Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2006

Open Access 01-12-2006 | Research

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

Authors: Nancy E Avis, Edward Ip, Kristie Long Foley

Published in: Health and Quality of Life Outcomes | Issue 1/2006

Login to get access

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bottomley A: The cancer patient and quality of life. The Oncologist 2002, 7: 120–125. 10.1634/theoncologist.7-2-120PubMedCrossRef Bottomley A: The cancer patient and quality of life. The Oncologist 2002, 7: 120–125. 10.1634/theoncologist.7-2-120PubMedCrossRef
2.
go back to reference Gotay CC, Korn EL, McCabe MS, Moore TD, Cheson BD: Quality-of-life assessment in cancer treatment protocols: research issues in protocol development. J Natl Cancer Inst 1992, 84: 575–579.PubMedCrossRef Gotay CC, Korn EL, McCabe MS, Moore TD, Cheson BD: Quality-of-life assessment in cancer treatment protocols: research issues in protocol development. J Natl Cancer Inst 1992, 84: 575–579.PubMedCrossRef
3.
go back to reference Tanaka T, Gotay CC: Physicians' and medical students' perspectives on patients' quality of life. Acad Med 1998, 73: 1003–1005. 10.1097/00001888-199809000-00022PubMedCrossRef Tanaka T, Gotay CC: Physicians' and medical students' perspectives on patients' quality of life. Acad Med 1998, 73: 1003–1005. 10.1097/00001888-199809000-00022PubMedCrossRef
4.
go back to reference Society AC: Cancer Facts and Figures, 2005. American Cancer Society 2005. Society AC: Cancer Facts and Figures, 2005. American Cancer Society 2005.
5.
go back to reference Gotay CC, Muraoka MY: Quality of life in long-term survivors of adult-onset cancers. J Natl Cancer Inst 1998, 90: 656–667. 10.1093/jnci/90.9.656PubMedCrossRef Gotay CC, Muraoka MY: Quality of life in long-term survivors of adult-onset cancers. J Natl Cancer Inst 1998, 90: 656–667. 10.1093/jnci/90.9.656PubMedCrossRef
6.
go back to reference Ferrell BR, Dow KH, Grant M: Measurement of the quality of life in cancer survivors. Qual Life Res 1995, 4: 523–531. 10.1007/BF00634747PubMedCrossRef Ferrell BR, Dow KH, Grant M: Measurement of the quality of life in cancer survivors. Qual Life Res 1995, 4: 523–531. 10.1007/BF00634747PubMedCrossRef
7.
go back to reference Dorval M, Maunsell E, Deschenes L, Brisson J, Masse B: Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol 1998, 16: 487–494.PubMed Dorval M, Maunsell E, Deschenes L, Brisson J, Masse B: Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol 1998, 16: 487–494.PubMed
8.
go back to reference Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR: Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 2002, 94: 39–49.PubMedCrossRef Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR: Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 2002, 94: 39–49.PubMedCrossRef
9.
go back to reference Ganz PA: Late effects of cancer and its treatment. Semin Oncol Nurs 2001, 17: 241–248. 10.1053/sonu.2001.27914PubMedCrossRef Ganz PA: Late effects of cancer and its treatment. Semin Oncol Nurs 2001, 17: 241–248. 10.1053/sonu.2001.27914PubMedCrossRef
10.
go back to reference Berglund G, Bolund C, Fornander T, Rutqvist LE, Sjoden PO: Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients. Eur J Cancer 1991, 27: 1075–1081.PubMedCrossRef Berglund G, Bolund C, Fornander T, Rutqvist LE, Sjoden PO: Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients. Eur J Cancer 1991, 27: 1075–1081.PubMedCrossRef
11.
go back to reference Dow KH, Ferrell BR, Leigh S, Ly J, Gulasekaram P: An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Res Treat 1996, 39: 261–273. 10.1007/BF01806154PubMedCrossRef Dow KH, Ferrell BR, Leigh S, Ly J, Gulasekaram P: An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Res Treat 1996, 39: 261–273. 10.1007/BF01806154PubMedCrossRef
12.
go back to reference Heflin LH, Meyerowitz BE, Hall P, Lichtenstein P, Johansson B, Pedersen NL, Gatz M: Cancer as a risk factor for long-term cognitive deficits and dementia. J Natl Cancer Inst 2005, 97: 854–856.PubMedCrossRef Heflin LH, Meyerowitz BE, Hall P, Lichtenstein P, Johansson B, Pedersen NL, Gatz M: Cancer as a risk factor for long-term cognitive deficits and dementia. J Natl Cancer Inst 2005, 97: 854–856.PubMedCrossRef
13.
go back to reference Bjordal K, Mastekaasa A, Kaasa S: Self-reported satisfaction with life and physical health in long-term cancer survivors and a matched control group. Oral Oncology, European J Cancer 1995, 31: 340–345. 10.1016/0964-1955(95)00039-9CrossRef Bjordal K, Mastekaasa A, Kaasa S: Self-reported satisfaction with life and physical health in long-term cancer survivors and a matched control group. Oral Oncology, European J Cancer 1995, 31: 340–345. 10.1016/0964-1955(95)00039-9CrossRef
14.
go back to reference Deimling GT, Kahana B, Bowman KF, Schaefer ML: Cancer survivorship and psychological distress in later life. Psychooncology 2002, 11: 479–494. 10.1002/pon.614PubMedCrossRef Deimling GT, Kahana B, Bowman KF, Schaefer ML: Cancer survivorship and psychological distress in later life. Psychooncology 2002, 11: 479–494. 10.1002/pon.614PubMedCrossRef
15.
go back to reference Wyatt G, Friedman LL: Long-term female cancer survivors: quality of life issues and clinical implications. Cancer Nurs 1996, 19: 1–7. 10.1097/00002820-199602000-00001PubMedCrossRef Wyatt G, Friedman LL: Long-term female cancer survivors: quality of life issues and clinical implications. Cancer Nurs 1996, 19: 1–7. 10.1097/00002820-199602000-00001PubMedCrossRef
16.
go back to reference Partridge AH, Burstein HJ, Winer EP: Side effects of chemotherapy and combined chemohormonal therapy in women with early-stage breast cancer. J Natl Cancer Inst Monogr 2001, 135–142. Partridge AH, Burstein HJ, Winer EP: Side effects of chemotherapy and combined chemohormonal therapy in women with early-stage breast cancer. J Natl Cancer Inst Monogr 2001, 135–142.
17.
go back to reference Burstein HJ, Winer EP: Primary care for survivors of breast cancer. N Engl J Med 2000, 343: 1086–1094. 10.1056/NEJM200010123431506PubMedCrossRef Burstein HJ, Winer EP: Primary care for survivors of breast cancer. N Engl J Med 2000, 343: 1086–1094. 10.1056/NEJM200010123431506PubMedCrossRef
18.
go back to reference Cordova MJ, Cunningham LL, Carlson CR, Andrykowski MA: Posttraumatic growth following breast cancer: a controlled comparison study. Health Psychol 2001, 20: 176–185. 10.1037/0278-6133.20.3.176PubMedCrossRef Cordova MJ, Cunningham LL, Carlson CR, Andrykowski MA: Posttraumatic growth following breast cancer: a controlled comparison study. Health Psychol 2001, 20: 176–185. 10.1037/0278-6133.20.3.176PubMedCrossRef
19.
go back to reference Antoni MH, Lehman JM, Kilbourn KM, Boyers AE, Culver JL, Alferi SM, Yount SE, McGregor BA, Arena PL, Harris SD, Price AA, Carver CS: Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol 2001, 20: 20–32. 10.1037/0278-6133.20.1.20PubMedCrossRef Antoni MH, Lehman JM, Kilbourn KM, Boyers AE, Culver JL, Alferi SM, Yount SE, McGregor BA, Arena PL, Harris SD, Price AA, Carver CS: Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol 2001, 20: 20–32. 10.1037/0278-6133.20.1.20PubMedCrossRef
20.
go back to reference Helgeson VS, Snyder P, Seltman H: Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychol 2004, 23: 3–15. 10.1037/0278-6133.23.1.3PubMedCrossRef Helgeson VS, Snyder P, Seltman H: Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychol 2004, 23: 3–15. 10.1037/0278-6133.23.1.3PubMedCrossRef
21.
go back to reference Aspinwall LG, MacNamara A: Taking positive changes seriously. Cancer 2005, 104: 2549–2556. 10.1002/cncr.21244PubMedCrossRef Aspinwall LG, MacNamara A: Taking positive changes seriously. Cancer 2005, 104: 2549–2556. 10.1002/cncr.21244PubMedCrossRef
22.
go back to reference Avis NE, Smith KW, McGraw S, Smith RG, Petronis VM, Carver CS: Assessing quality of life in adult cancer survivors (QLACS). Qual Life Res 2005, 14: 1007–1023. 10.1007/s11136-004-2147-2PubMedCrossRef Avis NE, Smith KW, McGraw S, Smith RG, Petronis VM, Carver CS: Assessing quality of life in adult cancer survivors (QLACS). Qual Life Res 2005, 14: 1007–1023. 10.1007/s11136-004-2147-2PubMedCrossRef
23.
go back to reference Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J, .: The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993, 11: 570–579.PubMed Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J, .: The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993, 11: 570–579.PubMed
24.
go back to reference Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, .: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993, 85: 365–376.PubMedCrossRef Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, .: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993, 85: 365–376.PubMedCrossRef
25.
go back to reference Schipper H, Clinch J, McMurray A, Levitt M: Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation. J Clin Oncol 1984, 2: 472–483.PubMed Schipper H, Clinch J, McMurray A, Levitt M: Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation. J Clin Oncol 1984, 2: 472–483.PubMed
26.
go back to reference Schag CA, Heinrich RL: Development of a comprehensive quality of life measurement tool: CARES. Oncology (Williston Park) 1990, 4: 135–138. Schag CA, Heinrich RL: Development of a comprehensive quality of life measurement tool: CARES. Oncology (Williston Park) 1990, 4: 135–138.
27.
go back to reference Ferrell BR, Dow KH, Leigh S, Ly J, Gulasekaram P: Quality of life in long-term cancer survivors. Oncology Nursing Forum 1995, 22: 915–922.PubMed Ferrell BR, Dow KH, Leigh S, Ly J, Gulasekaram P: Quality of life in long-term cancer survivors. Oncology Nursing Forum 1995, 22: 915–922.PubMed
28.
go back to reference Foley KL, Farmer DF, Petronis VM, Smith RG, McGraw S, Smith K, Carver CS, Avis N: A qualitative exploration of the cancer experience among long-term survivors: comparisons by cancer type, ethnicity, gender, and age. Psychooncology 2006, 15: 248–258. 10.1002/pon.942PubMedCrossRef Foley KL, Farmer DF, Petronis VM, Smith RG, McGraw S, Smith K, Carver CS, Avis N: A qualitative exploration of the cancer experience among long-term survivors: comparisons by cancer type, ethnicity, gender, and age. Psychooncology 2006, 15: 248–258. 10.1002/pon.942PubMedCrossRef
29.
go back to reference Avis NE, Crawford S, Manuel J: Quality of life among younger women with breast cancer. J Clin Oncol 2005, 23: 3322–3330. 10.1200/JCO.2005.05.130PubMedCrossRef Avis NE, Crawford S, Manuel J: Quality of life among younger women with breast cancer. J Clin Oncol 2005, 23: 3322–3330. 10.1200/JCO.2005.05.130PubMedCrossRef
30.
go back to reference Ware JE: SF-36 Health Survey Manual and Interpretation Guide. Boston, The Health Institute, New England Medical Center; 1993. Ware JE: SF-36 Health Survey Manual and Interpretation Guide. Boston, The Health Institute, New England Medical Center; 1993.
31.
go back to reference Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S, Cobleigh M, Shiomoto G: Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol 1997, 15: 974–986.PubMed Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S, Cobleigh M, Shiomoto G: Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol 1997, 15: 974–986.PubMed
32.
go back to reference de Boer AG, van Lanschot JJ, Stalmeier PF, van Sandick JW, Hulscher JB, de Haes JC, Sprangers MA: Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Qual Life Res 2004, 13: 311–320. 10.1023/B:QURE.0000018499.64574.1fPubMedCrossRef de Boer AG, van Lanschot JJ, Stalmeier PF, van Sandick JW, Hulscher JB, de Haes JC, Sprangers MA: Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Qual Life Res 2004, 13: 311–320. 10.1023/B:QURE.0000018499.64574.1fPubMedCrossRef
33.
go back to reference Ganz PA, Day R, Ware JE Jr., Redmond C, Fisher B: Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. J Natl Cancer Inst 1995, 87: 1372–1382.PubMedCrossRef Ganz PA, Day R, Ware JE Jr., Redmond C, Fisher B: Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. J Natl Cancer Inst 1995, 87: 1372–1382.PubMedCrossRef
34.
go back to reference Day R, Ganz PA, Costantino JP, Cronin WM, Wickerham DL, Fisher B: Health-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Clin Oncol 1999, 17: 2659–2669.PubMed Day R, Ganz PA, Costantino JP, Cronin WM, Wickerham DL, Fisher B: Health-related quality of life and tamoxifen in breast cancer prevention: a report from the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Clin Oncol 1999, 17: 2659–2669.PubMed
35.
go back to reference Dunkel-Schetter C, Feinstein LG, Taylor SE, Falke RL: Patterns of coping with cancer. Health Psychol 1992, 11: 79–87. 10.1037/0278-6133.11.2.79PubMedCrossRef Dunkel-Schetter C, Feinstein LG, Taylor SE, Falke RL: Patterns of coping with cancer. Health Psychol 1992, 11: 79–87. 10.1037/0278-6133.11.2.79PubMedCrossRef
36.
go back to reference Manuel JC, Burwell SR, Crawford SL, Lawrence RH, Farmer DF, Hege A, Phillips K, Avis NE: Younger women's perceptions of coping with breast cancer: A mixed methods approach. Cancer Nursing 2006. Manuel JC, Burwell SR, Crawford SL, Lawrence RH, Farmer DF, Hege A, Phillips K, Avis NE: Younger women's perceptions of coping with breast cancer: A mixed methods approach. Cancer Nursing 2006.
37.
go back to reference Jacobson NS, Truax P: Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 1991, 59: 12–19. 10.1037/0022-006X.59.1.12PubMedCrossRef Jacobson NS, Truax P: Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 1991, 59: 12–19. 10.1037/0022-006X.59.1.12PubMedCrossRef
38.
go back to reference Cohen J: Statistical power analysis for the behavioral sciences. Hillsdale, NJ, Erlbaum; 1988. Cohen J: Statistical power analysis for the behavioral sciences. Hillsdale, NJ, Erlbaum; 1988.
39.
go back to reference Bloom JR, Stewart SL, Chang S, Banks PJ: Then and now: quality of life of young breast cancer survivors. Psychooncology 2004, 13: 147–160. 10.1002/pon.794PubMedCrossRef Bloom JR, Stewart SL, Chang S, Banks PJ: Then and now: quality of life of young breast cancer survivors. Psychooncology 2004, 13: 147–160. 10.1002/pon.794PubMedCrossRef
40.
go back to reference Carver CS, Smith RG, Antoni MH, Petronis VM, Weiss S, Derhagopian RP: Optimistic personality and psychosocial well-being during treatment predict psychosocial well-being among long-term survivors of breast cancer. Health Psychol 2005, 24: 508–516. 10.1037/0278-6133.24.5.508PubMedCrossRef Carver CS, Smith RG, Antoni MH, Petronis VM, Weiss S, Derhagopian RP: Optimistic personality and psychosocial well-being during treatment predict psychosocial well-being among long-term survivors of breast cancer. Health Psychol 2005, 24: 508–516. 10.1037/0278-6133.24.5.508PubMedCrossRef
41.
go back to reference Nunnaly JC, Bernstein I: The assessment of Reliability. In Psychometric Theory. 3rd. edition. New York, McGraw-Hill; 1994. Nunnaly JC, Bernstein I: The assessment of Reliability. In Psychometric Theory. 3rd. edition. New York, McGraw-Hill; 1994.
42.
go back to reference Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE: Life after breast cancer: understanding women's health-related quality of life and sexual functioning. J Clin Oncol 1998, 16: 501–514.PubMed Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE: Life after breast cancer: understanding women's health-related quality of life and sexual functioning. J Clin Oncol 1998, 16: 501–514.PubMed
43.
go back to reference Mor V, Malin M, Allen S: Age differences in the psychosocial problems encountered by breast cancer patients. J Natl Cancer Inst Monogr 1994, 191–197. Mor V, Malin M, Allen S: Age differences in the psychosocial problems encountered by breast cancer patients. J Natl Cancer Inst Monogr 1994, 191–197.
44.
go back to reference Vinokur AD, Threatt BA, Vinokur-Kaplan D, Satariano WA: The process of recovery from breast cancer for younger and older patients. Changes during the first year. Cancer 1990, 65: 1242–1254. Publisher Full Text 10.1002/1097-0142(19900301)65:5<1242::AID-CNCR2820650535>3.0.CO;2-1PubMedCrossRef Vinokur AD, Threatt BA, Vinokur-Kaplan D, Satariano WA: The process of recovery from breast cancer for younger and older patients. Changes during the first year. Cancer 1990, 65: 1242–1254. Publisher Full Text 10.1002/1097-0142(19900301)65:5<1242::AID-CNCR2820650535>3.0.CO;2-1PubMedCrossRef
Metadata
Title
Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for long-term cancer survivors in a sample of breast cancer survivors
Authors
Nancy E Avis
Edward Ip
Kristie Long Foley
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2006
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-4-92

Other articles of this Issue 1/2006

Health and Quality of Life Outcomes 1/2006 Go to the issue