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A comparison of the FACT-G and the Supportive Care Needs Survey (SCNS) in women with ovarian cancer: unidimensionality of constructs

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Abstract

Purpose

Health-related quality of life (HRQoL) and unmet needs (needs) questionnaires offer alternative perspectives for assessing cancer patients’ concerns. We examined whether the conceptual differences underlying these alternative approaches yield corresponding empirical differences.

Methods

Eight-hundred and seventy-four women with ovarian cancer completed the Functional Assessment of Cancer Therapy scale (FACT-G; HRQoL) and the Supportive Care Needs Survey (SCNS-SF34; needs) every 3 months for 2 years. Correlational analysis, exploratory and confirmatory factor analysis (EFA/CFA), and Rasch analysis tested the relationship between patients’ responses to similar domains and similar items across the two questionnaires.

Results

Strong correlations were found between items with virtually identical wording (0.67–0.75), while moderate to strong correlations (0.55–0.65) were found for those with very similar wording. EFA identified two common domains across the two questionnaires: physical and psychological. For each common domain, CFA indicated models involving a single construct with systematic variation within each questionnaire fit best. Rasch analysis including very similar items within the physical and psychological domains (separately) demonstrated strong evidence of unidimensionality.

Conclusions

The high degree of similarity between patient responses to items addressing the same or very similar concerns suggests either that HRQoL and needs approaches do not reflect different constructs or that patients may not be able to differentiate between the severity of a concern and the level of need associated with that concern, especially when these are assessed in quick succession.

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Abbreviations

AIC:

Akaike information criterion

AOCS:

Australian quality of life study

CI:

Confidence interval

CFA:

Confirmatory factor analysis

CFI:

Comparative fit index

EFA:

Exploratory factor analysis

FACT:

The functional assessment of cancer scale

FWB:

Functional wellbeing subscale of FACT

HRQoL:

Health-related quality of life

IRT:

Item response theory

PHY:

Physical and daily living subscale of SCNS

PSI:

Person separation index

PSY:

Psychological subscale of SCNS

PWB:

Physical wellbeing subscale of FACT

QoL:

Quality of life

RMSEA:

Root mean square error of approximation

SCNS:

The supportive care needs survey

SD:

Standard deviation

SWB:

Social wellbeing subscale of FACT

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Acknowledgments

AOCS-QoL study was funded by The Cancer Councils of New South Wales and Queensland (RG 36/05). Financial support for the parent study was provided by the U.S. Army Medical Research and Materiel Command under DAMD17-01-1-0729, the National Health and Medical Research Council of Australia (400413 and 400281) and the Cancer Councils of New South Wales, Queensland, South Australia, Tasmania and Victoria and the Cancer Foundation of Western Australia. Additional recruitment was conducted under the Australian Cancer Study (Ovarian Cancer), funded by NHMRC (199600). Full membership of the AOCS Group is listed at http://www.aocstudy.org/. Participating sites include New South Wales: John Hunter Hospital, North Shore Private Hospital, Royal Hospital for Women, Royal North Shore Hospital, Royal Prince Alfred Hospital, Westmead Hospital, New South Wales Cancer Registry; Queensland: Mater Misericordiae Hospital, Royal Brisbane and Women’s Hospital, Townsville Hospital, Wesley Hospital, Queensland Cancer Registry; South Australia: Flinders Medical Centre, Queen Elizabeth II, Royal Adelaide Hospital, South Australian Cancer Registry; Tasmania: Royal Hobart Hospital; Victoria: Freemasons Hospital, Mercy Hospital For Women, Royal Women’s Hospital, Victorian Cancer Registry; Western Australia: King Edward Memorial Hospital, St John of God Hospitals Subiaco, Sir Charles Gairdner Hospital, Western Australia Research Tissue Network (WARTN), Western Australia Cancer Registry. We also acknowledge the contribution of the study nurses and research assistants and would like to thank all of the women who participated in the study.

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Authors and Affiliations

  1. Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia

    B. Colagiuri, M. T. King, P. N. Butow, T. Luckett & M. A. Price

  2. School of Psychology, F23, The University of New South Wales, Sydney, NSW, 2052, Australia

    B. Colagiuri

  3. School of Psychology, The University of Sydney, Sydney, NSW, Australia

    M. T. King, P. N. Butow, M. A. Price & D. P. Birney

  4. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW, Australia

    P. N. Butow & M. A. Price

  5. Pearson Psychometric Laboratory, Graduate School of Education, The University of Western Australia, Crawley, WA, Australia

    J. A. McGrane

  6. Improving Palliative Care through Clinical Trials (ImPaCCT) South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia

    T. Luckett

  7. Accelerated Learning Laboratory, Australian School of Business, University of New South Wales, Sydney, NSW, Australia

    D. P. Birney

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  1. B. Colagiuri
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The Australian Ovarian Cancer Study Group

The Australian Ovarian Cancer Study—Quality of Life Study Investigators

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Correspondence to B. Colagiuri.

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Colagiuri, B., King, M.T., Butow, P.N. et al. A comparison of the FACT-G and the Supportive Care Needs Survey (SCNS) in women with ovarian cancer: unidimensionality of constructs. Qual Life Res 21, 887–897 (2012). https://doi.org/10.1007/s11136-011-9993-5

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