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Health Perceptions and HRQL With Soft-Tissue Sarcoma at 12 Months Post-Op: Using the Wilson-Cleary Model to Evaluate
Nicole J Andersen1, Catherine Bergeron1, Robert Turcotte2
1Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.
Introduction:
It is increasingly apparent that the most used patient-reported outcome measure in health-related quality of life (HRQL) soft-tissue sarcoma research (Toronto Extremity Salvage Score) is limited by its exclusive focus on physical function. It is now recommended that it only be used in combination with other global outcome measures, such as the Reintegration to Normal Living Index (RNLI) and Euroqol-5D-3L (EQ-5D-3L). We assessed the measurement properties of the RNLI and EQ-5D using the Wilson-Cleary Model and sought to better understand health perceptions and HRQL at 12 months post-op.
Methods:
Data for this secondary analysis were drawn from an inception cohort of people receiving care for soft-tissue sarcoma at our institution. Inclusion criteria were being ≥ 18 years old and a diagnosis of localized soft-tissue sarcoma (biopsy-confirmed). Measures included the MSTS-87 (pain), RNLI (health perceptions), and EQ-5D-3L (HRQL). RStudio was used to calculate descriptive statistics, assess internal consistency, and evaluate the measurement and structural models.
Results:
The study sample (n = 276) was 45% female with a mean age of 56 (18). Internal consistency was high with the RNLI (α = 0.91) and acceptable with EQ-5D-3L (α = 0.74). Findings suggested good model fit with the measurement model (CFI = 0.98, RMSEA = 0.37, SRMR = 0.0) and structural model (CFI = 0.98, RMSEA = 0.37, SRMR = 0.08). Moreover, HRQL appeared most impacted by the ability to engage in daily activities (work/study, home maintenance, family affairs, and leisure).
Conclusion:
The RNLI (health perceptions) and EQ-5D (HRQL) appeared to be reliable and valid with this patient group. Findings suggest targets for optimizing soft-tissue sarcoma outcomes are maximizing functional restoration, encouraging participation in fulfilling activities throughout recovery (even if adapted), and routine psychosocial distress monitoring.
