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Psychometric properties of the EORTC Quality of Life Questionnaire in inpatient cancer rehabilitation in Germany

Published online by Cambridge University Press:  04 April 2005

JÖRG DIRMAIER ,
SILKE ZAUN ,
UWE KOCH ,
TIMO HARFST  and
HOLGER SCHULZ
JÖRG DIRMAIER
Affiliation:
Institute and Polyclinic for Medical Psychology, Centre for Psychosocial Medicine, University Clinic Hamburg-Eppendorf, Hamburg, Germany
SILKE ZAUN
Affiliation:
Nordfriesland-Clinic, St. Peter-Ording, Germany
UWE KOCH
Affiliation:
Institute and Polyclinic for Medical Psychology, Centre for Psychosocial Medicine, University Clinic Hamburg-Eppendorf, Hamburg, Germany
TIMO HARFST
Affiliation:
Institute and Polyclinic for Medical Psychology, Centre for Psychosocial Medicine, University Clinic Hamburg-Eppendorf, Hamburg, Germany
HOLGER SCHULZ
Affiliation:
Institute and Polyclinic for Medical Psychology, Centre for Psychosocial Medicine, University Clinic Hamburg-Eppendorf, Hamburg, Germany
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Abstract

Objective: Recent years have shown an increase in the use of questionnaires measuring health-related quality of life to verify the quality of treatment in the field of oncology. An often used cancer-specific questionnaire is the “Quality of Life Core Questionnaire of the European Organization for the Research and Treatment of Cancer” (EORTC QLQ-C30). The purpose of this study is to analyze the psychometric properties of the EORTC QLQ-C30 (version 1) in order to determine the feasibility and appropriateness for its use in inpatient cancer rehabilitation in Germany with heterogeneous diagnoses.

Methods: The questionnaire was administrated to a sample of 972 cancer patients at the beginning of treatment and to 892 patients after treatment. Besides descriptive analysis, the statistical analyses include confirmatory analysis and the multitrait/multimethod approach to test the questionnaire's postulated scale structure (factorial validity) and its reliability (internal consistencies). The analysis also includes a comparison of responsiveness indices (effect size, reliable change index) to test the sensitivity of the instrument.

Results: The EORTC QLQ-C30 showed satisfactory levels of reliability and sensitivity, but the postulated scale structure could not be confirmed. The results illustrate that the varimax-rotated solution of a principal component analysis does not confirm the scale structure postulated by the authors. Correspondingly, the selected fit indices within the scope of the confirmatory factor analysis do not show satisfactory results either.

Significance of results: We therefore consider version 1 of the EORTC QLQ-C30 to be only limitedly useful for the routine assessment of changes in the quality of life of cancer patients in inpatient rehabilitation in Germany, especially because of the instrument's length and possible redundancies. For this reason, a scoring procedure limited to a subset of items is suggested, revealing satisfactory to good psychometric indices. However, further psychometric tests are necessary, especially with regard to validity and sensitivity.

Keywords

CancerQuality of lifeRehabilitationSensitivityValidity
Type
Research Article
Information
Palliative & Supportive Care , Volume 2 , Issue 2 , June 2004 , pp. 115 - 124
Copyright
© 2004 Cambridge University Press

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References

REFERENCES

Aaronson, N.K., Ahmedzai, S., Bergman, B., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365–376.Google Scholar
Aaronson, N.K., Bullinger, M., & Ahmedzai, S. (1988). A modular approach to quality of life assessment in cancer clinical trials. Recent Results in Cancer Research, 111, 231–249.Google Scholar
Arbuckle, J.L. & Wothke, W. (1999). Amos 4.0 Users' Guide. Chicago: SmallWaters.
Browne, M.W. & Cudeck, R. (1993). Alternative ways of assessing model fit. In Testing Structural Equation Models. Long, J.S. (ed.), pp. 136–162. Newbury Park: Sage.
Campbell, D.T. & Fiske, D.W. (1959). Convergent und discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81–105.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Hillsdale, NJ: Lawrence Erlbaum.
Floyd, F.J. & Widaman, K.F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299.Google Scholar
Gorsuch, R. (1983). Factor Analysis. Hillsdale, NJ: Lawrence Erlbaum.
Hays, R.D. (1991). Memorandum. Revised Multitrait Analysis Program Software (MAP-R). Boston, MA: Health Institute, New England Medical Center.
Hu, L. & Bentler, P.M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.Google Scholar
Jacobson, N.S. & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.Google Scholar
Kaasa, S. & Loge, J.H. (2003). Quality of life in palliative care: Principles and practice. Palliative Medicine, 17, 11–20.Google Scholar
Kim, J.O. & Mueller, C.W. (1978). Factor Analysis: Statistical Methods and Practical Issues. Vol. 14. Thousand Oaks, CA: Sage Publications.
King, M.T. (1996). The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Quality of Life Research, 5, 555–567.Google Scholar
Koch, U., Mehnert, A., & Petersen, C. (2002). Evaluation of the Psycho-Oncological Department of the Herford Clinic. Hamburg: Institute and Polyclinic for Medical Psychology.
Krischke, N.R. & Petermann, F. (1995). Quality of life of cancer patients in inpatient rehabilitation. Praxis der Klinischen Verhaltensmedizin und Rehabilitation, 32, 291–299.Google Scholar
Küchler, T., Rappat, S., Holst, K., et al. (1999). Impact of psychotherapeutic support on gastrointestinal cancer patients undergoing surgery: Survival results of a trial. Journal of Hepathogastroenterology, 46, 322–335.Google Scholar
Kyriaki, M., Eleni, T., Efi, P., et al. (2001). The EORTC core quality of life questionnaire (QLQ-C30, version 3.0) in terminally ill cancer patients under palliative care: Validity and reliability in a Hellenic sample. International Journal of Cancer, 94, 135–139.Google Scholar
Liang, M.H. (1995). Evaluating measurement responsiveness. Journal of Rheumatology, 22, 1191–1192.Google Scholar
Liang, M.H. (2000). Longitudinal construct validity: Establishment of clinical meaning in patient evaluative instruments. Medical Care, 38(Suppl. 9), 1184–1190.Google Scholar
Morgan, G. (2000). Assessment of quality of life in palliative care. International Journal of Palliative Nursing, 6, 406–410.Google Scholar
Muthen, B.O. (1978). Contributions to factor analysis of dichotomous items. Psychometrika, 43, 511–560.Google Scholar
Osoba, D., Rodriguez, G., Myles, J., et al. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16, 139–144.Google Scholar
Osoba, D., Zee, B., Pater, J., et al. (1994). Psychometric properties and responsiveness of the EORTC Quality of Life Questionnaire (QLQ-C30) in patients with breast, ovarian and lung cancer. Quality of Life Research, 3, 353–364.Google Scholar
Paci, E., Miccinesi, G., Toscani, F., et al. (2001). Quality of life assessment and outcome of palliative care. Journal of Pain and Symptom Management, 21, 179–188.Google Scholar
Pfennings, L.E., van der Ploeg, H.M., Cohen, L., et al. (1999). A comparison of responsiveness indices in multiple sclerosis patients. Quality of Life Research, 8, 481–489.Google Scholar
Ringdal, G.I. & Ringdal, K. (1993). Testing the EORTC Quality of Life questionnaire on cancer patients with heterogeneous diagnoses. Quality of Life Research, 2, 129–140.Google Scholar
Ringdal, G.I. & Ringdal, K. (2000). A follow-up study of the quality of life in cancer patients with different prognoses. Quality of Life Research, 9, 65–73.Google Scholar
Schuck, P. (2000). Designs and statistics for assessing change sensitivity of questionnaires in health-related quality of life research. Zeitschrift für Medizinische Psychologie, 3, 125–130.Google Scholar
Schulz, H., Winzer, A., Stump, S., et al. (2001). The effects of psycho-oncological interventions on the quality of life of cancer patients. Onkologe, 7, 157–166.Google Scholar
Stump, S., Koch, U., Baider, L., et al. (1998). The effects of a structured psycho-oncological group program—The German-Israeli intervention study. Psycho-Oncology, 7(Suppl. 4), 12–14.Google Scholar
Weis, J., Moser, M.T., Fachinger, D., et al. (2000). Designs and statistics for assessing change sensitivity of questionnaires in health-related quality of life research. In Quality of Life Research from a Medical Psychology and Medical Sociology Perspective. Bullinger, M. (ed.), pp. 43–58. Göttingen: Hogrefe.
Wiebe, S., Rose, K., Derry, P., et al. (1997). Outcome assessment in epilepsy: Comparative responsiveness of quality of life and psychosocial instruments. Epilepsia, 38, 430–438.Google Scholar