Reliability and validity of an observer-rated disfigurement scale for head and neck cancer patients

Abstract

Background Facial disfigurement is considered to be one of the most distressing aspects of head and neck cancer and its treatment, but it has been the focus of little systematic study. Existing studies have yielded conflicting results about the psychosocial impact of disfigurement. No studies to date have examined disfigurement using a valid and reliable observer‐rated measure. The purpose of the current study was to examine the validity (convergent and discriminant) and the inter‐rater reliability of a novel nine‐point observer‐rated disfigurement scale. Methods The sample consisted of 74 ambulatory head and neck cancer patients more than 6 months post treatment. Ratings of disfigurement were assigned independently by surgical and nonsurgical raters. Validity was assessed by comparing the association between disfigurement ratings and sociodemographic and illness treatment variables. Reliability was assessed by examining the concordance between the surgical and nonsurgical ratings. Results Disfigurement ratings were not associated with several sociodemographic variables, supporting the discriminant validity of the scale. Disfigurement was significantly related to a diagnosis of oral cancer, a history of adjunctive radiation, the type of surgical procedure performed, the degree of physical dysfunction, and the presence of postoperative complications. Observer ratings of disfigurement were significantly related to patient ratings of disfigurement. These findings support the convergent validity of the disfigurement scale. Inter‐rater reliability of the scale was high (intraclass correlation coefficient = .91). Conclusion The study provides preliminary evidence for the validity and inter‐rater reliability of a novel nine point observer‐rated disfigurement scale that may be useful in evaluating the impact of disfigurement on quality of life in head and neck cancer. © 2000 John Wiley & Sons, Inc. Head Neck 22: 132–141, 2000.

Development and evaluation of a problem-focused psychosocial intervention for patients with head and neck cancer

“…The LOT is a reliable, valid and easy to administer tool [30]. Disfigurement was measured using the observer-rated disfigurement scale [20] being a single-item, nine-point Likert scale, which measures the degree of facial disfigurement for patients with H&NC. The authors [20] have reported good convergent validity and inter-rater reliability, with a correlation coefficient of 0.91 (n=74).…”

Investigating quality of life and coping resources after laryngectomy

“…It is defined as an individual's sense of well-being in the somatic, emotional and social domains and has become a major topic in the interface between research in medicine and psychology [15]. The multidimensional construct of quality of life is usually assessed by questionnaires that have been validated for this purpose in earlier studies [1,8,12,17,19,21,22]. Acquired data are analysed statistically and the results are interpreted.…”

Factors associated with healthcare professional's rating of disfigurement and self-perceived body image in female patients with head and neck cancer

“…Around 57% of HNC patients who receive surgical treatment also experience major disfigurement (Gamba et al, 1992). Objective evaluation is based on the visible negative alteration of appearance caused by disruption of the skin, soft tissue or bony structures (Katz, Irish, Devins, Rodin, & Gullane, 2000). Facial appearance is of central importance to body image.…”