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Abstract
Purpose
This study was designed to investigate the reliability and validity of the World Health Organization Quality of Life Assessment Instrument (WHOQOL) in patients with breast cancer according to depressive symptoms.
Methods
One-hundred seventeen patients with breast cancer who had undergone a radical operation were recruited. The 100 item-WHOQOL instrument and Hamilton Rating Scale for Depression were used to measure all the subjects. The five domain scores, except for the WHOQOL spiritual domain, were compared between patients with and without depressive symptoms, and then the reliability and validity of the five domains were calculated.
Results
Depressed patients
with breast cancer had lower scores in all five domains of the WHOQOL than those who were not depressed in all five domains of WHOQOL [df=(1, 115), F=46.6, p<0.001]. Reliability and validity in the physical domain of depressed patients with breast cancer decreased markedly.
Conclusion
WHOQOL is a valid and useful instrument for evaluating the quality of life in patients with breast cancer, but is limited in scoring of depressed patients with breast cancer, particularly in the physical domain. Therefore, quality of life must be interpreted with carefully hand in depressed patients with breast cancer.
Figures and Tables
Figure 1
Scores of WHOQOL for patients with breast cancer. QOL=quality of life; PHY=physical domain; PSY=psychological domain; IND=independence domain; SOC=social domain; ENV=environmental domain.
Figure 2
A confirmatory factor analysis model in patients with breast cancer without depression.
QOL=total scores of WHOQOL; PHY=physical domain; PSY=psychological domain; IND=independence domain; SOC=social domain; ENV=environmental domain; CFI=comparative fit index; GFI=goodness-of-fit index; The standardized validity coefficients are shown on the arrows. The error variances are showed at the left side to the domains.
Figure 3
A confirmatory factor analysis model in patients with breast cancer with depression.
QOL=total scores of WHOQOL; PHY=physical domain; PSY=psychological domain; IND=independence domain; SOC=social domain; ENV=environmental domain; CFI=comparative fit index; GFI=goodness-of-fit index; The standardized validity coefficients are shown on the arrows. The error variances are showed at the left side to the domains.
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