Quality of life measurement in bone marrow transplantation: development of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale

Abstract

Summary:uncertainty of a cure with high-dose, intensive treatment regimens. While there has been increasing attention paid to QOL issues in BMT patients, [3][4][5][6][7][8][9] there have been few We developed a 12-item bone marrow transplant subscale (BMTS) for the general Functional Assessment of instruments designed specifically to measure quality of life in the transplant patient population. One other available Cancer Therapy (FACT) measure. The subscale combined with the FACT, (FACT-BMT) is a 47-item, valid instrument 10 was developed for post-treatment survivors of bone marrow transplantation, so its appropriateness for and reliable measure of five dimensions of quality of life in bone marrow transplant patients. The three-step patients during transplantation is unknown.Health-related quality of life measurement has evolved validation process involved the generation and selection of BMT-specific items and the testing of the overall meaover the past 25 years to the point where the Food and Drug Administration recommends QOL assessment for any sure. Items were selected from a list produced by seven oncology experts and 15 patients and were designed to new drug therapies developed in cancer medicine. 11,12Initially, general measures of psychological health and assess content not represented in the general FACT items. A total of 182 patients completed the FACT-BMT functional status were used to assess patient response to cancer therapies and other areas such as cardiac care and at baseline, prior to BMT. An analysis measuring sensitivity to change was performed with 74 patients after renal transplantation. Cancer specific instruments were developed to measure the particular issues faced by cancer transplantation and 60 patients over the three timepoints of baseline, hospital discharge and 100 days. The patients. 13,14 Further advancement of QOL measurement technology has produced site-specific scales that FACT-BMT and all subscales were correlated, sensitivity to change was measured, and the internal consistaccompany general cancer measures and are utilized to assess the unique problems faced by patients with differency for each scale was calculated. Coefficients of reliability and validity ranged from 0.86 to 0.89 for the ent diagnoses.14,15While many uses of QOL data have been described, 16 entire FACT-BMT and 0.54 to 0.63 for the BMTS. The BMTS was able to discriminate patients on the basis of there are three primary reasons why QOL measurement is important, especially in a BMT population. 17 First, when performance status rating and also demonstrated sensitivity to change over time. The FACT-BMT has good two treatments are compared in a clinical trial, QOL data may provide additional information upon which to base psychometric properties for use in assessing quality of life in bone marrow transplant patients. The addition treatment decisions. Since BMT regimens are relatively new compared to standard chemotherapeutic and radioof the bone marrow transplant subscale to the general FACT measure makes it an e...

Having a sibling as donor: Patients' experiences immediately before allogeneic hematopoietic stem cell transplantation

“…QoL is therefore broader than HRQoL since it includes evaluation of non-health-related features of life whereas HRQoL is connected to an individual's health or disease status (Bowling, 2001;Bowling, 2005 (Fayers & Machin, 2007). The reason the concept QoL is used in Study I, and in this thesis, is that when data collection and selection of QoL measurements started in 2005 most QoL studies in patients undergoing HSCT used the concept QoL as HRQoL had not yet been completely established in this context (Cella et al, 1993;Chiodi et al, 2000;Ferrell et al, 1992;Heinonen et al, 2001a;Kopp et al, 2000;McQuellon et al, 1997;Saleh & Brockopp, 2001). In Study I the concept QoL is based on the WHO definition (described above); that it is an individual perception influenced by cultural, social and environmental contexts, where disease and treatment may influence its perception.…”

“…The questionnaires used to measure patient QoL were the Functional Assessment of Cancer Therapy -Bone Marrow Transplantation scale (FACT-BMT), version 4 (Cella et al, 1993;McQuellon et al, 1997) and the Functional Assessment of Chronic Illness Therapy -the Spiritual Well-being scale (FACITSp), version 4 (Peterman et al, 2002) (Appendix I). The FACIT measurement system is a collection of QoL questionnaires with a core questionnaire, Functional Assessment of Cancer Therapy -General (FACT-G), with a number of supplementary subscales specific to tumour type, treatment or condition.…”

“…Their answers are then scored according to scale-specific guidelines (Cella, 1997). A higher score indicates better QoL (McQuellon et al, 1997;Peterman et al, 2002). Validated Swedish translations of the ques-tionnaires (Bonomi et al, 1996) were acquired from FACIT for use in the present study.…”

“…the items in FACT-BMT together with the spiritual well-being subscale. (Cella, 1997;Cella et al, 1993;McQuellon et al, 1997). Patients who did not answer the minimum number of items recommended by the FACIT guidelines were considered withdrawals and their responses were excluded from the analysis.…”

“…The FACT-BMT, version 4 (Cella et al, 1993;McQuellon et al, 1997) and the FACIT-Sp (Appendix I), version 4 (Peterman et al, 2002) were used to measure QoL. FACT-BMT was chosen as it is a frequently used and recommended instrument in studies of QoL in patients undergoing HSCT with demonstrated reliability and validity (Kopp et al, 2000;McQuellon et al, 1997).…”