Measuring the individual quality of life of patients with prostate cancer

Abstract

Prostate cancer can have diverse effects on patients' quality of life (QoL). Standard QoL questionnaires do not address all of the concerns expressed by such patients. The primary purpose of this study was to identify those issues with the greatest influence on the QoL of patients with prostate cancer. A secondary aim was to compare the performance of the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) semi-structured interview with the Functional Assessment of Cancer Therapy-Prostate questionnaire (FACT-P). A mixed population of patients with prostate cancer (including those with localized and metastatic disease) completed the SEIQoL-DW and the FACT-P. The SEIQoL-DW was satisfactorily completed by 180 patients, including 93 patients with metastatic disease. Patients identified 144 separate QoL concerns, and these were then independently grouped by three of the authors into 13 distinct themes. The most frequently identified themes were 'leisure and hobbies', 'family' and 'health'. The themes that patients considered to be the most important were 'partner/spouse', 'family' and 'health'. Patients were most satisfied with their QoL in the domains of 'family', 'partner/spouse' and 'friends'. They were least satisfied with 'sexuality', 'mobility' and 'psychological factors'. Patients with metastatic disease rated their QoL significantly (Po0.0001) lower than other patients using the FACT-P, but not using the SEIQoL-DW (P ¼ 0.07). Patients with prostate cancer identified numerous QoL concerns that are not included (or are underrepresented) in standard health-related QoL questionnaires such as the FACT-P. Health-related QoL questionnaires may underestimate the QoL of patients with metastatic disease.

Quality of life in patients with prostate cancer: development and application of a hybrid assessment method

“…From the 194 subjects included in the original study, 11 155 patients were invited to participate in an assessment of the direct-weighting procedure of FACT-P domains. Five subjects were subsequently excluded from the analysis (one man failed to understand the directweighting procedure and four men did not complete a sufficient number of the FACT items to provide useable data).…”

“…As part of a larger study 11 patients with prostate cancer were recruited from the uro-oncology outpatient department and from among hospice inpatients. To be eligible for the study, patients had to have a proven diagnosis of prostate cancer, sufficient English language skills to participate in a semi-structured interview and be able to give written informed consent.…”

“…A more detailed description of the FACT-P and the SEIQoL-DW is provided in the accompanying paper. 11 The FACT-P questionnaire version 4 4 is a 39-item questionnaire consisting of five domains; 'Physical wellbeing', 'Social/Family well-being', 'Emotional wellbeing', 'Functional well-being' and 'Additional concerns' (consisting of items relating specifically to prostate cancer and/or its treatment).…”

“…10 Details of the administration of the SEIQoL-DW and a description of the commonly reported concerns of patients with prostate cancer have been reported in the accompanying paper. 11 Patients' Eastern Cooperative Oncology Group (ECOG) performance status and the time taken to complete each instrument were recorded. At the second assessment patients were asked whether they felt that their QoL was 'better', 'the same' or 'worse' than at the first assessment.…”

“…11 However, this approach is time-consuming (adding approximately 20 min to data collection per subject) and resource intensive. The purpose of this study was to explore an alternative approach to measuring QoL that relies on a combination of the FACT questionnaire with the 'direct-weighting' method of gauging QoL domains employed in the SEIQoL-DW.…”