title: A psychometric evaluation of the functional assessment of chronic illness therapy-palliative care (FACIT-Pal) scale with palliative care samples in three African countries.
abstract: BACKGROUND
  Although sub-Saharan Africa suffers the greatest burden of progressive illness, there are few outcome measures with adequate properties to measure needs and outcomes.
  
  
  OBJECTIVE
  To examine the psychometric properties of the Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-Pal) among people receiving palliative care in three African countries.
  
  
  METHODS
  Adult patients in South Africa, Kenya, and Uganda gave self-reported data to the core FACIT-G plus Pal subscale. Data were subjected to factor analysis, corrected item-total correlations, and Cronbach's α for full scale and subscales.
  
  
  RESULTS
  The resulting four factors bear a strong similarity to the original Functional Assessment of Cancer Therapy-General in our sample of 461: physical symptoms, functional well-being, friends and family, and emotional well-being. Cronbach's α for the full 27-item scale was 0.90 and for the physical well-being, social/family well-being, emotional well-being, and functional well-being subscales, it was 0.83, 0.78, 0.80, and 0.87, respectively. Varimax rotation of the 19-item FACIT-Pal scale showed three clear interpretable factors. Factor 1, a sense of purpose and meaning in life; Factor 2, physical symptoms; and Factor 3, social integration. For the 19-item FACIT-Pal, Cronbach's α was 0.81, and individual corrected item-total correlations ranged from 0.24 to 0.61. Cronbach's α for the eight items comprising Factor 1 (meaning in life) was 0.83. For the other two factors, it was 0.70 (physical symptoms, six items) and 0.68 (social integration, three items).
  
  
  CONCLUSIONS
  The FACIT-Pal is a reliable multidimensional scale for people with life-limiting incurable diseases in sub-Saharan Africa, and the observed factors are interpretable and clinically meaningful.
authors.affiliation: Department of Psychology, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Richard
authors.initials: R
authors.lastname: Siegert
authors.affiliation: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, United Kingdom.
authors.forename: Lucy
authors.initials: L
authors.lastname: Selman
authors.affiliation: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, United Kingdom.
authors.forename: Irene J
authors.initials: IJ
authors.lastname: Higginson
authors.affiliation: Kenya Hospices and Palliative Care Association, Nairobi, Kenya.
authors.forename: Zippy
authors.initials: Z
authors.lastname: Ali
authors.affiliation: HealthCare Chaplaincy, New York, New York, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Powell
authors.affiliation: African Palliative Care Association, Kampala, Uganda.
authors.forename: Eve
authors.initials: E
authors.lastname: Namisango
authors.affiliation: Open Society Foundations, New York, New York, USA.
authors.forename: Faith
authors.initials: F
authors.lastname: Mwangi-Powell
authors.affiliation: Hospice Palliative Care Association of South Africa, Cape Town, South Africa; The School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Liz
authors.initials: L
authors.lastname: Gwyther
authors.affiliation: African Palliative Care Association, Kampala, Uganda.
authors.forename: Nancy
authors.initials: N
authors.lastname: Gikaara
authors.affiliation: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, United Kingdom. Electronic address: ea-richardharding@kcl.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D062072:Patient Acuity; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D057566:Self Report; D013019:South Africa; D014454:Uganda; D055815:Young Adult
keywords: Africa; HIV; Palliative; cancer; quality of life; self-report