ABSTRACT
PURPOSE: The aims of this study were to investigate the impact of individual health-related quality of life (HRQL) evaluation on the attention towards symptom control and psychosocial function in advanced cancer patients. METHODS: Patients with advanced lung cancer or mesothelioma who attended a pulmonary oncology outpatient clinic were randomized to either of two strategies for HRQL assessment. The experimental group (EG) answered the EORTC QLQ-C30 + LC13 questionnaire using a digital table interface, with outprint of aggregated scale scores presented to the consulting physician as a support for evaluation. The control group (CG) answered a paper version of the same questionnaire, which was stored for later analysis. Consultations were audio-recorded. Outcome measures were a quantitative content analysis of audio-recorded consultations and medical and psychosocial interventions abstracted from clinical records. RESULTS: One hundred seventy-one patients were randomized and participated in the study. Issues regarding emotional function were more frequently discussed during consultations in the EG (p < 0.05). Similarly, interventions directed to emotional and social concerns were more frequent in the EG (p = 0.013 and p = 0.0036, respectively). HRQL measures over time were similar across the groups. CONCLUSION: Individual HRQL assessment increased the attention to psychosocial functioning in patients with chest malignancies.
Subject(s)
Lung Neoplasms , Mesothelioma , Palliative Care/methods , Pleural Neoplasms , Practice Patterns, Physicians' , Quality of Life , Symptom Assessment , Adult , Aged , Aged, 80 and over , Attention , Decision Making , Feasibility Studies , Female , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/psychology , Lung Neoplasms/therapy , Male , Mesothelioma/diagnosis , Mesothelioma/psychology , Mesothelioma/therapy , Middle Aged , Pleural Neoplasms/diagnosis , Pleural Neoplasms/psychology , Pleural Neoplasms/therapy , Prospective Studies , Psychometrics , Surveys and Questionnaires , Sweden , Symptom Assessment/methodsABSTRACT
AIMS: To evaluate the reliability and validity of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and LC13 questionnaire in a palliative setting, and to undertake a broad clinical evaluation of the questionnaire. PATIENTS: One hundred and twelve patients with advanced lung cancer or pleural mesothelioma, not amenable to curative or life-prolonging treatment, were consecutively included. METHODS: Construct validity and reliability of the EORTC questionnaire were examined by multitrait analysis and internal consistency. Criterion validity was examined by variance by and correlation with an array of clinical measures, including tumour stage, performance status, 6-min walk test, spirometry, and blood tests. Concurrent validity was evaluated by established scales for emotional distress and pain. RESULTS: With the exception of cognitive functioning, reliability and construct validity of the QLQ-C30 was confirmed. Criterion and concurrent validity was supported for most of the functioning and symptom scales. In a multivariate stepwise regression analysis, EORTC physical functioning was predicted by performance status and 6-min walk distance (r (2)=.70), emotional functioning by HADS anxiety ratings (r (2)=.59), and global quality of life by performance status, HADS depression ratings, and FEV1 %predicted (r (2)=.50). CONCLUSION: The results support the validity and clinical relevance and of the EORTC questionnaire in a palliative setting.
