THE PERFORMANCE STATUS SCALE FOR HEAD AND NECK-CANCER PATIENTS AND THE FUNCTIONAL ASSESSMENT OF CANCER-THERAPY HEAD AND NECK SCALE - A STUDY OF UTILITY AND VALIDITY

BACKGROUND. The goal of this investigation was to examine the relation ship between, and application of, two disease specific quality of life (QL) measures currently being employed for head and neck cancer patie nts: the Functional Assessment of Cancer Therapy-Head and Neck Scale ( FACT-H&N) and the Performance Status Scale for Head and Neck Cancer Pa tients (PSS-HN). METHODS. The FACT-H&N and PSS-HN were administered to 151 head and neck cancer patients with a range of disease sites, trea tment status (on vs. off treatment), and treatment modalities (surgery , radiation, and chemotherapy). RESULTS. FACT-H&N subscale and total s cores and PSS-HN subscale scores proved sensitive to patients groups ( showed significant and clinically meaningful differences) on the basis of treatment status (on vs. off treatment) and global performance sta tus (Karnofsky scores). The pattern of correlations between FACT-H&N a nd PSS-HN subscales supported the scales' construct (convergent vs. di vergent) validity. The strongest and most significant associations wer e observed between PSS-HN Normalcy of Diet and Eating in Public, and t he head and neck subscale (HNS) of FACT-H&N, both of which were design ed to measure the unique problems of head and neck cancer patients. Mo re modest associations were observed between subscales measuring physi cal and functional areas of performance, social functioning, and emoti onal well-being. CONCLUSIONS. The FACT-HNS was found to be reliable an d valid when applied to head and neck cancer patients. It clearly adds information to that collected by the parent (core) instrument. The PS S-HN also provides unique information, independent of that provided by the Karnofsky or the FACT-H&N. This study supported the multidimensio nal nature of QL for head and neck cancer patients, and thus the impor tance of assessing disease specific concerns in addition to general he alth status when assessing functional and QL outcome. (C) 1996 America n Cancer Society.