The CARES-SF used for prospective assessment of health-related quality of life after stem cell transplantation.
OBJECTIVE
By employing the Cancer Rehabilitation and Evaluation System short form (CARES-SF) prospectively we wanted to focus on the rehabilitation needs after high-dose chemotherapy (HDC) and stem cell transplantation, in order to identify problems that should be addressed by health-care professionals during the course of disease and treatment.


METHODS
The CARES-SF was administered before and at 2, 6 and 12 months post-transplant to 130 cancer patients treated with HDC and allogeneic (SCT) or autologous stem cell transplantation (ASCT). Physical function scale scores were compared with the corresponding scale of the EORTC QLQ-C30.


RESULTS
The SCT group reported significantly better physical function than the ASCT group before transplant on both the CARES-SF (p<0.0001) and the EORTC QLQ-C30 (p<0.01). Almost identical mean CARES-SF scores across groups (SCT: 0.7-1.4, ASCT: 0.8-1.3) were found at the subsequent assessments, consistent with the QLQ-C30 data. Correlations between CARES-SF and QLQ-C30 Physical Function Scales ranged from 0.45 to 0.65. The SCT group had better psychosocial subscale scores (mean 0.4 and 0.5 versus ASCT: 0.7 and 0.8, p < 0.01) at the 6 and 12-month assessments, as well as better satisfaction on the marital subscale ( p=0.01) 6 months post-transplant. Few patients requested specific help: 19% at baseline with 'fear of the cancer progressing' and 9% with 'reduction in physical energy' after 6 and 12 months.


CONCLUSIONS
The CARES-SF detected differences across groups of patients as well as within-patient changes over time. The possibility for patients to express their need for professional assistance renders the CARES-SF appropriate after SCT/ASCT. The sexual, marital and medical interaction subscales in particular address specific issues of relevance for follow-up care, compared with more traditional questionnaires assessing health related quality of life (HRQOL).
Hjermstad
Marianne J
MJ
The Norwegian Cancer Society, Oslo, Norway. m.j.hjermstad@basalmed.uio.no
Evensen
Stein A
SA
Kvaløy
Stein O
SO
Loge
Jon H
JH
Fayers
Peter M
PM
Kaasa
Stein
S
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018450:Disease Progression; D005221:Fatigue; D005239:Fear; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008393:Marriage; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D017060:Patient Satisfaction; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000523:psychology*; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D012680:Sensitivity and Specificity; D019529:Sexuality; D011795:Surveys and Questionnaires