Skip to main content
SpringerLink
Log in

The EORTC QLQ-C15-PAL questionnaire: validation study for Spanish bone metastases patients

  • Brief Communication
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Quality of life (QL) is a key outcome for advanced disease cancer patients. The European Organization for Research and Treatment of Cancer (EORTC) has developed the QLQ-C15-PAL questionnaire, a short version of the QLQ-C30 for palliative care. The aim of the present study is to validate the QLQ-C15-PAL for use with Spanish patients with bone metastasis.

Methods

For this study, we used a consecutive sample of stage IV cancer patients with bone metastases who started radiotherapy with palliative intention. Two assessments were proposed for each patient: one on the first day of treatment and one a month after the end of the radiotherapy sessions. Psychometric evaluation of the structure, reliability, and validity was undertaken.

Results

One hundred and sixteen patients completed the first questionnaire and seventy five completed the second. Multitrait scaling analysis showed that all items met the standards for convergent validity, and all except the fatigue scale met the standards for divergent validity. Cronbach’s coefficient met the 0.7 alpha criterion on all scales except pain (second assessment). Most QLQ-C15-PAL areas had low-to-moderate correlations with the other areas. Significant differences appeared in the comparisons between groups with regard to: patients who died before the second assessment (six areas); patients receiving chemotherapy before starting radiotherapy in the two assessments (three and four areas, respectively); the performance status in the two assessments (nine and eight areas); and the number of RT sessions received (four). Quality of life was better in the second assessment in nine areas.

Conclusion

The QLQ-C15-PAL is a reliable and valid instrument when applied to a sample of Spanish patients. These results are in line with those of other validation studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Caissie, A., Zeng, L., Nguyen, J., Zhang, L., Jon, F., Dennis, K., et al. (2012). Assessment of health-related quality of life with the European Organization for Research and Treatment of Cancer QLQ-C15-PAL after palliative radiotherapy of bone metastases. Clinical Oncology (Royal College of Radiologists), 24(2), 125–133.

    Article  CAS  Google Scholar 

  2. Soelver, L., Oestergaard, B., Rydahl-Hansen, S., & Wagner, L. (2012). Advanced cancer patients’ self-assessed physical and emotional problems on admission and discharge from hospital general wards—a questionnaire study. European Journal of Cancer Care (Engl), 21(5), 667–676.

    Article  CAS  Google Scholar 

  3. Groenvold, M., Petersen, M. A., Aaronson, N. K., Arraras, J. I., Blazeby, J. M., Bottomley, A., et al. (2006). The development of the EORTC QLQ-C15-PAL: A shortened questionnaire for cancer patients in palliative care. European Journal of Cancer, 42(1), 55–64.

    Article  PubMed  Google Scholar 

  4. Kaasa, S., & Loge, J. H. (2003). Quality of life in palliative care: Principles and practice. Palliative Medicine, 17(1), 11–20.

    Article  PubMed  Google Scholar 

  5. Lien, K., Zeng, L., Nguyen, J., Cramarossa, G., Culleton, S., Caissie, A., et al. (2011). Comparison of the EORTC QLQ-C15-PAL and the FACIT-Pal for assessment of quality of life in patients with advanced cancer. Expert Review of Pharmacoeconomics and Outcomes Research, 11(5), 541–547.

    Article  PubMed  Google Scholar 

  6. Miyazaki, K., Suzukamo, Y., Shimozuma, K., & Nakayama, T. (2012). Verification of the psychometric properties of the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 palliative (EORTC QLQ-C15-PAL). Quality of Life Research, 21(2), 335–340.

    Article  PubMed  Google Scholar 

  7. Bruera, E., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6–9.

    CAS  PubMed  Google Scholar 

  8. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. Journal of National Cancer Institute, 85(5), 365–376.

    Article  CAS  Google Scholar 

  9. Petersen, M. A., Groenvold, M., Aaronson, N., Blazeby, J., Brandberg, Y., de Graeff, A., et al. (2006). Item response theory was used to shorten EORTC QLQ-C30 scales for use in palliative care. Journal of Clinical Epidemiology, 59(1), 36–44.

    Article  PubMed  Google Scholar 

  10. Bjorner, J. B., Petersen, M. A., Groenvold, M., Aaronson, N., Ahlner-Elmqvist, M., Arraras, J. I., et al. (2004). Use of item response theory to develop a shortened version of the EORTC QLQ-C30 emotional functioning scale. Quality of Life Research, 13(10), 1683–1697.

    Article  CAS  PubMed  Google Scholar 

  11. Groenvold, M., Petersen, M. A., Aaronson, N. K., Arraras, J. I., Blazeby, J. M., Bottomley, A., et al. (2006). EORTC QLQ-C15-PAL: the new standard in the assessment of health-related quality of life in advanced cancer? Palliative Medicine, 20(2), 59–61.

    Article  PubMed  Google Scholar 

  12. Taphoorn, M. J., Claassens, L., Aaronson, N. K., Coens, C., Mauer, M., Osoba, D., et al. (2010). An international validation study of the EORTC brain cancer module (EORTC QLQ-BN20) for assessing health-related quality of life and symptoms in brain cancer patients. European Journal of Cancer, 46(6), 1033–1040.

    Article  PubMed  Google Scholar 

  13. Vivat, B., Young, T., Efficace, F., Sigurdadóttir, V., Arraras, J. I., Asgeirsdóttir, G. H., et al. (2013). Cross-cultural development of the EORTC QLQ-SWB36: A stand-alone measure of spiritual wellbeing for palliative care patients with cancer. Palliative Medicine, 27(5), 457–469.

    Article  PubMed  Google Scholar 

  14. Cull, A., Sprangers, M., Bjordal, K., Aaronson, N. K., & West, K. (2002). EORTC quality of life group translation procedure (2nd ed.). Brussels: EORTC.

    Google Scholar 

  15. Karnofsky, D. A., & Burchenal, J. H. (1948). The clinical evaluation of chemotherapeutic agents in cancer. In C. M. McLeod (Ed.), Evaluation of chemotherapeutic agents (pp. 199–205). New York: Colombia University.

    Google Scholar 

  16. Tabachnik, B. J., & Fidell, L. S. (1993). Using multivariate statistics. London: Harper & Row.

    Google Scholar 

  17. Ware, J. E., Harris, W. J., Gandek, B., Rogers, B. W., & Reese, P. R. (1997). MAP-R for windows: Multitrait multi-item analysis program—revised user’s guide. Boston: Health Assessment Lab.

    Google Scholar 

  18. Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297.

    Article  Google Scholar 

  19. Arraras, J. I., Arias, F., Tejedor, M., Pruja, E., Marcos, M., Martínez, E., et al. (2002). The EORTC QLQ-C30 (version 3.0) quality of life questionnaire: Validation study for Spain with head and neck cancer patients. Psychooncology, 11(3), 249–256.

    Article  CAS  PubMed  Google Scholar 

  20. Hjermstad, M. J., Fayers, P. M., Bjordal, K., & Kaasa, S. (1998). Using reference data on quality of life–the importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3). European Journal of Cancer, 34(9), 1381–1389.

    Article  CAS  PubMed  Google Scholar 

  21. Steinmann, D., Schäfer, C., van Oorschot, B., Wypior, H. J., Bruns, F., Bölling, T., et al. (2009). Strahlentherapie und Onkologie, 185(3), 190–197.

    Article  PubMed  Google Scholar 

  22. Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139–144.

    CAS  PubMed  Google Scholar 

  23. Middel, B., & Van Sonderen, E. (2002). Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research. International Journal of Integrated Care, 2(17), 1–18.

    Google Scholar 

  24. Caissie, A., Nguyen, J., Chen, E., Zhang, L., Sahgal, A., Clemons, M., et al. (2012). Quality of life in patients with brain metastases using the EORTC QLQ-BN20+2 and QLQ-C15-PAL. International Journal of Radiation Oncology Biology Physics, 83(4), 1238–1245.

    Article  Google Scholar 

  25. Hermann, K., Engeser, P., Szecsenyi, J., & Miksch, A. (2012). Palliative patients cared for at home by PAMINO-trained and other GPs. Health-related quality of life as measured by QLQ-C15-PAL and POS. BioMed Central Palliative Care, 11(1), 13.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Shin, K., Zeng, L., Chen, E., Zhang, L., Culleton, S., Dennis, K., et al. (2012). Do elderly patients with metastatic cancer have worse quality of life scores? Supportive Care in Cancer, 20(9), 2121–2127.

    Article  Google Scholar 

  27. Suárez-del-Real, Y., Allende-Pérez, S., Alférez-Mancera, A., Rodríguez, R. B., Jiménez-Toxtle, S., Mohar, A., et al. (2001). Validation of the Mexican-Spanish version of the EORTC QLQ-C15-PAL questionnaire for the evaluation of health-related quality of life in patients on palliative care. Psychooncology, 20(8), 889–896.

    Article  Google Scholar 

  28. Caissie, A., Culleton, S., Nguyen, J., Zhang, L., Zeng, L., Holden, L., et al. (2012). EORTC QLQ-C15-PAL quality of life scores in patients with advanced cancer referred for palliative radiotherapy. Supportive Care in Cancer, 20(4), 841–848.

    Article  PubMed  Google Scholar 

  29. Koo, K., Zeng, L., Chen, E., Zhang, L., Culleton, S., Dennis, K., et al. (2012). Do elderly patients with metastatic cancer have worse quality of life scores? Supportive Care in Cancer, 20(9), 2121–2127.

    Article  PubMed  Google Scholar 

  30. Steinmann, D., Paelecke-Habermann, Y., Geinitz, H., Aschoff, R., Bayerl, A., Bölling, T., et al. (2012). Prospective evaluation of quality of life effects in patients undergoing palliative radiotherapy for brain metastases. BioMed Central Cancer, 10(12), 283.

    Google Scholar 

Download references

Acknowledgments

This study was supported by the Departamento de Salud del Gobierno de Navarra, Spain. We would like to thank Morten Petersen for his advice in the analyses.

Author information

Authors and Affiliations

  1. Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain

    Juan Ignacio Arraras, Fernando Arias de la Vega, Gemma Asin, Mikel Rico, Uxue Zarandona, Clara Eito, Marta Barrondo, Marta Errasti & Miguel Angel Dominguez

  2. Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain

    Juan Ignacio Arraras, Uxue Zarandona, Juan Verdún & Jose Rivadeneira

  3. Fundación Miguel Servet, NavarraBiomed, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain

    Koldo Cambra

Authors
  1. Juan Ignacio Arraras
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fernando Arias de la Vega
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gemma Asin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mikel Rico
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Uxue Zarandona
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Clara Eito
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Koldo Cambra
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marta Barrondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marta Errasti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Juan Verdún
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jose Rivadeneira
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Miguel Angel Dominguez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juan Ignacio Arraras.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arraras, J.I., de la Vega, F.A., Asin, G. et al. The EORTC QLQ-C15-PAL questionnaire: validation study for Spanish bone metastases patients. Qual Life Res 23, 849–855 (2014). https://doi.org/10.1007/s11136-013-0511-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-013-0511-9

Keywords

Search

Navigation