ASSESSING QUALITY-OF-LIFE IN ONCOLOGY - R ATIONALE AND OBJECTIVES OF THE FIRST-PHASE OF THE QVONC PROJECT

Although the subjective nature of quality of life perception is genera lly accepted, less attention has been paid to the procedure of selecti ng domains to be explored with questionnaires. In most cases domains a re selected by panel of experts. it is not known whether these domains are relevant for the patients. Moreover, questionnaires developed in 'foreign' countries may not be culturally sound or relevant for patien ts living in different cultural background, In order to explore what r eally contributes to quality of life of Italian patients, a survey was conducted with the aim of identifying any dimension of quality of lif e, positively or negatively impacted on from the illness and therapies . A sample of two hundred and eighty eight cancer patients with previo usly specified characteristics (primary tumor, stage of disease and pl ace of residence) were identified. After consenting to partecipate to the study, a staff member (a physician, a nurse or a psychologist) ask ed the patient to complete an open-ended questionnaire in the out-pati ent clinic or at home. This questionnaire, partially derived from a st udy by Padilla et al, made up of 5 questions: 'What does the term qual ity of life mean to you?', 'What contributes to a good quality of life ?', 'What contributes to a poor or bad quality of life?', 'Which eithe r physical or psychological symptom interferes with your quality of li fe?', 'State any positive or negative change in your quality of life, due to illness or treatments'. The first question was asked to explore the meaning of quality of life for the patient; the second and third question were asked to determine the contents of quality of life not h ealth related; the fourth question and the diary provided information about quality of life contents related to his own experience of diseas e. Two hundred and forty eight questionnaires (86.1%) were obtained fr om 7 Cancer Centres participating to the study (Genova, Milano, Roma, Perugia, Napoli, Cagliari, Palermo). All the questionnaires were trans cribed and subsequently broken down in phrases on a form that allowed coding. Three raters (a research nurse, an oncologist and a clinical-p sychologist) made the content analysis using as conceptual framework t he list of domains identified by the Italian Society of Psyche-Oncolog y. The present study shows the possibility to define the content domai n of quality of life attributes for cancer patients, using patients as experts.