Ferrell B R, Dow K H, Grant M
City of Hope National Medical Center, Department of Nursing Research and Education, Duarte, CA 91010, USA.
Qual Life Res. 1995 Dec;4(6):523-31. doi: 10.1007/BF00634747.
A QOL instrument was developed to measure the specific concerns of long term cancer survivors. The QOL-CS is based on previous versions of the QOL instrument developed by researchers at the City of Hope National Medical Centre (Grant, Padilla, and Ferrell). This instrument was revised over a one year pilot by Hassey-Dow and Ferrell. The revised instrument included 41 items representing the four domains of quality of life incorporating physical, psychological, social, and spiritual well being. The present study was conducted as a mail survey to the membership (n = 1,200) of the National Coalition for Cancer Survivorship with 686 subjects responding to the survey. This survey included a Demographic tool, QOL-CS and the FACT-G tool developed by Cella. Psychometric analysis, performed on 686 respondents, included measures of reliability and validity. Two measures of reliability included test-retest and internal consistency. The overall QOL-CS tool test-retest reliability was 0.89 with subscales of Physical r = 0.88, Psychological r = 0.88, Social r = 0.81, and Spiritual, r = 0.90. The second measure of reliability was computation of internal consistency using Cronbach's alpha coefficient as a measure of agreement between items and subscales. Analysis revealed an overall r = 0.93. Subscale alphas average ranged from r = 0.71 for spiritual well being, r = 0.77 for physical, r = 0.81 for social, and r = 0.89 for psychological. Several measures of validity were used to determine the extent to which the instrument measured the concept of QOL in cancer survivors. The first method of content validity was based on a panel of QOL researchers and nurses with expertise in oncology. The second measure used stepwise multiple regression to determine factors most predictive of overall QOL in cancer survivors. Seventeen variables were found to be statistically significant accounting for 91% of the variance in overall QOL. The fourth measure of validity used Pearson's correlations to estimate the relationships between the subscales of QOL-CS and the subscales of the established FACT-G tool. There was moderate to strong correlation between associated subscales including QOL-CS physical to FACT physical (r = 0.74), QOL-CS Psych to FACT Emotional (r = 0.65), QOL Social to FACT Social (r = 0.44). The overall QOL-CS correlation with the FACT-G was 0.78. Additional measures of validity included correlations of individual items of the QOL-CS tool, factor analysis, and construct validity discriminating known groups of cancer survivors. Findings demonstrated that the QOL-CS and its subscales adequately measured QOL in this growing population of cancer survivors.
开发了一种生活质量（QOL）工具来衡量长期癌症幸存者的特定担忧。QOL-CS基于希望之城国家医疗中心的研究人员（格兰特、帕迪拉和费雷尔）之前开发的QOL工具版本。该工具由哈西-道和费雷尔在为期一年的试点中进行了修订。修订后的工具包括41个项目，代表了生活质量的四个领域，涵盖身体、心理、社会和精神健康。本研究通过邮件调查的方式对全国癌症幸存者联盟的1200名成员进行，共有686名受试者回复了调查。该调查包括一个人口统计学工具、QOL-CS和塞拉开发的FACT-G工具。对686名受访者进行的心理测量分析包括信度和效度测量。信度的两种测量方法包括重测法和内部一致性。QOL-CS工具的整体重测信度为0.89，其中身体亚量表r = 0.88，心理亚量表r = 0.88，社会亚量表r = 0.81，精神亚量表r = 0.90。信度的第二种测量方法是使用克朗巴赫α系数计算内部一致性，以此作为项目和亚量表之间一致性的度量。分析显示整体r = 0.93。亚量表的α系数平均值范围从精神健康的r = 0.71，身体的r = 0.77，社会的r = 0.81，到心理的r = 0.89。使用了几种效度测量方法来确定该工具在多大程度上测量了癌症幸存者的生活质量概念。内容效度的第一种方法基于一组在肿瘤学方面具有专业知识的生活质量研究人员和护士。第二种测量方法使用逐步多元回归来确定最能预测癌症幸存者整体生活质量的因素。发现17个变量具有统计学意义，占整体生活质量方差的91%。效度的第四种测量方法使用皮尔逊相关性来估计QOL-CS亚量表与既定的FACT-G工具亚量表之间的关系。相关亚量表之间存在中度到高度的相关性，包括QOL-CS身体与FACT身体（r = 0.74），QOL-CS心理与FACT情绪（r = 0.65），QOL社会与FACT社会（r = 0.44）。QOL-CS与FACT-G的整体相关性为0.78。其他效度测量方法包括QOL-CS工具单个项目的相关性、因子分析以及区分已知癌症幸存者群体的结构效度。研究结果表明，QOL-CS及其亚量表在这一不断增长的癌症幸存者群体中充分测量了生活质量。
