Development of the Facial Skin Care Index: A Health-Related Outcomes Index for Skin Cancer Patients |
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Authors: | B. ALEX MATTHEWS PhD JOHN S. RHEE MD MARCY NEUBURG MD MARY L. BURZYNSKI RN ANN B. NATTINGER MD MPH |
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Affiliation: | Health Policy Institute, Center for Patient Care & Outcomes Research, Department of Otolaryngology and Communication Sciences, Froedtert Memorial Lutheran Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin 53226-0509, USA. amatthew@mcw.edu |
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Abstract: | BACKGROUND: Existing health-related quality-of-life (HRQOL) tools do not appear to capture patients' specific skin cancer concerns. OBJECTIVE: To describe the conceptual foundation, item generation, reduction process, and reliability testing for the Facial Skin Cancer Index (FSCI), a HRQOL outcomes tool for skin cancer researchers and clinicians. METHODS: Participants in Phases I to III consisted of adult patients (N=134) diagnosed with biopsy-proven nonmelanoma cervicofacial skin cancer. Data were collected via self-report surveys and clinical records. RESULTS: Seventy-one distinct items were generated in Phase I and rated for their importance by an independent sample during Phase II; 36 items representing six theoretical HRQOL domains were retained. Test-retest I results indicated that four subscales showed adequate reliability coefficients (alpha=0.60 to 0.91). Twenty-six items remained for test-retest II. Results indicated excellent internal consistency for emotional, social, appearance, and modified financial/work subscales (range 0.79 to 0.95); test-retest correlation coefficients were consistent across time (range 0.81 to 0.97; lifestyle omitted). CONCLUSION: Pretesting afforded the opportunity to select items that optimally met our a priori conceptual and psychometric criteria for high data quality. Phase IV testing (validity and sensitivity before surgery and 4 months after Mohs micrographic surgery) for the 20-item FSCI is under way. |
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