A functional status scale for measuring quality of life outcomes in head and neck cancer patients

Increased survival rates and disease control dictate that quality of life after treatment for head and neck cancel be evaluated. A disease-specific measure was developed from interviews with 115 patients, and items reflect the terminology, used by the patients to describe treatment-related problems and concerns. Validity and reliability of this self-report scale were tested with 172 head and neck cancer patients and 30 patients who had breast and gynecological cancers. Discriminate validity was excellent. Convergent validity of the scale was demonstrated by Pearson correlations of 0.68 with a general health status measure, 0.68 with the Karnofsky Performance Scale, and 0.76 with the Performance Status Scale for Head and Neck Cancer Patients. Reliability as measured by Cronbach's alpha was 0.88. Analysis of variance demonstrated that the scale was sensitive to differences in stage of disease (p = 0.017) and extent of first surgery (p = 0.001) in this cohort of head and neck cancer patients. Psychometric evaluation indicates that the scale could be used as an outcome measure between groups at one point in time, but future research is needed to establish the scale's sensitivity to positive and negative changes in functional status for longitudinal studies.