Evidence-Based Nursing Unit, National University Hospital, Singapore.
Int J Evid Based Healthc. 2012 Mar;10(1):27-52. doi: 10.1111/j.1744-1609.2012.00252.x.
The aim of this review was to analyse the literature critically and present the best available evidence related to quality of life (QoL) instruments that consists of all four subscales of physical, psychological, social and spiritual, which can be used in the clinical setting to assess adult patients with cancer on chemotherapy.
This review included randomised control trials and observational studies without control group related to QoL instruments used for cancer chemotherapy. The types of participants for this review included all adults with cancer over the age of 18 years who have undergone chemotherapy. The QoL instruments for this review included instruments that consist of all subscales of physical, psychological, social and spiritual. In order to retrieve QoL instruments that were current and not outdated, this review included studies reported in the recent 10 years.
A three-step search strategy was utilised to search for primary research articles published in the English language from January 1998 to December 2009. An initial search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and the text terms used to describe the article. A second search strategy using all the identified keywords and the index terms was used for the 20 databases. The third search strategy was to search for additional studies from the relevant list of all identified articles.
The two independent reviewers appraised the included articles for methodological quality using the modified Elliot tool for reliability and validity.
A total of 3149 references was retrieved during the initial search. Only 13 articles with validation of the QoL instruments that contained all the four subscales of physical, psychological, social and spiritual were included in this review. Four QoL instruments were identified. These include the City of Hope QOL - Ovarian Cancer Tool (QOL-OVCA), QOL-Breast cancer version (QOL-BC), New India QoL tool and QoL Index-Cancer version (QLI-CV). Among the four identified QoL instruments, the frequency of assessment was more than once for QLI-CV, with intervals of 2 weeks to 6 months. Regarding the number of items, the QOL-BC instrument has the most number of items. All identified QoL instruments have content validity done. For reliability examination, all the identified QoL instruments have Cronbach's alpha of 0.7 and above for subscales. The correlation between subscales scores and overall QoL score was 0.53-0.93, 0.39-0.95 and 0.65-0.83 for QOL-OVCA, QOL-BC and QLI-CV, respectively.
In this review, there was one article on development of new QoL instrument, the New India QoL tool, which has comprehensive validity examinations - the least number of items that may be useful in the clinical setting but need further psychometric testing in different settings or languages. The QLI-CV instrument has had comprehensive intra- and inter-method validation on different languages, different cultural settings and various types of cancer. However, the instrument may not be feasible because the method to calculate the QoL score is not straightforward.
本综述的目的是批判性地分析文献，并呈现与生活质量（QoL）工具相关的最佳现有证据，这些工具包括身体、心理、社会和精神四个方面。这些工具可用于临床环境中评估接受化疗的成年癌症患者。
本综述纳入了与用于癌症化疗的 QoL 工具相关的随机对照试验和无对照组的观察性研究。本综述的参与者类型包括所有年龄在 18 岁以上接受过化疗的成年癌症患者。本综述的 QoL 工具包括包含身体、心理、社会和精神所有方面的工具。为了检索到最新的且不过时的 QoL 工具，本综述纳入了近 10 年发表的研究。
采用三步式检索策略，从 1998 年 1 月至 2009 年 12 月，在英语文献中检索初级研究文章。首先对 MEDLINE 和 CINAHL 进行了初步搜索，然后对标题和摘要中包含的文本词以及用于描述文章的文本词进行了分析。其次，使用所有确定的关键词和索引词对 20 个数据库进行了二次搜索。最后，从所有确定文章的相关列表中搜索其他研究。
两位独立的评审员使用经过修改的 Elliot 工具对纳入的文章进行了可靠性和有效性评估。
在最初的搜索中，共检索到 3149 篇参考文献。只有 13 篇文章对包含身体、心理、社会和精神四个方面的 QoL 工具进行了验证，被纳入了本综述。确定了 4 种 QoL 工具。这些工具包括希望之城卵巢癌 QOL 工具（QOL-OVCA）、乳腺癌 QOL 工具（QOL-BC）、印度新 QoL 工具和癌症 QOL 指数工具（QLI-CV）。在确定的四种 QoL 工具中，QLI-CV 的评估频率超过一次，间隔为 2 周到 6 个月。关于项目数量，QOL-BC 工具的项目最多。所有确定的 QoL 工具都具有内容有效性。在可靠性检查方面，所有确定的 QoL 工具的子量表的 Cronbach's alpha 均为 0.7 及以上。QOL-OVCA、QOL-BC 和 QLI-CV 的子量表评分与总体 QoL 评分之间的相关性分别为 0.53-0.93、0.39-0.95 和 0.65-0.83。
在本综述中，有一篇关于新 QoL 工具开发的文章，即印度新 QoL 工具，该工具具有全面的有效性检查，即项目数量最少，可能在临床环境中有用，但需要在不同环境或语言中进行进一步的心理测量学测试。QLI-CV 工具已在不同语言、不同文化背景和不同类型的癌症中进行了全面的内部和外部方法验证。然而，由于计算 QoL 评分的方法并不简单，该工具可能并不实用。
