Measurement of quality of life in bone marrow transplantation survivors

This study was designed to assess the reliability and validity of a Quality of Life (QOL) instrument on a sample of 179 allogeneic Bone Marrow Transplant (BMT) survivors. The QOL-BMT tool was developed specifically for this population and was based on the investigators' prior research and a conceptual model of Quality of Life. Patients who were at least 100 days post BMT completed the 30 item visual analogue questionnaire. The instrument measured physical symptoms (e.g., weight loss, frequent colds, skin changes, cataracts, sexual problems), psychological to illness, social concerns (e.g., relationship adjustment, return to work), and spiritual well-being (e.g., sense of control, future goals). Psychometric analysis of the instrument included measures of reliability and validity. The study findings demonstrate the unique aspects of QOL dimensions in BMT survivors and the value of QOL assessment in clinical practice and research.This study was supported by the City of Hope National Medical Center, NCI Cancer Center Core Grant, R30 CA 33572 and the City of Hope BRSG Grant Support.     

The impacts of breast conserving treatment and mastectomy on the quality of life in early-stage breast cancer patients

The quality of life (QOL) in 55 early-stage breast cancer patients after surgery was prospectively assessed using a newly developed Japanese QOL questionnaire: The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD). The impacts of breast conserving treatment (BCT) (22 cases) and modified radical mastectomy (MRM) (33 cases) on the QOL in those subjects were compared. The overall QOL scores were evaluated during four periods (before surgery, 0–2, 3–12, and 13–24 months after surgery). The mean scores of the four categories of the QOL-ACD (activity, physical condition, psychological condition, and social relationships) were also compared. The results demonstrated that a significant improvement was observed in the overall QOL scores among the three periods after surgery (0–2, 3–12, and 13–24 months) only in the BCT group (P<0.05). There were no significant differences between the two groups in the overall QOL scores during any of the three periods after surgery, and the mean score of the ‘psychological condition’ during 0–2 months period in the BCT group was significantly lower than that in the MRM group (P< 0.05).     

Analysis of the factors influencing the quality of life of patients with advanced or recurrent breast cancer

To investigate the factors influencing the quality of life (QOL) of Japanese patients with advanced or recurrent breast cancer, a newly developed QOL questionnaire, The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD), was answered by 23 patients, and a multiple regression analysis was performed. The demographic and medical factors relating to the overall QOL score and to the four categories of the QOL-ACD, namely (1) activity, (2) physical condition, (3) psychological condition, and (4) social relationships, were analyzed. The results indicated that skin metastasis, a heavier body weight, and bone metastasis had a strong negative influence on the overall QOL scroe, whereas endocrine therapy, the existence of a primary lesion, and more extensive first surgery had a strong positive influence on it. With regard to the analysis of the four categories, endocrine therapy was found to be positively related to all four categories. The multiple correlation coefficient (R) between the estimated overall QOL score and the observed overall QOL score was about 0.77. The results of this analysis showed that endocrine therapy can improve the QOL of patients with advanced or recurrent breast cancer, and that the QOL-ACD questionnaire could prove extremely useful for predicting the QOL of individual patients and for aiding clinicians in deciding on the most appropriate type of therapy for each patient.     

癌症患者生活质量评估量表QLQ-52的设计及质量评价

目的:设计一套适合中国文化背景的癌症患者生活质量评估量表QLQ52。方法:通过对133名癌症患者的测评,以考核所设计的QLQ52的信度、效度、反应度以及可行性。结果:QLQ52由52项指标构成,反映了癌症患者生理、心理、独立性、社会关系及环境、精神支柱和满意度6个方面;QLQ52的被测者信度Pearson相关系数为0.334(P<0.01),分半信度为0.9242,α系数0.9404,内容效度94.00%,结构效度系数0.87,准则关联效度Pearson相关分析系数0.574(P<0.01);反应度:治疗前、中的癌症患者的生活质量与治疗后比较差异有显著性(P<0.05);可行性:完整率93.66%,填表完成时间的均数为14.30分钟,中位数为12分钟。结论:QLQ52量表具有较好的信度、效度、反应度和临床应用可行性,可试用于评价我国癌症患者的生活质量。     

氨溴索对慢性支气管炎患者生存质量的影响

目的 :探讨氨溴索对慢性支气管炎患者生存质量的影响。方法 :52例慢性支气管炎患者随机分成氨溴索治疗组 (n=26)和对照组 (n=26)。对照组酌情使用茶碱缓解剂。氨溴索治疗组在对照组基础上使用口服氨溴索 ,每次30mg,每日3次 ,均于餐后服用 ,疗程7～10天。利用生存质量 (QOL)评分标准分别在治疗前、治疗后1周、治疗后2周对两组患者生存质量评估。结果 :氨溴索治疗组治疗后其QOL总均分 (TMS)、日常生活能力 (F1S)、社会活动情况 (F2S)、抑郁心理状态 (F3S)、焦虑心理症状 (F4S)评分较治疗前降低 ,P<0.05 ,有显著意义。而对照组差异无显著意义(P>0.05)。结论 :氨溴索用于慢性阻塞性肺病患者后 ,可以减轻慢性阻塞性肺病患者因痰液粘稠、排痰不畅、痰阻等因素造成的气流阻塞 ,改善患者的呼吸功能 ,使动脉血氧饱和度增加 ,改善缺氧 ,减轻症状 ,增加活动范围 ,从而提高生存质量。     

长沙市留学生社会支持及生活质量满意度研究

目的了解长沙市留学生社会支持及生活质量现状,探讨留学生社会支持的途径,提高长沙市留学生身心健康水平。方法使用觉察社会支持量表（PSSS）和生活质量满意度调查问卷对长沙市4所大学的120名留学生进行问卷调查。结果长沙市留学生社会支持水平普遍较高,但生活质量满意度因专业、学校、宗教信仰、培养方式、性别和学历不同差异有统计学意义（P〈0.05）。结论长沙市高校关注留学生的身心健康,为其提供良好的社会支持。但留学生生活质量满意度因不同因素存在差异,需更多关注留学生中的弱势群体。     

Calibration of Quality-Adjusted Life Years for Oncology Clinical Trials

ContextQuality-adjusted life year (QALY) estimation is a well-known but little used technique to compare survival adjusted for complications. Lack of calibration and interpretation guidance hinders implementation of QALY analyses.ObjectivesWe conducted simulation studies to assess the impact of differences in survival, toxicity rates, and utility values on QALY results.MethodsSurvival comparisons used both log-rank and Wilcoxon testing. We examined power considerations for a North Central Cancer Treatment Group Phase III lung cancer clinical trial (89-20-52).ResultsSample sizes of 100 events per treatment have low power to generate a statistically significant difference in QALYs unless the toxicity rate is 44% higher in one arm. For sample sizes of 200 per arm and equal survival times, toxicity needs to be at least 38% more in one arm for the result to be statistically significant, using a utility of 0.3 for days with toxicity. Sample sizes of 300 (500)/arm provide 80% power if there is a 31% (25%) toxicity difference. If the overall survival hazard ratio between the two treatment arms is 1.25, then samples of at least 150 patients and 13% increased toxicity are necessary to have 80% power to detect QALY differences. In study 89-20-52, there was only 56% power to determine the statistical significance of the observed QALY differences, clarifying the enigmatic conclusion of no statistically significant difference in QALY despite an observed 14.5% increase in toxicity between treatments.ConclusionThis calibration allows researchers to interpret the clinical significance of QALY analyses and facilitates QALY inclusion in clinical trials through improved study design.     

Development of a parent-proxy quality-of-life chronic cough-specific questionnaire: clinical impact vs psychometric evaluations

BACKGROUND: Chronic cough affects at least 7% of children, and the impact of this on families is significant. Although adult cough-specific quality-of-life (QOL) instruments have been shown to be a useful cough outcome measure, no suitable cough-specific QOL for parents of children with chronic cough exists. This article compares two methods of item reduction (clinical impact and psychometric) and reports on the statistical properties of both QOL instruments. METHOD: One hundred seventy children (97 boys and 73 girls; median age, 4 years; interquartile range, 3 to 7.25 years) and one of their parents participated. A preliminary 50-item parent cough-specific QOL (PC-QOL) questionnaire was developed from conversations with parents of children with chronic cough (ie, cough for > 3 weeks). Parents also completed generic QOL questionnaires (eg, Pediatric Quality of Life Inventory, version 4.0 [PedsQL4.0] and the 12-item Short Form Health Survey, version 2 [SF-12v2]). RESULTS: The clinical impact and psychometric method of item reduction resulted in 27-item and 26-item PC-QOL questionnaires, respectively, with approximately 50% of items overlapping. Internal consistency among the final items from both methods was excellent. Some evidence for concurrent and criterion validity of both methods was established as significant correlations were found between subscales of the PC-QOL questionnaire and the scales of the SF-12v2 and PedsQL4.0 scores. The PC-QOL questionnaire derived from both methods was sensitive to change following an intervention. CONCLUSION: Chronic cough significantly impacts on the QOL of both parents and children. Although the PC-QOL questionnaires derived from a clinical impact method and from a psychometric method contained different items, both versions were shown to be internally consistent and valid. Further testing is required to compare both final versions to objective and subjective cough measures.     

Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury

Objective

To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury.