Quality-of-life measurement in advanced cancer: Assessing the individual

Purpose: Despite the increasing importance of assessing quality of life (Qo L) in patients with advanced cancer, relatively little is known about indiv idual patient's perceptions of the issues contributing to their QoL, The Sc hedule for the Evaluation of individual Quality of Life (SEIQoL) and the sh orter SEIQoL-Direct Weighting (SEIQoL-DW) assess individualized QoL using a semistructured interview technique, Here we report findings from the first administration of the SEIQoL and SEIQoL-DW to patients with advanced incur able cancer. Patients and Methods: QoL was assessed on ct single occasion using the SEIQ oL a nd SEIQoL-DW in 80 patients with advanced incurable cancer. Results: All patients were able to complete the SEIQoL-DW, and 78% complete d the SEIQoL, Of a passible score of 100, the median QoL global score was a s follows: SEIQoL, 61 (range, 24 to 94); SEIQoL-DW, 60.5 (range, 6 to 95), Psychometric data for SEIQoL indicated very high levels of internal consist ency (median r = .90) and internal validity (median R-2 = 0.88). Patients' judgments of their QoL were unique to the individual. Family concerns were almost universally rated as more important than health, the difference bein g significant when measured using the SEIQoL-DW(P = .002), Conclusion: Patients with advanced incurable cancer were very good judges o f their QoL, and many patients rated their QoL as good. Judgments were high ly individual, with very high levels of consistency and validity. The prima cy given to health in many QoL questionnaires may be questioned in this pop ulation. The implications of these findings are discussed with regard to cl inical assessment and advance directives. (C) 1999 by American Society of C linical Oncology.