Measurement of quality of life in minority breast cancer survivors

Abstract

While breast cancer has received a great deal of attention from researchers regarding quality of life issues, the ethnic make-up of the studied population has, in general, lacked representation of women from ethnic minority backgrounds. Further, quality of life instruments have rarely been cross-culturally validated, giving rise to concerns about the accuracy of existing measures with a culturally diverse population. The present study was designed to investigate validity of the Breast Cancer Quality of Life Checklist, developed to assess quality of life in breast cancer survivors from ethnic minority backgrounds as part of a larger study on the effects of menopausal issues on breast cancer patients being undertaken by Alyson Moadel, Ph.D., Principal Investigator.;Qualitative research was conducted with the targeted population of Black and Hispanic women (n = 20) and compared with quantitative results obtained through the checklist (n = 199) to determine whether the checklist comprehensively addressed the construct of quality of life among ethnic minority breast cancer survivors. The hypothesis, which was supported, was that the checklist did not do so. The second question was to identify the most salient quality of life issues among breast cancer patients from Black and Hispanic backgrounds. Triangulation of the qualitative data from telephone interviews based on percent of interviewee endorsement and univariate analysis (chi2) of the quantitative data from the checklist respondents provided an inclusive range of issues important to this population.;Overall, the Breast Cancer Quality of Life Checklist demonstrated content validity in several domains, including physical, emotional, cognitive and side-effects. The validity of the menopause-related items throughout the domains was also confirmed by the consistent response of minority women to the effects of these symptoms. Two domains not included, Social/Functional and Spiritual/Existential, prevent the checklist from rendering a comprehensive construct of quality of life. Quantitative analysis suggests that Hispanics have higher quality of life concerns than Blacks, including emotional symptoms, treatment side-effects and cognitive functioning.;Further clarification of the most salient quality of life issues for these understudied populations will enable development of appropriate clinical interventions.