Siafaka Vassiliki, Mavridis Dimitris, Tsonis Orestis, Tzamakou Eleftheria, Christogiannis Christos, Tefa Louiza, Arnaoutoglou Eleni, Tzimas Petros, Pentheroudakis George
School of Health Sciences, University of Ioannina, Ioannina, Greece.
Department of Primary Education, University of Ioannina, Ioannina, Greece.
Palliat Support Care. 2024 Aug;22(4):698-708. doi: 10.1017/S1478951522001055.
Assessment of the psychometric characteristics of the Greek version of the brief World Health Organization Quality of Life Instrument (WHOQOL-BREF) in patients with advanced cancer and pain, and exploration of the association between psychological distress and quality of life (QoL).
The sample consisted of 145 patients with advanced cancer and pain who completed the WHOQOL-BREF, the Symptom Checklist-90 (SCL-90), and the Pain Visual Analogue Scale (VAS). In analysis, the following methods were used: Cronbach's alpha, Item Response Theory (IRT), polychoric, Pearson and polyserial correlation, -test, and Linear regression.
The internal consistency was high for all domains of the WHOQOL-BREF (Cronbach's ≥ 0.731). Similarly, with the exception of three items, the WHOQOL-BREF items has large discrimination parameters suggesting that they have a high ability in differentiating subjects. On SCL-90, the three dimensions with the highest scores were Depression, Somatization, and Anxiety. The overall score for psychological distress, the Global Severity Index (GSI), showed significant negative association with all the WHOQOL-BREF factor scores (Physical Health: = -1.488, < 0.001, Psychological Health: = -1.688, < 0.001, Social Relationships: = -0.910, < 0.001, Environment: = -1.064, < 0.001). Male gender was associated with lower scores for Social Relationships ( = -0.358, = 0.007) and Environment ( = -0.293, = 0.026).
The Greek version of the WHOQOL-BREF showed good psychometric properties in patients with advanced cancer and can be used as a reliable instrument in clinical practice. The level of psychological distress can be considered a determinant of QoL in patients with advanced cancer and pain, independently of pain intensity or other clinical characteristics. In cancer, the disease process can activate multiple physiological and psychological mechanisms that lead to a wide range of symptoms of psychological distress. To improve their QoL, psychological intervention focused on the identification and alleviation of psychological distress in patients with advanced cancer, and help in finding meaning in their experience, should be provided.
评估希腊版简短世界卫生组织生活质量量表（WHOQOL - BREF）在晚期癌症及疼痛患者中的心理测量学特征，并探究心理困扰与生活质量（QoL）之间的关联。
样本包括145名患有晚期癌症及疼痛的患者，他们完成了WHOQOL - BREF、症状自评量表90（SCL - 90）以及疼痛视觉模拟量表（VAS）。分析中使用了以下方法：克朗巴哈系数、项目反应理论（IRT）、多态相关、皮尔逊和多系列相关、t检验以及线性回归。
WHOQOL - BREF所有领域的内部一致性都很高（克朗巴哈系数≥0.731）。同样，除了三个项目外，WHOQOL - BREF项目具有较大的区分参数，表明它们在区分受试者方面具有很高能力。在SCL - 90上，得分最高的三个维度是抑郁、躯体化和焦虑。心理困扰的总体得分，即总体严重程度指数（GSI），与所有WHOQOL - BREF因子得分均呈显著负相关（身体健康：r = -1.488，p < 0.001；心理健康：r = -1.688，p < 0.001；社会关系：r = -0.910，p < 0.001；环境：r = -1.064，p < 0.001）。男性在社会关系（r = -0.358，p = 0.007）和环境（r = -0.293，p = 0.026）方面得分较低。
希腊版WHOQOL - BREF在晚期癌症患者中显示出良好的心理测量学特性，可在临床实践中作为可靠工具使用。心理困扰水平可被视为晚期癌症及疼痛患者生活质量的一个决定因素，独立于疼痛强度或其他临床特征。在癌症中，疾病过程可激活多种生理和心理机制，导致广泛的心理困扰症状。为改善他们的生活质量，应提供专注于识别和减轻晚期癌症患者心理困扰并帮助他们从经历中找到意义的心理干预。
