Development And Evaluation Of Quality Of Life Instruments For Patients With Brain Cancer

Objective To develop a Chinese version's quality of life (QOL) instrument and to sinicize EORTC QLQ-BN20 for forming Chinese version, which can be used to evaluate the quality of life and therapy effects for patients with brain cancer.Method According to the definition of quality of life from WHO, we drew off the theoretical scheme about the measurement instrument for brain cancer. Based on reviewing literature, learning the related knowledge including psychology and sociology and referring to the generally accepted special scales for brain cancer patients, we extensively consulted the ideas and suggestions from expert group(including the clinical experts on tumor therapy, especially neurosurgery experts, and some brain cancer patients) and adopted the method of qualitative interview combining significance score in order to form a questionnaire for pilot testing.Then we investigated 125 brain cancer patients in the Third Affiliated Hospital of Kunming Medical College by using this questionnaire. Four methods had been used to screen and analyze the items of the special module. After screening, the reserved items were discussed and the formal scale named the QLICP-BN (quality of life instruments for cancer patients-brain cancer)was formed. The validity, reliability and responsibility of the formal scale were developed by translation and back-translation and cultural adaptation, and evaluated by QOL data measured from 125 in patients of brain cancer.Results (1)QLICP-BN make up of five domains:physical function, psychological function, social function, general symptoms and side effect and special symptom for brain cancer, including 62 items. While the four domains made up of the general module for all cancer patients and the last domain former the special module for brain cancer patients. The test-retest correlation coefficients of all domains and overall scale all were large than 0.90. The paired t-test indicated no statistically significant change between the first time and the second time(P＞0.05). Except the social function domain, Cronbach's a coefficients of the others domains were larger than 0.7 and those of general module and the overall scale respectively were 0.852 and 0.906. Split-half reliability coefficients of all domains were from 0.544 to 0.871. Those of general module and the overall scale respectively were 0.869 and 0.925 4 common factors were extracted and the cumulative variance was 66.792%. After Varimax orthogonal rotation, we found the results were coincident with the theoretical scheme. The structural equation modeχ~2=809.64, RMSEA=0.083, TLI=0.941, CFI=0.963, SRMR=0.076. The correlation analysis that there were strong correlation between items and their own domains; conversely there were weak correlation between items and other domains. The correlation coefficient between overall scale and the criterion (the global health status domain of the Chinese version of EORTC QLQ-BN20) was 0.583. Except the social function domain, the differences of the others domains of the instrument between first and third time point had statistical significance. About 15-25 minutes were spent in completing the instrument and the completed rate was 100% demonstrated. All of Pearson's correlation coefficients are smaller than 0.04. The clinical tests and quality of life scores do not have the close degree simple straight line correlation relations.(2)Chinese version of EORTC QLQ-BN20 was made up of four domains (future uncertainty, visual disorder, locomotion dysfunction, lack of communication) and seven simple items(headache, recurrence, drowsiness, hair loss, skin itching, leg weakness, bladder control) and included 20 items. The test-retest correlation coefficients of all domains and overall scale all were large than 0.80. The paired t-test indicated no statistically significant change between the first time and the second time(P＞0.05). Cronbach's a coefficients of all domains were larger than 0.6. Split-half reliability coefficients of all domains were larger than 0.6.5 common factors were extracted and the cumulative variance was 67.567%. After Varimax orthogonal rotation, we found the results were coincident with the theoretical scheme.Conclusion QLICP-BN and Chinese version of the EORTC QLQ-BN20 both are reliable, valid and sensitive. They can be used to determine and estimate the quality of life for brain cancer patients. The clinical tests and Quality of Life scores did not have the close linear correlations.