Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for long-term cancer survivors in a sample of breast cancer survivors.

Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Health and Quality of Life Outcomes (Impact Factor: 2.1). 02/2006; 4:92. DOI: 10.1186/1477-7525-4-92
Source: PubMed

ABSTRACT This paper evaluates psychometric properties of a recently developed measure focusing on the health-related quality of life (HRQL) of long-term cancer survivors, the Quality of Life in Adult Survivors scale (QLACS), in a sample of breast cancer survivors. This represents an important area of study, given the large number of breast cancer patients surviving many years post diagnosis.
Analyses are based on an 8-year follow-up of a sample of breast cancer survivors who participated in an earlier study conducted in 1995. Participants were re-contacted in 2003 and those who were reachable and agreed to participate (n = 94) were surveyed using a variety of measures including the QLACS. Additional follow-up surveys were conducted 2 weeks and one year later. Psychometric tests of the QLACS included test-retest reliability, concurrent and retrospective validity, and responsiveness.
The QLACS domain and summary scores showed good test-retest reliability (all test-retest correlations were above .7) and high internal consistency. The Generic Summary Score showed convergent validity with other measures designed to assess generic HRQL. The Cancer-Specific Summary score exhibited divergent validity with generic HRQL measures, but not a cancer-related specific measure. The QLACS Cancer-Specific Summary Score demonstrated satisfactory predictive validity for factors that were previously shown to be correlated with HRQL. The QLACS generally demonstrated a high level of responsiveness to life changes.
The QLACS may serve as a useful measure for assessing HRQL among long-term breast cancer survivors that are not otherwise captured by generic measures or those specifically designed for newly diagnosed patients.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The end of primary treatment for cancer patients is increasingly recognized as an important time of adjustment that may impact quality of life (QoL). A psychometrically sound QoL instrument that assesses the mix of acute and longer-term concerns present during this unique time has not yet been identified. This article evaluates the Quality of Life in Adult Cancer Survivors (QLACS) scale, originally developed for long-term (>5 years) cancer survivors, as an appropriate QoL measure for this transition period.
    Quality of Life Research 07/2014; · 2.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The recent NCCN Guidelines for Survivorship recommend systematic evaluation and multidisciplinary treatment of cancer-related sexual dysfunctions. However, most oncology professionals fail to routinely assess sexual problems and lack expertise to treat them. An Internet-based intervention was designed to educate female patients and their partners about cancer-related sexual problems, describe medical treatment options and how to find expert care, and provide self-help strategies. A randomized trial assessed efficacy of the intervention when used as self-help versus the same Web access and 3 supplemental counseling sessions. Survivors of localized breast or gynecologic cancers completed online questionnaires at baseline, posttreatment, and 3- and 6-month follow-up, including the Female Sexual Function Index (FSFI), the Menopausal Sexual Interest Questionnaire (MSIQ), the Brief Symptom Inventory-18 (BSI-18) to assess emotional distress, and the Quality of Life in Adult Cancer Survivors (QLACS) scale. Program evaluation ratings were completed posttreatment. Fifty-eight women completed baseline questionnaires (mean age, 53 ± 9 years). Drop-out rates were 22% during treatment and 34% at 6-month follow-up. Linear mixed models for each outcome across time showed improvement in total scores on the FSFI, MSIQ, and QLACS (P<.001) and BSI-18 (P=.001). The counseled group improved significantly more on sexuality measures, but changes in emotional distress and quality of life did not differ between groups. Program content and ease of use were rated positively. Research is needed on how best to integrate this intervention into routine clinical practice, and particularly how to improve uptake and adherence.
    Journal of the National Comprehensive Cancer Network: JNCCN 11/2013; 11(11):1389-97. · 4.24 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective To provide new insights into the psychometrics of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire, originally developed for longer-term survivors 5 + years post-diagnosis. Specifically, to examine the classic psychometric properties of QLACS in a sample of shorter-term survivors, and to undertake Rasch analysis to explore the extent to which the Generic and Cancer-Specific summary scales (and separately-analysed Benefits of cancer domain) are unidimensional, with linear measurement properties and no differential item functioning (DIF). Methods Patients with potentially curative breast, colorectal or prostate cancer completed QLACS 15 months post-diagnosis (N = 407). Score distributions, floor and ceiling effects, internal reliability, and feasibility (completion time and missing data) were examined. Rasch analysis included examination of item fit, DIF and unidimensionality. Results The QLACS domains and summary scales had very similar score distributions and classic psychometric properties (no ceiling effects, majority no floor effects, acceptable reliability) to those found in development work with longer-term survivors. Median completion time was 10 minutes and total missing data 2.3%. The Generic summary scale contained several misfitting items and exhibited multidimensionality. The Cancer-Specific summary scale and Benefits domain showed fit to the Rasch model and demonstrated unidimensionality and no DIF, with just one or no item modifications respectively. Conclusion QLACS demonstrates similarly good classic psychometric properties among shorter-term as among longer-term survivors, and has good feasibility. The Cancer-Specific summary scale and Benefits domain showed an impressive degree of fit to the Rasch model, although the validity of computing the Generic summary score was not supported.
    Journal of Psychosomatic Research 10/2014; · 2.84 Impact Factor

Full-text (3 Sources)

Available from
Jun 1, 2014