title: The development and validation of a quality-of-life questionnaire for head and neck cancer patients with enteral feeding tubes: the QOL-EF.
abstract: OBJECTIVE
  To develop a questionnaire that measures the impact of enteral feeding tubes (EFTs) on the quality of life (QOL) of head and neck cancer (HNC) patients
  
  
  METHODS
  The development of the questionnaire (QOL-EF) was done in four phases. Phase 1-3 included: (1) literature review and consultation with an expert focus group (item generation), (2) pilot-testing in 12 patients and, (3) judgmental item reduction. In phase 4, the QOL-EF, FACT-H&N, and UW-QOL were administered to a cross-sectional group of HNC patients on active EFT feeding to test the reliability and validity of the QOL-EF.
  
  
  RESULTS
  A 20-item QOL-EF was developed. In phase 4, 72 patients were accrued over 2.5 years, 31 of which were part of the test-retest subgroup. Cronbach's α for the QOL-EF was 0.73, and test-retest reliability was 0.83. Moderate correlations were observed between scores for the QOL-EF and both the FACT-H&N (-0.58) and the UW-QOL (-0.42).
  
  
  CONCLUSIONS
  The QOL-EF is a treatment-specific QOL instrument developed and validated for use in HNC patients with EFTs. It may become an important tool in evaluating treatment outcomes and complications in these patients.
authors.affiliation: Department of Radiation Oncology Princess Margaret Hospital, University Health Network and University of Toronto, 610 University Ave., Toronto, Ontario, Canada, M5G 2M9.
authors.forename: Christiaan Seimeon Michael
authors.initials: CS
authors.lastname: Stevens
authors.forename: Betty
authors.initials: B
authors.lastname: Lemon
authors.forename: Gina A
authors.initials: GA
authors.lastname: Lockwood
authors.forename: John N
authors.initials: JN
authors.lastname: Waldron
authors.forename: Andrea
authors.initials: A
authors.lastname: Bezjak
authors.forename: Jolie
authors.initials: J
authors.lastname: Ringash
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D018709:Statistics, Nonparametric; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult