Giesler R B, Miles B J, Cowen M E, Kattan M W
Indiana University Schools of Medicine & Nursing, Indianapolis, USA.
Qual Life Res. 2000;9(6):645-65. doi: 10.1023/a:1008931703884.
Quality of life in prostate cancer patients with clinically localized disease has become the focus of increasing attention over the past decade. However, few instruments have been developed and validated to assess quality of life specifically in this patient population.
The purpose of this investigation was to create a comprehensive, multi-scale quality of life instrument that can be tailored to the needs of the clinician/investigator in multiple settings. DESIGN, SUBJECTS, AND MEASURES: Patients diagnosed with clinically localized prostate cancer were mailed a questionnaire consisting of new and previously validated quality of life items and ancillary scales. Data from returned questionnaires were analyzed and used to create a multiscale instrument that assesses the effects of treatment and disease on urinary, sexual, and bowel domains, supplemented by a scale assessing anxiety over disease course/effectiveness of treatment. The instrument was then mailed to a second sample of prostate cancer patients once and then again two weeks later to assess test retest reliability. To assess feasibility in clinical settings, the instrument was self-administered to a third patient sample during a urology clinic visit.
All scales exhibited good internal consistency and test retest reliability, convergent and discriminant validity, and significant correlations with disease specific, generic health-related, and global measures of quality of life. Men with greater physiologic impairment reported more limitations in role activities and more bother. Scales were also able to differentiate patients undergoing different therapies. All scales exhibited negligible correlations with a measure of socially desirable responding. Additionally, the instrument proved feasible when used as a self-administered questionnaire in a clinical setting.
The current instrument possesses brief multi-item scales that can be successfully self-administered in multiple settings. The instrument is flexible, relatively quick, psychometrically reliable and valid, and permits a more comprehensive assessment of patients' quality of life.
在过去十年中，临床局限性前列腺癌患者的生活质量已成为日益关注的焦点。然而，针对这一特定患者群体专门开发和验证的用于评估生活质量的工具却很少。
本研究的目的是创建一种全面的、多维度的生活质量工具，该工具可以根据临床医生/研究人员在多种环境中的需求进行定制。
设计、研究对象与测量方法：向被诊断为临床局限性前列腺癌的患者邮寄一份问卷，问卷包含新的以及先前已验证的生活质量项目和辅助量表。对回收问卷的数据进行分析，并用于创建一个多维度工具，该工具评估治疗和疾病对泌尿、性和肠道领域的影响，并辅以一个评估对疾病进程/治疗效果焦虑程度的量表。然后将该工具邮寄给另一组前列腺癌患者样本一次，两周后再次邮寄，以评估重测信度。为了评估在临床环境中的可行性，在泌尿外科门诊就诊期间，让第三组患者样本自行填写该工具。
所有量表均表现出良好的内部一致性、重测信度、聚合效度和区分效度，并且与疾病特异性、一般健康相关和总体生活质量测量指标具有显著相关性。生理损伤较大的男性在角色活动方面报告有更多限制且困扰更多。量表还能够区分接受不同治疗的患者。所有量表与社会期望反应测量指标的相关性均微不足道。此外，当在临床环境中作为自行填写的问卷使用时，该工具被证明是可行的。
当前的工具拥有简短的多项目量表，能够在多种环境中成功地自行填写。该工具灵活、相对快捷、心理测量学上可靠且有效，并且能够对患者的生活质量进行更全面的评估。
