and Treatment of Cancer (EORTC) was undertaken to improve low internal consistency estimates (Cronbach's alpha) and content validity for the role functioning scale and a conceptual difficulty (undue emphasis on physical functioning) in the global quality of life (QOL) scale. The role functioning items were reworded and a four-category response format was substituted for the previous dichotomous format. A new item asking about overall health was substituted for the overall physical condition item in the global QOL domain. The original and new versions were tested at three time points in a total of 1,181 patients with cancer in Canada (n=696) and the Netherlands (n=485). In both samples there was a marked improvement in internal consistency for the role functioning scale (Cronbach's alphas ranging from 0.78-0.88) in the new version. In the global QOL scale, the substitution of the new item for the previous one did not alter internal consistency (Cronbach's alphas ranging from 0.81-0.92). The revised versions of the role functioning and global QOL domains have been incorporated into the QLQ-C30 (version 2.0).     

综合心理干预对乳腺癌化疗期间情绪及生存质量的影响

目的探讨综合心理干预对乳腺癌患者化疗期间抑郁、焦虑情绪及生存质量的影响。方法将南阳市中心医院2012年10月—2013年12月收治的133例乳腺癌化疗患者随机分为对照组和干预组,对照组仅接受常规化疗和护理,干预组接受额外的综合心理干预治疗,干预前后应用生命质量测定量表（FACT-B4.0）,抑郁自评量表（SDS）,焦虑自评量表（SAS）进行评分。结果综合心理干预后患者抑郁、焦虑情绪得到了显著改善（P〈0.05）,生存质量测定量表显示干预后患者社会状况、情感状况明显提高（P〈0.05）。结论对乳腺癌患者进行综合心理干预能够有效改善患者的情绪状态,提高生存质量。     

Validating and Improving the Reliability of the EORTC QLQ-C30 Using a Multidimensional Rasch Model

ObjectiveThe reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) has not been examined while taking into account the correlation between subscales. The reliability of the EORTC QLQ-C30 subscales is modest, thus limiting their utility in both clinical and research settings. The purpose of this study was to validate the factor structure of multiple-item subscales of the EORTC QLQ-C30 and to improve their reliability by means of an item response analysis by using the multidimensional partial credit model.MethodsA total of 2295 patients with complete data were used for the analysis. One- and nine-dimensional partial credit models were used to fit the data to validate the construct validity of the multiple-item subscales of the QLQ-C30.ResultsThe model comparison showed that the nine-dimensional factor structure of multiple-item subscales was satisfactory. The multidimensional partial credit model fit data of the multiple-item subscales of the QLQ-C30 reasonably well. The estimated test reliabilities of each domain obtained from the multidimensional approach were higher than those obtained from the unidimensional approach.ConclusionsThe constructs represented by the multiple-item subscales of the QLQ-C30 were validated. The improved reliability of the multiple-item subscales of the QLQ-C30 under the multidimensional approach can facilitate their applications in clinical and research settings.     

移动医疗应用程序干预对乳腺癌患者生活质量影响的meta分析

目的 系统评价移动医疗应用程序(mobile health application,M-health APP)干预对乳腺癌患者生活质量的影响.方法 计算机检索多个数据库,时间限定为建库-2020年3月.收集M-health APP干预对乳腺癌患者生活质量影响的随机对照研究或类实验性研究,根据研究异质性采用meta分析或...     

优质护理在乳腺癌手术患者中的应用效果

目的：探讨优质护理在乳腺癌手术患者中应用的效果。方法：将56例乳腺癌手术患者随机分为对照组和观察组,各28例,分别给予常规护理和优质护理。比较两组患者术后生活质量及患侧上肢功能康复情况。结果：观察组患者生活质量总分、躯体活动、心理活动、社会活动方面改善程度、患侧上肢功能恢复程度均明显优于对照组。结论：优质护理能有效提高护理质量,明显改善乳腺癌手术患者的生活质量。     

Validation of the Korean version of the EORTC QLQ-C30

This study evaluated the Korean version of the EORTC QLQ-C30 (version 3.0) in terms of psychometric properties and its validation. One hundred and seventy patients completed three questionnaires EORTC QLQ-C30, the Beck depression inventory (BDI), and a brief pain inventory (BPI). Multitrait scaling analyses demonstrated that all scales met multidimensional conceptualization criteria, in terms of convergence and discrimination validity. Cronbach's alpha coefficients for eight multiple-item scales were greater than 0.70, with the exception of cognitive functioning. All interscale correlations were statistically significant in the expected direction (p < 0.01). Multivariate analyses showed that physical and emotional functioning were significant explanatory variables for the global quality-of-life (QOL) scale (regression coefficients: 0.36, p < 0.001; and 0.37, p < 0.001; respectively). All scales were significantly associated with pain severity and interference of the BPI, and with the cognitive-affective and somatic scales of the BDI. The emotional-functioning scale was substantially correlated with the cognitive-affective scale and somatic scale of the BDI. These results demonstrate that the Korean version of the EORTC QLQ-C30 is a valid instrument for evaluating Korean-speaking patients with cancer, and can be used to distinguish clearly between subgroups of patients of differing performance status.     

乳腺癌患者生存质量的影响因素

乳腺癌是女性常见的恶性肿瘤,直接损害了患者的第二性征,影响了患者的生存质量。影响乳腺癌患者生存质量的因素很多,本文主要从一般人口学特征(年龄、婚姻状况、文化程度、经济状况)心理因素、社会因素、病理分期、治疗方式等几个方面对乳腺癌患者生存质量影响因素进行综述。     

团体疗法对乳腺癌患者干预效果的Meta分析

目的 系统评价团体疗法对乳腺癌患者的干预效果。方法 计算机检索Embase、PubMed、Web of Science、中国生物医学文献数据库、中国知网、万方、维普中团体疗法对乳腺癌患者干预效果的随机对照研究,并对纳入的文献进行质量评价与数据提取,采用RevMan 5.3软件进行统计分析。结果 最终纳入12篇文献,共患者753例。Meta分析结果显示,较常规干预措施,团体干预疗法对乳腺癌患者焦虑（SMD = - 0.39,95%CI:- 0.57～- 0.21,P＜0.01）、抑郁（SMD = -0.69,95%CI:- 1.09～- 0.30,P＜0.01）情绪有明显改善,同时缓解患者疲劳感（P = 0.003）、提升其生活质量（P＜0.001）。结论 团体干预疗法能够缓解乳腺癌患者焦虑、抑郁和疲劳感,并提升生活质量。     

Multidimensional Computerized Adaptive Testing of the EORTC QLQ-C30: Basic Developments and Evaluations

Objective: Self-report questionnaires are widely used to measure health-related quality of life (HRQOL). Ideally, such questionnaires should be adapted to the individual patient and at the same time scores should be directly comparable across patients. This may be achieved using computerized adaptive testing (CAT). Usually, CAT is carried out for a single domain at a time. However, many HRQOL domains are highly correlated. Multidimensional CAT may utilize these correlations to improve measurement efficiency. We investigated the possible advantages and difficulties of multidimensional CAT. Study design and setting: We evaluated multidimensional CAT of three scales from the EORTC QLQ-C30: the physical functioning, emotional functioning, and fatigue scales. Analyses utilised a database with 2958 European cancer patients.Results: It was possible to obtain scores for the three domains with five to seven items administered using multidimensional CAT that were very close to the scores obtained using all 12 items and with no or little loss of measurement precision.Conclusion: The findings suggest that multidimensional CAT may significantly improve measurement precision and efficiency and encourage further research into multidimensional CAT. Particularly, the estimation of the model underlying the multidimensional CAT and the conceptual aspects need further investigations.     

Population-based study of the relationship of treatment and sociodemographics on quality of life for early stage breast cancer

Objective: To examine the relationship between cancer stage, surgical treatment and chemotherapy on quality of life (QOL) after breast cancer and determine if sociodemographic characteristics modify the observed relationships. Methods: A population-based sample of women with Stages 0–II breast cancer in the United States (N=1357) completed surveys including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and the Breast Cancer-Specific Quality of Life Questionnaire (QLQ BR-23). Regression models calculated mean QOL scores across primary surgical treatment and chemotherapy. Clinically significant differences in QOL were defined as 10 point difference (out of 100) between groups. Results: Meaningful differences in QOL by surgical treatment were limited to body image with women receiving mastectomy with reconstruction reporting lower scores than women receiving breast conserving surgery (p < 0.001). Chemotherapy lowered QOL scores overall across four QOL dimensions (p values < 0.001), with a disproportionately greater impact on those with lower levels of education. Younger women reported lower QOL scores for seven of nine QOL dimensions (p values < 0.001). Conclusions: Women should be reassured that few QOL differences exist based on surgical treatment, however, clinicians should recognize that the impact of treatment on QOL does vary by a woman’s age and educational level.     

Quality of life in patients of nasopharyngeal carcinoma: Validation of the Taiwan Chinese version of the EORTC QLQ-C30 and the EORTC QLQ-H&N35

The authors followed the guidelines of translation and pilot testing of the EORTC QLQ-C30 and EORTC-QLQ-H&N35 questionnaires. The questionnaires were given to 50 nasopharyngeal carcinoma patients under active treatment and 50 under follow-up at our institution from November 2000 to June 2001. A retest was conducted 2 weeks after the first interview/form completion for the follow-up group. The intraclass correlation coefficients of the two questionnaires were moderate to high in the follow-up group. Cronbach's coefficients of all scales of the two questionnaires were 0.70 except that of cognitive functioning. Correlation of scales measuring similar dimensions of the QLQ-C30 and the SF-36 were moderate to high, while that of the QLQ-H&N35 and the QLQ-C30 and the SF-36 were moderate to low. Patients in the active treatment group had more serious acute problems due to disease and chemotherapy. Patients in the follow-up group had more serious chronic problems due to radiation therapy. We concluded that the Taiwan Chinese version of the EORTC QLQ-C30 and the EORTC QLQ-H&N35 had moderate to high test–retest reliability, high internal consistency in most scales, and could show the expected differences between patients in active treatment and follow-up group.