[Measurement of quality of life. Application to the screening of psychological distress in cancer patients].

As cancer treatments are becoming more and more traumatic the quality of life of these patients must be taken into consideration. This study was set up in 1982 and aimed at screening patients suffering from major psychological distress using a quantitative assessment of the quality of life. A self-administered questionnaire (QLQ) and linear analogues (LA) were developed and validated. The patient's acceptance of these two measuring instruments was tested on a sample group of patients in the Oncology Department of Besançon University Hospital and gave a result of 94% which was higher than that of a psychological interview (64%). A comparison of the assessment of the quality of life by the patient, the psychologist and the physician is an important phase in this concept. Agreement by the doctor and the patient using the Karnofsky indices was moderate (62% of the cases using a simplified scale): patients tended to overstate the extremes. The overall scores and the different questionnaire items completed by the patient and the psychologist were correlated, but agreement varied according to each item. An attempt was made to establish a predictive value for the questionnaire and the linear analogues to identify patients suffering from major psychological distress and requiring psychosocial support by comparing the results of the tests with the assessment of the psychologist during an interview. A stepwise logistical regression selected a combination of three items which screened more than 80% of these patients. The linear analogues were not sufficiently discriminatory to be used. The overall results suggest that a quality of life measurement can be integrated into daily clinical practice.