鼻咽癌患者生存质量FACT-H&N量表测评

Validation of functional assessment of cancer therapy-head and neck (FACT-H&N) scale(Chinese version) for measuring quality of life in patients with nasopharyngeal carcinoma

目的应用头颈部肿瘤患者生存质量测定量表(FACT-H&N)对鼻咽癌患者生存质量进行测评。方法选取中山大学肿瘤医院确诊的鼻咽癌患者444例,采用FACT-H&N量表进行生存质量测评,同时评价量表信度与效度。结果治疗中患者生理状况得分为(19.08±5.454)分;功能状况得分为(14.00±5.490)分;头颈部附加条目得分为(20.11±6.052)分;量表总得分为(95.18±18.360)分;均低于治疗前和治疗后得分;治疗后患者头颈部附加条目得分和生存质量总得分虽比治疗中有所上升,但未恢复至治疗前水平;量表内部一致性信度(克朗巴赫系数)为0.899,量表各领域的克朗巴赫系数(Cronbachα)为0.692～0.859;生理状况、功能状况和头颈部附加条目3个领域的重测相关系数(r)均>0.5,相关性良好;提取5个公因子的累积方差贡献率为61%,与量表设计基本吻合。结论治疗中的鼻咽癌患者生存质量明显下降;FACT-H&N量表可用于鼻咽癌患者生存质量测定和相关研究。

Objective To assess the validity of the functional assessment of cancer therapy-head and neck （FACT- H＆N） （Chinese version） in patients with nasopharyngeal carcinoma. Methods Four hundred and forty four patients com- pleted FACT-H＆N scale. The internal consistency for the total scale and its subscales were assessed with Cronbach＇s alpha. Test-retest reliability was determined with paired t-test and Person correlation. The data were analyzed with exploratory fac- tor analysis to determine factor construct validity. Inter-subscale correlations were analyzed with Person correlation and com- pared with the Cronbach＇s alpha of each subscale. Scores of the patients before, under, and after treatment were compared with analysis of variance. Results The scores of the physical well-being, functional well-being and the additional head and neck items during treatment period decreased compared with that of pre-treatment and post-treatment periods. The total score of the whole questionnaire didn＇ t increase to the same level of the pre-treatment period. Cronbach＇s ct coefficient of the total scale was 0. 899 and that of for the five domains ranged from 0. 692 to 0. 859. Test-retest showed good reproducibility. Five factors were extracted by exploratory factor analysis in accord with the questionnaire. Correlation coefficients between one subscale and others were less than Cronbach＇s α coefficient of that subscale. Conclusion The total scale is valid for measuring quality of life in patients with nasopharyngeal carcinoma with good reliability, validity and responsiveness.