Validation of the FACT-G scale for evaluating quality of life in cancer patients in Colombia

Ricardo Sánchez, Monica Ballesteros, Benjamin J Arnold
Quality of Life Research 2011, 20 (1): 19-29

PURPOSE: To validate the FACT-G scale for measuring quality of life of patients with cancer in Colombia.

METHODS: The analysis included factor analysis, confirmatory analysis, Rasch analysis, convergent validity, internal consistency (473 patients diagnosed with cancer), test-retest reliability (97 patients evaluated at two different time points) and sensitivity to change (25 patients evaluated before and after an intervention).

RESULTS: A four-factor structure has been found ("Physical well-being", "Social-family well-being", "Functional well-being" and "Emotional well-being"). Two subscales ("Emotional well-being" and "Social-family well-being") have misfitting items. Cronbach's alpha was 0.89 for the whole scale. None of the items had significant impact on the scale's alpha when removed. Lin's concordance correlation coefficient indicated test-retest reliability (rho c: 0.64-0.76) adequate to the uses of the tool. Regarding sensitivity to change, repeated measures analysis demonstrated significant change of the score after an intervention [F(3, 72) = 39.89, P = 0.000]. Except for the domain "Social-family well-being", Pearson's correlation coefficient between equivalent domain scores on FACT-G and the EORTC QLQC-30 ranged from 0.5 to 0.7.

CONCLUSIONS: The FACT-G scale measures a four-factor construct. Results indicate that the FACT-G scale is an instrument that performs consistently over time, with evidence of responsiveness. The finding of misfitting items in two subscales ("Social-family well-being", and "Emotional well-being") imposes caution in interpreting the scores of these domains.

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