Psychometric Properties of the Functional Assessment of Cancer Therapy-Neutropenia in Asian Cancer Patients With Chemotherapy-Induced Neutropenia

摘要

Context: The Functional Assessment of Cancer Therapy-Neutropenia (FACT-N) is a neutropenia-specific questionnaire to assess patients' health-related quality of life. Objectives: This study aimed to examine the psychometric properties of FACT-N among cancer patients with chemotherapy-induced neutropenia (CIN). Methods: This prospective, cross-sectional study included multiethnic Asian cancer patients. Patients completed the questionnaires within seven days after diagnosed with CIN. Eligible patients completed either the English or Chinese version of the EuroQol 5-Dimensions (EQ-5D) and the FACT-N once, according to their language preference. The reliability was evaluated by using Cronbach alpha (@a). The known-group validity was assessed based on patient's Eastern Cooperative Oncology Group performance status, neutropenia grade, and experience of fever. The convergent validity was evaluated by contrasting the FACT-N subscales with the EQ-5D domains. Multiple linear regression models were performed to compare the FACT-N total scores between the two language versions. Results: A total of 276 eligible patients (200 English speaking and 76 Chinese speaking) were included in this study. Internal consistencies within the FACT-N subscales were satisfactory (Cronbach @a = 0.71-0.85), except for the flu-like symptoms subscale (Cronbach @a = 0.67). For known-group validity, the FACT-N total score could differentiate patients according to their Eastern Cooperative Oncology Group performance status (P < 0.001), neutropenia grade (P = 0.028), and experience of fever (P < 0.001). The correlations between the FACT-N subscales and their hypothesized constructs in EQ-5D domains were weak to moderate (|r| = 0.15-0.44). The measurement equivalence between the English and Chinese versions was established for the FACT-N total scores. Conclusion: The FACT-N is a valid and reliable instrument to be used in clinical practice to evaluate the health-related quality of life among multiethnic Asian patients with CIN.