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No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2003

Health Related Quality of Life in Patients Treated With Radical Cystectomy and Urinary Diversion for Urothelial Carcinoma of the Bladder: Development and Validation of a New Disease Specific Questionnaire

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    Purpose:

    The impact of treatment on the health related quality of life (HRQOL) of patients is being recognized with increasing importance, particularly in those with urological malignancies. However, a validated disease and treatment specific instrument to assess HRQOL following radical cystectomy (RC) and urinary diversion (UD) is currently lacking. We report the results of a new questionnaire designed specifically to measure HRQOL in these patients.

    Materials and Methods:

    A 45-item questionnaire consisting of the Functional Assessment of Cancer Therapy (FACT)-General and 17 additional items designed to measure disease and treatment specific health outcomes were combined to form the Vanderbilt Cystectomy Index (FACT-VCI). FACT-VCI and the generic RAND 36-Item Health Survey (SF-36) were administered to 50 patients from our institution RC data base who were more than 1 year from the time of surgery. Each patient was asked to complete the survey at 1 and 4 weeks. The results of the SF-36 and FACT-VCI were correlated along with the first and second administration of the FACT-VCI.

    Results:

    Overall FACT-VCI was found to have adequate internal consistency (Cronbach’s α >0.70). Furthermore, intraclass correlation for the first and second administration of the VCI was 0.79. In addition, there was good correlation between the validated SF-36 and FACT-VCI (r = 0.81). The result was initial validation of a questionnaire for the assessment of HRQOL in patients following RC and UD.

    Conclusions:

    Instruments designed to measure accurately HRQOL following RC and UD are in early development. We have now constructed and validated a disease and treatment specific questionnaire that can objectively assess HRQOL following RC and UD. A prospective longitudinal study of FACT-VCI is currently ongoing.

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    From the Departments of Urologic Surgery (MSC, SCD, SSC, TC, JAS) and Patient Care Services (NW), Vanderbilt University School of Medicine, Nashville, Tennessee

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