FACIT-AI, New Tools For Evaluation Of The Quality Of Life In Patients With Malignant Ascites Speaking Of Reliability And Validity Of -FACIT-AI And

This thesis reviewed the research progress of malignant ascites and its quality of life by literature review while the clinical research aimed to introduce and evaluate a new quality of life scale for ascites patients.Three articles reviewed the development on pathogenesis, treatment and prognosis of malignant ascites by both modern medicine and Chinese medicine and the research progress of quality of life scale at home and aboard. Analysis by synthesis, mainly secondary to peritoneal carcinomatosis, formation increase and reflux obstruction were the major influence factors of malignant ascites. With various response rate, traditional modalities include serial paracentesis, diuretic therapy and peritoneovenous shunting. New therapies involves intracavitary chemotherapy, immunotherapy, radioisotopes, targeted therapies, hyperthermic intraperitoneal chemotherapy and so on. In spite of some positive results, the clinical application of the new therapies is not yet completely elucidated and further investigations and trails are necessary. Traditional Chinese medicine believes that the main pathological factors of malignant ascites are Qi stagnation, blood stasis and fluid retention. So that patients with malignant ascites should be treat with the rule of warming Yang, promoting diuresis and clearing statis.The tharapies, including internal and externaltreatment of TCM, injections for intravenous or peritoneal use, obtained certain response,but large cases of clinical research is still needed. Scale is the main instrument to assess one’s quality of life(QOL). There are two famous scale system for cancer patients to measure QOL:European Organization for Research and Treatment of Cancer(EORTC) and Functional Assessment of Chronic Illness Therapy(FACIT). Chinese experts also created Chinese-culture-based QOL systems. They are Quality of Life Questionnaire for Chinese Cancer patients receiving Chemobiotherapy(QLQ-CCC) and Quality of Life Instruments for Cancer Patients (QLICP). The FACIT-AI is the only one to assess QOL for patients with malignant ascites, but the Chinese version is not yet available.The second part is a clinical study. Objective To evaluate the reliability and validity of the Chinese-version Functional Assessment of Chronic Illness Therapy-Ascites Index (FACIT-AI). Method A forward-backward translation procedure was adopted to develop the Chinese version of FACIT-AI and the test in69patients with malignant ascites followed. Cronbach’s a, split-half reliability and test-retest reliability were used to assess the reliability of the scale. Content validity index was used to assess the content validity while factor analysis for construct validity, correlation analysis for criterion validity. Results The Cronbac’a was0.772for the total scale and the split-half reliability was0.693and the test-retest correlation was0.972. The content validity index for the scale was0.8-1.0. Four factors were extracted by factor analysis, which contributed63.51%of the variance. Item-total correlations ranged from0.591to0.897. Conclusion The Chinese-version of FACIT-AI has good reliability and validity and can be used as a measurement tool for the quality of life in Chinese patients with malignant ascites.