Psychometric Properties of the Polish Version of the FACIT-Sp-12: Assessing Spiritual Well-Being Among Patients with Chronic Diseases.

BACKGROUND Spirituality plays a crucial role in enhancing quality of life. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) scale is a reliable tool to assess an individual's spiritual well-being, specifically in the context of chronic illness. Although the instrument is widely used worldwide, it has not yet been validated for Polish conditions. The aim of this study was to translate and investigate the reliability and validity of the Polish version of the FACIT-Sp-12 and examine whether it is associated with measures of religiosity and religious practice. MATERIAL AND METHODS The self-administered FACIT-Sp questionnaire, containing 12 spiritual well-being items, was translated into the Polish language, following the FACIT multilingual translation methodology. A group of 355 patients with chronic diseases were enrolled. Validation analysis was conducted. The reliability of the scale and subscales was evaluated with internal consistency coefficients. RESULTS A confirmatory factor analysis corroborated a 3-factor model (Meaning, Peace, and Faith) of the FACIT-Sp-12 Polish version, which showed moderate internal consistency. The Cronbach's alpha coefficient was 0.614 for the overall scale, 0.657 for the Meaning subscale, 0.873 for the Peace subscale, and 0.855 for the Faith subscale. The mean score was 29.46 (SD=6.69) for the overall spiritual well-being scale. Total scores of the FACIT-Sp-12 were strongly correlated with the Polish version of the Duke University Religion Index. CONCLUSIONS The psychometric properties of the Polish version of the FACIT-Sp-12 were satisfactory, and the scale can be used in Poland for assessing the spiritual well-being of patients with chronic illness.

Psychometric properties of the FACT-G quality of life scale for family caregivers of cancer patients.

PURPOSE: This study aimed to examine psychometric properties of a caregiver version of the well-established Functional Assessment of Cancer Therapy-General Scale (FACT-G) after conducting focus groups and obtaining expert input. METHODS: We made minor wording modifications to the Patient FACT-G to enable caregivers to report how the illness affected their overall quality of life (QOL) and well-being on four subscales (physical, social, emotional, functional). We tested the acceptability, precision, factor structure, reliability and validity of the Caregiver FACT-G among partners of prostate cancer patients (N = 263) and caregivers (spouses, siblings, adult children) of patients with advanced cancer (breast, lung, colorectal, prostate) (N = 484) using data from two Randomized Clinical Trials (RCTs). RESULTS: With a factor structure similar to the Patient FACT-G, Caregiver FACT-G was acceptable and precise in measuring caregiver QOL, with high inter-factor correlations and internal consistency reliability (Cronbach's alphas 0.81-0.91). The Caregiver FACT-G had strong convergent validity demonstrated by significant positive correlations with caregiver self-efficacy (0.25-0.63), dyadic communication (0.18-0.51), and social support (0.18-0.54) in both samples. It also had strong discriminant validity evidenced by significant inverse correlations with negative appraisal of caregiving (- 0.37 to - 0.69), uncertainty (- 0.28 to - 0.53), hopelessness (- 0.25 to - 0.60), and avoidant coping (- 0.26 to - 0.58) in both samples. Caregivers' baseline FACT-G scores were significantly associated with their physical (0.23) and mental well-being (0.54; 4-month follow-up) and their depression (- 0.69; 3-month follow-up), indicating strong predictive validity. CONCLUSION: This is the first study evaluating the psychometric properties of the Caregiver FACT-G. More psychometric testing is warranted, especially among caregivers of diverse sociocultural backgrounds.

Measuring Spiritual Well-Being in Brazilian Adolescents with Chronic Illness Using the FACIT-Sp-12: Age Adaptation of the Self-Report Version, Development of the Parental-Report Version, and Validation.

Spiritual well-being is a major issue in health care, but instruments for measuring this construct in adolescents are lacking. This study adapted the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12) for use with Brazilian adolescents with chronic diseases and developed a parental observer-rated version, using an expert panel, back-translation, and cognitive interviews with 72 participants. The psychometric properties of both versions were verified with two- and three-factor models by testing with 212 participants. The self- and parental-reported versions showed face validity, content validity, and acceptable levels of internal consistency for the overall scale and the two-factor model. The convergent validity was satisfactory for most items in both two- and three-factor models, but there was a lack of discrimination in the three-factor model using multitrait-multimethod analysis. This study presents the first instrument to assess the spiritual well-being of adolescents from their point of view and to allow their parents to serve as evaluators. However, we recommend further psychometric testing of the self- and parental-report scales to assess spiritual well-being in adolescents with chronic diseases in Brazil.

Reliability and Validity of the Turkish Version of the FACIT-PAL Quality of Life Instrument.

CONTEXT: The accurate measurement of quality of life (QoL) among people with chronic and incurable illnesses is essential for evaluating service delivery, understanding the impact of illness and treatment effects, and testing intervention effectiveness. Palliative care interventions are relatively new in Turkey; therefore, it is important that reliable and valid QoL instruments are available to evaluate palliative care effectiveness in Turkish speakers. OBJECTIVES: The purpose of this study was to translate, linguistically validate, and determine the psychometric properties of the newly translated Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-Pal) scale (FACIT-Pal-TR) for Turkish-speaking cancer patients. METHODS: We used standard multilingual translation and validation methods for the initial translation of the FACIT-Pal-TR and then assessed the psychometric properties of reliability and validity of the translated scale. We used the Karnofsky Performance Scale and Edmonton Symptom Assessment Scale to assess concurrent and construct validity. RESULTS: A convenience sample of 232 cancer patients participated in this study. The Cronbach's alpha coefficient of FACIT-Pal-TR was 0.932 (between 0.732 and 0.860 for subscales). There was a statistically significant relationship between test and retest scores (r = 0.877, P < 0.001). The factor loadings of FACIT-Pal-TR were between 0.205 and 0.815. FACIT-Pal-TR construct validity was acceptable with 45 items and five subscales. There were statistically significant relationships between FACIT-Pal-TR scores and Edmonton Symptom Assessment Scale (P < 0.001) and Karnofsky Performance Scale (r = 0.656; P < 0.001) scores. CONCLUSIONS: The FACIT-Pal-TR demonstrates strong reliability and validity for evaluating palliative care-specific QoL in Turkish cancer patients.

Financial Burden Among Patients With Lung Cancer in a Publically Funded Health Care System.

INTRODUCTION: Financial distress has been established as a clinically relevant patient-reported outcome associated with worse mortality and quality of life. Our goal was to define factors associated with financial burden (FB) in a public health care system. MATERIALS AND METHODS: Patients with advanced lung cancer were recruited from outpatient clinics at the Princess Margaret Cancer Centre (Toronto, Canada). FB was measured with the validated Comprehensive Score for Financial Toxicity (COST) instrument, a 12-item survey scored from 0 to 44, with lower scores reflecting worse financial well-being. Data on patient and treatment characteristics, total out-of-pocket costs (OOP), and private insurance coverage were collected. Multivariable logistic regression models were fit for COST score and each variable, to determine factors associated with greater FB (COST < 21). RESULTS: Of 251 patients approached, 200 (80%) participated. The median age of the cohort was 65 years; 56% were female. The median total OOP ranged between $1000 and $5000 CAD. The median COST score was 21 (range, 0-44). FB was associated with age, with patients < 65 years reporting greater FB than older patients (COST, 18.0 vs. 24.0; P < .0001). In multivariable logistic regression analysis, younger age was associated with greater FB, when adjusting for income, employment status, OOP, and private insurance coverage (odds ratio, 3.6; 95% confidence interval, 1.5-9.1; P < .0001). CONCLUSION: Age is significantly associated with FB in the Canadian (Ontario) public health care system, with younger patients with lung cancer reporting greater financial distress. This study highlights priority patient populations where FB should be routinely assessed and appropriate resources for support offered.

THE TRANSLATION, VALIDATION AND CULTURAL ADAPTATION OF FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY - SPIRITUAL WELL-BEING 12 (FACIT-SP12) SCALE IN GREEK LANGUAGE.

BACKGROUND: According to World Health Organization (WHO), spirituality is an important domain of quality of life especially in terminal, life threatens chronic diseases. For many people spirituality and religion are not just very important dimensions of their existence, but also a source of support that contributes to wellbeing and coping with everyday difficulties of life. AIM: Aim of the study was the translation of the Facit Spiritual Well Being Scale (Facit-Sp12) in Greek language and the validation of the scale for the Greek population. MATERIAL AND METHODS: The Facit-Sp12 questionnaire is an anonymous self-administered questionnaire that contains twelve, four point Likert scale, closed questions (0=Not at all, 1=A little bit, 2=Some-what, 3=Quite a bit, 4=Very Much). The questionnaire was translated into Greek language and then back translated in the English in order to be checked for any inconsistencies. The sample of the study was 183 chronic kidney disease patients, undergoing hemodialysis. Exploratory factor analysis, with principal components analysis with Varimax rotation was performed for checking the construct validity of the questionnaire. The test-retest reliability and the internal consistency were also examined. Statistical analysis performed by the use of SPSS 21.0. Statistical significance level was set at p=0.05. RESULTS: The final Greek version of the questionnaire includes all of the twelve questions. The mean age of the participants was 61.81±13.9. Three factors were exported from the statistical analysis. The Cronbach-α coefficient was 0.77 for the total questionnaire and for each subscale was 0.70 for "meaning", 0.73 for "peace" and 0.87 for "faith". Between the three subscales "meaning" had the highest score (mean 12.49, SD=2.865). CONCLUSIONS: The Facit Spiritual Wellbeing Scale-Facit-Sp12, is a valuable and reliable questionnaire of three dimensions that can be used for assessing spirituality and spiritual wellbeing in Greek population.

Reliability and Validity of the Chinese Version of FACIT-AI, a New Tool for Assessing Quality of Life in Patients with Malignant Ascites.

OBJECTIVE: The study objective was to determine the reliability and validity of the Chinese version of the Functional Assessment of Chronic Illness Therapy - Ascites Index (FACIT-AI). METHODS: A forward-backward translation procedure was adopted to develop the Chinese version of the FACIT-AI, which was tested in 69 patients with malignant ascites. Cronbach's α, split-half reliability, and test-retest reliability were used to assess the reliability of the scale. The content validity index was used to assess the content validity, while factor analysis was used for construct validity and correlation analysis was used for criterion validity. RESULTS: The Cronbach's α was 0.772 for the total scale, and the split-half reliability was 0.693. The test-retest correlation was 0.972. The content validity index for the scale was 0.8-1.0. Four factors were extracted by factor analysis, and these contributed 63.51% of the total variance. Item-total correlations ranged from 0.591 to 0.897, and these were correlated with visual analog scale scores (correlation coefficient, 0.889; P<0.01). CONCLUSIONS: The Chinese version of the FACIT-AI has good reliability and validity and can be used as a tool to measure quality of life in Chinese patients with malignant ascites.

Development and Psychometric Properties of a Tuberculosis-Specific Multidimensional Health-Related Quality-of-Life Measure for Patients with Pulmonary Tuberculosis.

BACKGROUND: Various generic instruments exist to assess health-related quality of life (HRQOL) in patients with tuberculosis (TB), but a psychometrically sound disease-specific instrument is lacking. OBJECTIVES: The present study aimed to develop and psychometrically validate a multidimensional TB-specific HRQOL instrument relevant to the value of patients with pulmonary TB in Iraq with an eye toward cross-cultural application. METHODS: The core general HRQOL questionnaire is composed of the Functional Assessment of Cancer Therapy-General items. A modular approach was followed for the development of the Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB) questionnaire in which a set of items assessing quality-of-life (QOL) issues not sufficiently covered by the core Functional Assessment of Cancer Therapy-General items, but considered to be relevant to the target population, was added. Moreover, principal-component analysis was used to determine the new subscale structure of the questionnaire. RESULTS: In addition to the 27 items of the core questionnaire, a set of 20 items referring to disease symptoms related to the site of infection, adverse effects, and additional QOL dimensions such as fatigue, social stigma, and economic burden of the illness was included. Factor analysis demonstrated that the FACIT-TB construct comprised five domains. CONCLUSIONS: A rigorous method was applied in the development of the FACIT-TB measure to fully understand the impact of TB on patients' QOL. The instrument is psychometrically sound and portrays multiple important dimensions of HRQOL. FACIT-TB is relatively brief, is easy to administer and score, and is appropriate for use in clinical trials and practice.

Health-related quality of life as a predictor of tuberculosis treatment outcomes in Iraq.

OBJECTIVES: To determine how tuberculosis (TB) treatment affects the health-related quality of life (HRQL) of patients with pulmonary TB and to identify the predictors of favourable TB treatment outcomes in Baghdad, Iraq. METHODS: The Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB), a new TB-specific quality of life instrument derived from the internationally recognized FACIT measurement system for the assessment of HRQL, was administered. The mean total and subscale scores of the FACIT-TB at baseline, end of the intensive phase, and end of TB treatment were compared. RESULTS: After the 2-month intensive phase, physical well-being, functional well-being, and the overall total scores were significantly increased (p<0.01). Furthermore, at completion of TB treatment, there were significant improvements in the overall HRQL as indicated by the FACIT-TB total score and all subscales, except social and economic well-being and spiritual well-being. In a direct logistic regression model, only the FACIT-TB total score made a statistically significant contribution towards predicting the likelihood that a patient would have a favourable TB treatment outcome. CONCLUSIONS: Therapeutic intervention had a positive impact on patient HRQL. We conclude that FACIT-TB is a reliable tool to monitor HRQL during the course of TB treatment.

Translation and linguistic validation of the FACT-EGFRI-18 quality of life instrument from English into Dutch.

PURPOSE: The Functional Assessment of Cancer Therapy-Epidermal Growth Factor Receptor Inhibitor 18 (FACT-EGFRI-18) is a patient-reported outcomes questionnaire developed to assess the effect of EGFRI on patients. The FACT-EGFR-18 was translated into Dutch and evaluated in order to document that the translation adequately captures the concepts of the original English-language version of the questionnaire and is readily understood by subjects in the target population. METHOD: Translation of the FACT-EGFRI-18 from English to Dutch was accomplished by employing the Functional Assessment of Chronic Illness Therapy (FACIT) multilingual translation methodology. Ten native-speaking residents of the target country who reported EGFRI associated dermatological adverse events (dAEs) were asked to review the translation of the harmonized FACT-EGFRI-18. RESULTS: Participants generally found the Dutch FACT-EGFRI-18 easy to understand and complete. In addition, the translation retained the original meaning of the FACT-EGFRI-18 items and instructions. Based on the results of the cognitive debriefing interviews, no changes to improve clarity and comprehension of translations were identified. CONCLUSIONS: The Dutch FACT-EGFRI-18 demonstrates content validity and linguistic validity, and was found conceptually equivalent to its English source, thus confirming linguistic validation. The results suggest that the Dutch FACT-EGFRI-18 can be applied to measure dAE related health related quality of life in Dutch-speaking patients undergoing EGFRI therapy. Formal validation of the Dutch FACT-EGFRI-18 is ongoing.