Preliminary psychometric testing of the Fox Simple Quality-of-Life Scale

Although quality of life is extensively defined as subjective and multidimensional with both affective and cognitive components, few instruments capture important dimensions of the construct, and few are both conceptually congruent and user friendly for the clinical setting. The aim of this study was to develop and test a measure that would be easy to use clinically and capture both cognitive and affective components of quality of life. Initial item sources for the Fox Simple Quality-of-Life Scale (FSQOLS) were literature-based. Thirty items were compiled for content validity assessment by a panel of expert healthcare clinicians from various disciplines, predominantly nursing. Five items were removed as a result of the review because they reflected negatively worded or redundant items. The 25-item scale was mailed to 177 people with lung, colon, and ovarian cancer in various stages. Cancer types were selected theoretically, based on similarity in prognosis, degree of symptom burden, and possible meaning and experience. Of the 145 participants, all provided complete data on the FSQOLS. Psychometric evaluation of the FSQOLS included item-total correlations, principal components analysis with varimax rotation revealing two factors explaining 50% variance, reliability estimation using alpha estimates, and item-factor correlations. The FSQOLS exhibited significant convergent validity with four popular quality-of-life instruments: the Ferrans and Powers Quality of Life Index, the Functional Assessment of Cancer Therapy Scale, the Short-Form-36 Health Survey, and the General Well-Being Scale. Content validity of the scale was explored and supported using qualitative interviews of 14 participants with lung, colon and ovarian cancer, who were a subgroup of the sample for the initial instrument testing.