Selby P J, Chapman J A, Etazadi-Amoli J, Dalley D, Boyd N F
Br J Cancer. 1984 Jul;50(1):13-22. doi: 10.1038/bjc.1984.134.
Although the need for a method of measuring the quality of life of patients undergoing therapy for cancer has been widely recognised, no adequately evaluated or feasible method has been established. We describe a method in which 31 items were assessed by patient self report using linear analogue scales. Eighteen items inquiring about general health problems were derived from the Sickness Impact Profile, an established method of assessing the effect of health upon behaviour and function. Thirteen items inquiring about major problems associated with breast cancer were derived from clinical experience and the opinions of patients with this disease. Each item of the measurement method (instrument) has been evaluated for content, feasibility, reliability and validity by methods that are widely used in psychometry but less familiar in medicine. It appeared easy to use, acceptable and reliable in these assessment. Validity was evaluated indirectly since no standard measurements of quality of life exist for comparison. Most items appeared valid when compared to alternative measurement methods including the Sickness Impact Profile and evaluation by a physician in a structured interview. The correlations between items in the instrument were analysed by factor analysis and seemed to fit with the clinical features of breast cancer. The method distinguished between clinically distinct groups of patients and detected changes with time. The study illustrates the possible approaches to the scientific evaluation of methods for measuring subjective features of patients lives. This method appears suitable for some purposes to measure quality of life in breast cancer and is intended to be flexible enough to be modified for other diseases. However, further evaluation, development and refinement will be needed before routine clinical application can be recommended.
尽管人们已广泛认识到需要一种方法来衡量癌症治疗患者的生活质量，但尚未建立一种经过充分评估或可行的方法。我们描述了一种方法，其中31个项目通过患者使用线性模拟量表进行自我报告来评估。询问一般健康问题的18个项目源自疾病影响概况，这是一种评估健康对行为和功能影响的既定方法。询问与乳腺癌相关的主要问题的13个项目源自临床经验和患有这种疾病的患者的意见。测量方法（工具）的每个项目都通过心理测量学中广泛使用但医学领域不太熟悉的方法进行了内容、可行性、可靠性和有效性评估。在这些评估中，它似乎易于使用、可接受且可靠。由于不存在用于比较的生活质量标准测量方法，因此间接评估了有效性。与包括疾病影响概况和结构化访谈中医生评估在内的替代测量方法相比，大多数项目似乎有效。通过因子分析分析了工具中项目之间的相关性，似乎与乳腺癌的临床特征相符。该方法区分了临床上不同的患者群体并检测到随时间的变化。该研究说明了对测量患者生活主观特征的方法进行科学评估的可能方法。这种方法似乎适用于某些目的来测量乳腺癌患者的生活质量，并且旨在具有足够的灵活性以针对其他疾病进行修改。然而，在推荐常规临床应用之前，还需要进一步评估、开发和完善。
