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To derive Australian normative scores for the Functional Assessment of Cancer Therapy-General Population (FACT-GP) and to confirm its factor structure.
Quality of life (QoL) data (as measured by the FACT-GP) were collected within the Queensland Cancer Risk Study (QCRS) in 2004. The QCRS explored cancer screening and cancer risk behaviours among 941...
Context in source publication
Context 1
... 1 displays the measurement model for participants 20-39 years, and Table 3 displays the r 2 and factor loadings for those participants 40-59 and 60-75 years. Table 4 displays the remaining correlations between the subscales for the two older groups, while this information is included in Figure 1 for the youngest age group. Table 5 displays the corresponding raw and T-scores for each subscale and the FACT-GP summary score, which can be used for comparison with patients' results. ...
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Background
Many epidemiological and public health surveys report increasing difficulty obtaining high participation rates. We conducted a pilot follow-up study to determine whether a mailed or telephone survey would better facilitate data collection in a subset of respondents to an earlier telephone survey conducted as part of the National Birth De...
Citations
... Higher scores reflect better QoL. T-scores are generated and compared to Australian general population norms (M = 50, SD = 10) for each domain, with patients > 1SD below the mean considered impaired (Janda et al., 2009). The FACT-BMT is considered a valid and reliable measure of HSCT patients QoL (a = .86 ...
Haemopoietic stem-cell transplantation (HSCT) can be a highly distressing procedure that negatively impacts quality of life (QoL). Self-help interventions can help improve psychopathology and wellbeing in patients with physical illness, but have rarely been trialled with HSCT recipients. This study aimed to pilot the utility of a self-help manual intervention during the acute phase of HSCT. Forty autologous and allogeneic HSCT candidates were randomly assigned to a self-help manual intervention or treatment as usual (TAU). Psychological distress (BSI-18) and QoL (FACT-BMT-Vs4) were measured pre-, 2–3 weeks and 3 months post-HSCT. Linear mixed-effects analyses showed no significant group-time interaction for global QoL (p = .199) or global distress (p = .624). However, highlighting a protective role during admission, manual participants showed minimal QoL or somatic distress change at 2–3 weeks post-transplant compared with moderate-large effects for reduced QoL (d = 0.62) and increased somatic distress (d = − 0.81) for TAU patients. Thematic analysis suggests the manual helped prepare patients for transplant and provided strategies to improve distress and QoL. This pilot provides preliminary evidence for the benefit of a self-help manual during hospitalisation for a HSCT. More intensive, recovery-focussed care, however, may be needed to improve psychological health in the post-hospital period. Retrospectively registered trial (ANZCTR No. 12620001165976, 6th November 2020).
... Norm-adjusted t-scores were calculated to facilitate the interpretation of subscale scores. Normative data were derived from a large Australian general population sample, and a two-point between-groups difference in raw scores was interpreted as clinically meaningful [12]. General psychological distress ...
... Unlike previous studies reporting on wellbeing measured by the FACT-G, we used appropriate population-based norms to support the meaningful interpretation of scores [12]. Differences between our sample and the general population were clinically meaningful, with strong evidence against the null hypothesis of no difference, and suggest severely compromised emotional, functional and physical wellbeing in some women before radiotherapy. ...
Objective
To better serve women with gynaecological cancers, we need a sound understanding of their health, wellbeing and needs. This study sought to explore these issues in a sample of Australian women before commencing curative radiotherapy.
Methods
We undertook a secondary analysis of baseline data from a supportive care trial (n = 311). Descriptive statistics were used to summarise responses to measures of wellbeing, general psychological distress, symptom distress, sexual function and vaginal changes, and supportive care needs. Pre-specified regression models were used to examine sources of variation in wellbeing and sexual function.
Results
Women reported lower emotional, functional and physical wellbeing than population norms (all p < 0.001). The prevalence of general psychological distress was 31% (95% CI 26–36%). Distress caused by physical symptoms was typically low. Health system and information needs comprised eight of the top ten moderate-to-high supportive care needs. Most women reported no change in interest for physical contact or sex compared to pre-diagnosis, but some sexually active women (16–24%) reported smaller vaginal size, increased dryness, and more pain on intercourse. General psychological distress was a robust marker of poorer wellbeing and sexual function.
Conclusions
Before radiotherapy, a substantial minority of women with gynaecological cancers experience general psychological distress, reduced wellbeing and moderate-to-high health system and information needs. A model of comprehensive care incorporating assessment of unmet needs, general psychological distress, and sexual issues is recommended. Healthcare providers may require training to elicit and respond to a constellation of interrelated issues and access relevant services for women requiring additional support.
... El puntaje de resumen general varía de 0 a 104, con puntajes más altos que indican una mejor calidad de vida. Las evaluaciones de las propiedades psicométricas informan una buena validez y confiabilidad en todas las subescalas, equivalente a la versión original (Holzner et al., 2004;Janda et al., 2009). Aunque muchos estudios han utilizado cuestionarios FACT específicos de la enfermedad al estudiar la CVRS en pacientes, pocos estudios han descrito la CVRS en una población general que usa FACT-GP con fines comparativos. ...
... La calidad de vida fue clínica y significativamente menor entre los participantes no casados, con un índice de masa corporal que se desvió del peso normal y con una o más morbilidades autoreportadas. Se confirmó una solución de cuatro factores con adecuados índices de bondad de ajuste (RMSEA < 0.05 para los grupos de edad) (Janda et al., 2009). En el mismo sentido, Lindqvist Bagge et al. ...
... El presente estudio tuvo como propósito determinar las propiedades psicométricas del FACT-GP en población general mexicana. La estructura factorial identificada es similar con las reportadas en la literatura internacional (Janda et al., 2009), con cuatro componentes: Bienestar físico, Bienestar emocional, Bienestar familiar y social, Pareja y vida sexual, similares a la versión original. ...
La calidad de vida es un aspecto relevante en la vida de las personas, más aún cuando se presentan comorbilidades altas en población general, por lo que su medición de forma válida y confiable es necesaria. Objetivo: Determinar las propiedades psicométricas del Instrumento de Evaluación de Funcionalidad en el Tratamiento para Enfermedades Crónicas (FACT-GP) en población general mexicana. Método: Se empleó un diseño transversal, con un muestreo no probabilístico, por disponibilidad. Análisis estadístico: Se realizó un modelo factorial confirmatorio. Resultados: Se incluyeron 254 participantes con M = 23.5 años (21-32). Se identificaron 4 factores con 18 reactivos. La consistencia interna de la escala global fue .81, que explican el 58.93 % de la varianza. El análisis factorial confirmatorio presenta índices adecuados (CFI, RMR, RMSEA), que indican un ajuste equilibrado y parsimonioso de la estructura del modelo. Conclusión: El FACT-GP mostró una estructura similar a la versión original, con indicadores válidos y confiables para su uso en la atención clínica e investigación dirigida a población general mexicana.
... Ispitanici koji nisu bili u braku imali su najlošije socijalno funkcioniranje, nije bilo statistički značajnih razlika u drugim domenama kvalitete života i rezilijenciji među ispitanicima u odnosu na bračni status. Navedeni rezultat podudara se s istraživanjem provedenom u Queenslandu gdje su ispitanici koji su bili u braku ili žive zajedno imali bolje rezultate u području društveno obiteljskih odnosa od onih koji nisu u braku (13). ...
... This was similarly reported by Tribius S et al that long-term QOL was poorer in patients with a lower socioeconomic background [12]. Janda M et al also observe a similar trend in that higher education levels and being married were associated with greater social and functional wellbeing [13]. In a study by Gopal KS et al, patients with a lower education level or lower income were noted to have a poorer outcome with a higher cancer mortality rate [14]. ...
Background
The objective of the study was to evaluate the quality of life (QOL) of head and neck cancer survivors after surgical treatment and to identify patients’ main concerns. The study also aims to establish pre-treatment reference values particularly for the Asian patient. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and Head and Neck module (EORTC QLQ-HN35) were used for objective evaluation.
Methods
Patients planned for elective surgery for head and neck cancers were enrolled in the study. The questionnaires were completed at pre-treatment and at 6 months after surgery. Results were compared with previously published reference values.
Results
One hundred forty patients completed both questionnaires. Locally advanced tumour and extent of surgery (tracheostomy (p<0.01), surgical flap (p<0.01)) were associated with lower global health scores. Adjuvant treatment was also a contributory factor (p<0.01). Dysphagia and social eating was a primary concern within our population.
Conclusion
Surgical treatment of head and neck cancers is safe, but there is poor QOL in the early post-treatment period especially with eating. Previously published data suggested improvement after a year.
... We could not find UK HADS norms for older people, instead using Spinhoven et al.'s [24] Netherlands norms for 57-98-year-old individuals (3.90 for anxiety and 4.16 for depression). Community FACT-G norms from Australia [25] (85.42 age range 25-75 n=2,719) and Austria [26] (86.5 ages 18-70 n=926) were used for comparison. No norms were available for WREC. ...
Purpose
Prognostication in cancer is growing in importance as increasingly accurate tools are developed. Prognostic accuracy intensifies ethical concerns that a poor prognosis could be psychologically harmful to survivors. Uveal melanoma (UM) prognostication allows survivors to be reliably told that life expectancy is either normal (good prognosis) or severely curtailed because of metastatic disease (poor prognosis). Treatment cannot change life expectancy. To identify whether prognosis is associated with psychological harm, we compared harm in UM survivors with good and poor prognoses and those who declined testing and compared these outcomes to general population norms.
Methods
Non-randomized 5-year study of a consecutive series of 708 UM survivors (51.6% male, mean age 69.03, SD =12.12) with observations at 6, 12, 24, 36, 48 and 60 months. We operationalized psychological harm as anxiety and depression symptoms, worry about cancer recurrence (WREC) and poor quality of life (QoL).
Results
Compared to other groups, survivors with poor prognoses showed initially elevated anxiety and depression and consistently elevated worry about local or distant recurrence over 5 years. Good prognoses were not associated with outcomes. Generally, no prognostic groups reported anxiety, depression and WREC or QoL scores that exceeded general population norms.
Conclusions
Using a large sample, we found that harm accruing from a poor prognosis was statistically significant over 5 years, but did not exceed general non-cancer population norms.
Implications for Cancer Survivors
Survivors desire prognostic information. At a population level, we do not believe that our findings show sufficiently strong links between prognostication outcome and psychological harm to deny patients the option of knowing their prognosis. Nonetheless, it is important that patients are informed of potential adverse psychological consequences of a poor prognosis.
... We measured health-related quality of life using the Functional Assessment of Cancer Therapy-General (FACT-G) instrument, a 27-item measure specific to cancer that is validated in young people (18-25 years) and also in the QLD general population. 23 The FACT-G measures health-related quality of life on a 5-point Likert scale (0 = not at all, 4 = very much) across the domains of physical, emotional, social, and functional well-being. We used the Patient-Reported Outcomes Measurement Information System (PROMIS Ò ) self-efficacy scale for managing chronic conditions to measure health selfefficacy across five domains: daily activities, symptoms, medications and treatments, emotions, and social interactions on a 5-point Likert scale (1 = I am not at all confident, 5 = I am very confident). ...
... 26 FACT-G was stratified by sex, and also age to enable comparisons with validated data from the QLD general population. 23 No QLD general population norms were available for comparison for people younger than 20 years. PROMIS T-scores were generated using the web-based HealthMeasures Scoring Service. ...
... Clinically significant differences in FACT-G subscores (2 points) and overall score (5 points) between the sample and QLD population were determined. 23 Given the non-normal distribution of variables, Spearman's correlation was undertaken to explore the strength and direction of the relationship among variables, including the number of symptoms experienced as moderate or higher, FACT-G subscales and an overall score, and PROMIS. Mean and SD were used to summarize symptom severity, FACT-G (subscales and overall score), and PROMIS based on key characteristics of the sample, including sex, time since treatment finished, age at diagnosis, and type of cancer diagnosis. ...
Purpose: The numbers of adolescent and young adult (AYA) survivors of childhood cancer are exponentially growing. To ensure suitable services are available to meet the needs of this growing population, understanding the experience of late effects, quality of life, and potentially modifiable factors, such as self-efficacy, is required. Methods: AYA survivors of childhood cancer recruited through an After Cancer Therapy Service at a Children's Hospital rated their symptoms experience, quality of life, and self-efficacy using the Patient Reported Outcome Common Terminology Criteria for Adverse Events, Functional Assessment of Cancer Therapy-General (FACT-G), and Patient-Reported Outcomes Measurement Information System (PROMIS®), respectively. Descriptive statistics were used to characterize the sample. Quality-of-life scores were compared with population norms. Regression analyses were used to explore the relationships between symptom experience, quality of life, and self-efficacy. Results: Thirty participants (mean age 22 ± 4.4 years) reported an average of nine symptoms as persistently experienced at moderate or higher rated intensity among participants (standard deviation ±8.7; range: 0-32; interquartile range: 2-16); over half (n = 17, 56.7%) had finished treatment 10 or more years ago. Participants scored lower on the FACT-G Physical Well-being and Emotional Well-being, and higher on Social Well-being subscales than the general population. Around two-thirds of participants were confident in their ability to self-manage their health based on their health self-efficacy score. Bivariate linear regression identified a statistically significant increase in the overall quality of life with increased self-efficacy, adjusted for age and sex (0.60, 95% confidence interval [CI] 0.30-0.90, p < 0.01). Higher symptom burden was associated with a lower overall quality of life after adjusting for age and sex (-0.95, 95% CI: -1.35 to -0.54, p < 0.001). Conclusion: Young cancer survivors experience a substantial number of persistent symptoms related to their cancer treatment that may negatively impact aspects of their quality of life. Health self-efficacy is a potential target for future interventions.
... A reference value of 85.9 (SD ¼ 15.1) for the general population has been reported, providing a benchmark against which the impact of disease on QOL can be evaluated. 36 Lifestyle Risk Factors Weight Status. BMI was computed from self-reported weight in kilograms divided by height in meters squared. ...
Background and Aims
Lifestyle counseling to achieve a healthy weight, quit smoking, and reduce alcohol is a cornerstone in the management of Barrett’s Esophagus (BE). However, little is known about whether patients make these recommended lifestyle changes or the impact of non-adherence on their quality of life (QOL). This study characterized the lifestyle risk factors, QOL, and intervention preferences of BE patients as a first step toward developing lifestyle change interventions for this population.
Methods
Patients with a confirmed BE diagnosis (N = 106) completed surveys at a surveillance endoscopy visit (baseline) and at 3- and 6-month follow-ups. Patients reported on lifestyle risk factors, adherence determinants (e.g., perceived benefits/barriers, risk, intentions), QOL, and intervention preferences.
Results
Most patients (56%) had uncontrolled reflux, were overweight/obese (65.1%), and had low dietary fiber intake (91%). Many (45%) reported poor QOL. Patients’ perceived risk of developing esophageal cancer was high, but their behavior change intentions were low. Despite receiving lifestyle counseling from physicians, there were no significant changes in patients’ QOL or lifestyle risk factors over time. Nonetheless, patients indicated strong interest in internet (62.6%) and multimedia programs (57.9%) addressing acid reflux and weight control.
Conclusion
BE patients reported uncontrolled reflux, poor QOL, and multiple lifestyle risk factors that did not change over time. Despite low levels of intention for making lifestyle changes, patients were interested receiving more information about controlling acid reflux, suggesting a potential teachable moment and opportunity for web-based and multimedia multiple behavior interventions that seek to control acid reflux symptoms through weight loss and a high fiber diet.
... Sample size was pragmatic based on the number of survivors attending the SCSC clinic for follow-up in the defined period. FACT-G scores were converted to T-scores and compared with general Australian population data that is not cancerspecific [18]. To analyse continuous PROMs (e.g., minutes of weekly exercise) separate linear mixed-effects models were estimated with PROMs acting as dependent variables. ...
... In total, 20/ 59 (34%) survivors increased their overall FACT-G score by more than 10% between T1 and T3. The mean FACT-G Tscore of survivors at T3 was 51.2, higher than the general (not cancer-specific) Australian population mean of 50 [18]. The increase was across all four domains, with the largest increases in physical (T-score 43.8-47.2) and functional (49.2-51.7) ...
... Symptoms most commonly improving over time included fatigue, sore hands, pain and trouble concentrating, but a quarter of survivors scored ≥ 5 symptoms of at least moderate severity at 1 year, particularly fatigue, sleep disturbance, pain and memory impairment. QOL scores did not change greatly over the 1-year period, with global QOL scores similar to that of the general Australian population [18]. Two thirds of survivors remain overweight or obese, although 45% of these managed to reduce their weight. ...
Background
Sydney Cancer Survivorship Centre (SCSC) clinic provides multidisciplinary care after primary adjuvant treatment, with ~ 40% of attendees continuing follow-up with SCSC.MethodsSCSC survivors completed measures of symptoms, quality-of-life and lifestyle factors at initial visit (T1), first follow-up (T2) and 1 year (T3). Analyses used mixed effect models, adjusted for age, sex and tumour type.ResultsData from 206 survivors (2013–2019) were included: 51% male; median age 63 years; tumour types colorectal 68%, breast 12%, upper gastrointestinal 12%, other 8%. Mean time from: T1 to T2, 3.6 months; T1 to T3, 11.8 months. Mean weight remained stable, but 45% (35/77) of overweight/obese survivors lost weight from T1 to T3. Moderately-intense aerobic exercise increased by 63 mins/week at T2, and 68 mins/week T3. Proportion meeting aerobic exercise guidelines increased from 20 to 41%. Resistance exercise increased by 26 mins/week at T2. Global quality-of-life was unchanged from T1 to T2, improving slightly by T3 (3.7-point increase), mainly in males. Mean distress scores were stable, but at T3 the proportion scoring 4+/10 had declined from 41 to 33%. At T3, improvements were seen in pain, fatigue and energy, but > 20% reported moderate–severe fatigue, pain or sleep disturbance. Proportion reporting 5+ moderate–severe symptoms declined from 35% at T1 to 26% at T3, remaining higher in women.Conclusions
Survivors attending SCSC increased exercise by 3 months, and sustained it at 1 year. Most overweight/obese survivors avoided further weight gain. Survivors had relatively good quality-of-life, with improvement in many symptoms and lifestyle factors at 1 year.
... HRQOL is associated with sociodemographic factors such as gender [4], age [4,5], level of income and education [6]. It has also been shown that there is a correlation between self-reported HRQOL and self-rated health (SRH) status [7,8]. ...
... Though many studies have used disease-specific FACT-instruments when studying HRQOL in patients, few studies have described normative HRQOL scores in a general population using either FACT-G or FACT-GP [4,7,12]. Even if HRQOL data for cancer and chronically ill patients are useful when evaluating or comparing treatment regimes, it is also important that the results can be interpreted with respect to a general population. ...
... However, few studies have described normative HRQOL scores in the general population using the commonly used FACT-instruments. Since HRQOL scores have been associated with sociodemographic factors [5][6][7]13], the main aim of the present study was to describe the HRQOL scores in a general Swedish population by using the FACT-GP instrument and to investigate potential relationships with sociodemographic factors as well as with SRH. ...
Background:
Many studies have used disease-specific instruments, such as the Functional Assessment of Cancer Therapy (FACT), when studying health-related quality of life (HRQOL) in patients. Few studies however, have described normative HRQOL values in the general population using FACT - General Population (FACT-GP). The general aim of the present study is thus to describe the normative HRQOL values in the general Swedish population by using the FACT-GP instrument and to investigate to what degree sociodemographic factors and status of self-rated health (SRH) correlate with HRQOL.
Methods:
The participants consisted of a pre-stratified (gender, age and education) sample of Swedish citizens that previously had enrolled to be a part of a web panel hosted by a research institute (SOM Institute) at the University of Gothenburg in Sweden. The HRQOL was assessed by using the FACT-GP and SRH.
Results:
A higher FACT-GP score was mainly associated with males, higher age, higher income and better SRH. The results showed that the Swedish sample scored lower on FACT-GP than previous studies.
Conclusions:
Since HRQOL is frequently used as an important endpoint in healthcare research, there is an increasing need for normative data. The results from this study serve as a general population standard against which other studied HRQOL-data could be evaluated.
