Quality Of Life In Patients With Metastatic Breast Tripartite Investigation Feasibility Study

Purpose：Investigating possible differences among patients with metastaticbreast, patients’ spouses, and treating physicians in perception ofhealth-related quality of life (HRQOL) would guide medical decisions. Thisanalysis estimates the accuracy and feasibility of HRQOL from physician groupand spouse group to understand HRQOL more exactly.Material and method：Cases with metastatic breast cancer were collectedfrom August2011to October2012，the target number is60～70. Assessment ofquality of life from groups of patients, their spouses, and treating physiciansused EORTC QLQ-BR53scale. Each group was assessed twice. An interval betweentwo assessments is5～7days. The reliability of scale was tested by test-retestreliability and internal consistency reliability. Matching t-test was used totest the mean differences of assessment results. Exact agreement and intra-classcorrelation coefficient was used to determine the consistency and accuracy ofassessment results after the original data was calculated for each standarddomain. Because of the reliability coefficient is statistics that existingsampling error by calculating, and need to rule out the possibility of valueamounts to0by hypothesis test (Pearson coefficient by t-test; Cronbach`sαand ICC by F-test). All data was analyzed by statistical software of SPSS15.0and Excel2003.Results：1. There were61patients with metastatic breast cancer to be elected. Pearsoncorrelation coefficient were more then0.8, and the most of Cronbach`sα weremore than0.7between patient, and physician or spouse. EORTC QLQ-BR53has goodreliability for doctors and spouses.2. There was reasonable coherence in mean scores between patients, and physiciansor spouses (50.00%;60.87%). There were9areas to be underestimated byphysicians, including overall health, role functioning, physical functioning, social functioning, diarrhea, constipation, breast symptoms, arm symptoms,systematic therapy side effects, upset by hair loss (P<0.05). There were4areasto be underestimated by spouses, including emotional functioning, socialfunctioning, breast symptoms, upset by hair loss (P<0.05). There were5areasto be overestimated by spouses, including pain, fatigue, body image, sexualfunctioning, upset by hair loss (P<0.05).3. There was moderate consistency and poor accuracy in the group of patientsand physicians (mean exact coherence=42.78%；mean ICC=0.34). There was moderateconsistency and accuracy in the group of patients and spouses (mean exactagreement=45.26%；mean ICC=0.45).Conclusion：1.EORTC QLQ-BR53was used to assess HRQOL of patient by physician and spousethat has a good test-retest reliability and internal consistency reliability，So this scale is suitable for physician and spouse to assess HRQOL of patient.2. The accuracy and feasibility of the coherence by two roles of physician andspouse was generally poor，and spouse was slightly higher than physician.3. Both roles can not instead of patient himself to assessing HRQOL. Whenassessing patients HRQOL must collect information from the patients themselves.