Research Article
Volume 2 Issue 9 - 2020
Development of an Appropriate Quality of Life Instrument for Cancer Patients in South Africa
Jacoba Johanna Maria Jansen van Rensburg1*, Daleen Casteleijn2 and Johanna E Maree3
1Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
2Professor, Department of Occupational Therapy, University of the Witwatersrand, Johannesburg, South Africa
3Professor, Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
*Corresponding Author: Jacoba Johanna Maria Jansen van Rensburg, Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Received: July 04, 2020; Published: August 11, 2020


Objectives: Quality of life assessment is a valuable tool in cancer care as it allows us to understand how cancer and healthcare interventions influence the lives of the patients. An appropriate QoL assessment instrument would enable healthcare practitioners to identify and manage problems, which have a negative influence on QoL of cancer patients, timeously. The objective of the study was to develop and validate a patient informed QoL assessment instrument for our patient population.

Methods: A quantitative design was used. A Quality of Life questionnaire was developed by using the themes and categories identified during interviews with cancer patients and subjected to psychometric analysis using the Rasch Measurement Model.

Results: After validation of the questionnaire, by means of the Rasch model, it was found that the questionnaire conformed to Rasch model expectations. The developed instrument comprised relevant domains of QoL for South African cancer patients who access public healthcare for treatment, as identified during interviews with patients. It is proposed that the instrument be further validated for other populations in South Africa.

Significance of the Results: An appropriate QoL assessment instrument can be used for the assessment of QoL of cancer patients in order to identify and address problems timeously. The instrument needs to be culturally sensitive and include the domains of QoL which are relevant to the patient population. The QoL assessment instrument developed in this study is appropriate for cancer patients in South Africa who access public health service for treatment.

Keywords: Quality of Life (QoL); Domains of QoL; QoL Assessment; Rasch Measurement Model (RMM)


  1. Selman L., et al. “Quality of life among patients receiving palliative care in South Africa and Uganda: a multi-centred study”. Health and Quality of Life Outcomes (2011): 9.
  2. Maree J., et al. “Suitability of quality-of-life outcome measures in palliative care in the South African setting”. Palliative and Supportive Care (2016): 1-11.
  3. Jansen Van Rensburg J., et al. “An investigation into the quality of life of cancer patients in South Africa”. Asia Pacific Journal of Oncology Nursing 4 (2017): 336-341.
  4. CANSA. 2016 Statistics (2016).
  5. Lingwood Rj., et al. “The challenge of cancer control in Africa”. Nature Reviews Cancer 8 (2008): 398-403.
  6. Morhason-Bello Io., et al. “Challenges and opportunities in cancer control in Africa: a perspective from the African Organisation for Research and Training in Cancer”. The Lancet Oncology 14 (2013): e142-e151.
  7. Statistics South Africa. Public healthcare: How much per person (2017).
  8. Mojaki M., et al. “Referral steps in district health system are side-stepped”. South African Medical Journal 101 (2011): 109-109.
  9. Ferrans C. “Quality of life as an outcome of cancer care”. In: Yarbro C, Wujcik D and Gobel B (editions). Cancer Nursing. Principles and Practice. Massachusetts: Jones and Bartlett (2011).
  10. Bennett M and Closs S. “Clinical assessment and measurement”. In: Payne S, Seymore J and Ingleton C (editions). Palliative nursing: principles and evidence for practice. 2nd edition. London: McGraw-Hill (2008).
  11. Diehr P., et al. “Quality of life at the end of life”. Health and Quality of Life Outcomes (2007): 5.
  12. Zeng Y., et al. “Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors”. Health and Quality of Life Outcomes (2010): 8.
  13. Ding Y., et al. “Psychometric properties of the Chinese version of the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx measuring health-related quality of life”. Health and Quality of Life Outcomes 10 (2012):124.
  14. Ferrans Ce. “Quality of life: conceptual issues”. Seminars in Oncology Nursing (1990): 248-254.
  15. Mitchell A. “Quality of life in palliative care: patient as expert”. In: Kinghorn S and Gamlin R (editions). Palliative nursing: bringing comfort and hope. London: Balliere Tindall (2001). 
  16. Dunn J., et al. “Health-related quality of life and life satisfaction in colorectal cancer survivors: trajectories of adjustment”. Health and Quality of Life Outcomes 11 (2013): 46.
  17. Jansen Van Rensburg J. “The Development and Validation of a Quality of Life Assessment Instrument for Cancer Patients in South Africa”. PhD Thesis, University of the Witwatersrand (2016).
  18. Kaasa S and Loge JH. “Quality of life in palliative care: principles and practice”. Palliative Medicine 17 (2003): 11-20.
  19. Granda-Cameron C., et al. “Measuring patient-oriented outcomes in palliative care: Functionality and quality of life”. Clinical Journal of Oncology Nursing 12 (2008): 65-77.
  20. Byock I and Merriman M. “Measuring quality of life for patients with terminal illness: The Missoula-VITAS Quality of Life Index”. Palliative Medicine 12 (1998): 231-244.
  21. Business report. More people living below breadline - Stats SA (2015).
  22. Pallant J and Tennant A. “An introduction to the Rasch measurement model: An example using the Hospital Anxiety and Depression Scale (HADS)”. British Journal of Clinical Psychology 46 (2007): 1-18.
  23. Khadka J., et al. “The importance of rating scales in measuring patient-reported outcomes”. Health and Quality of Life Outcomes (2012): 10.
  24. Tennant A and Conaghan P. “The Rasch Measurement Model in Rheumatology: What is it and why use it? When should it be applied, and what should one look for in a Rasch paper?” Arthritis and Rheumatism 57 (2007): 1358-1362.
  25. Zucca A., et al. “Rasch analysis of the Mini-Mental Adjustment to Cancer Scale (mini-mac) among heterogenous sample of long-term cancer survivors: a cross-sectional study”. Health and Quality of Life Outcomes (2012): 10.
  26. Mallinson T. “Why measurement matters for measuring patient vision outcomes”. Optometry and Vision Science 84 (2007): 675-682.
  27. Adnane C., et al. “Cross-cultural and Moroccan validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer”. Annals of Otology, Rhinology and Laryngology (2016): 125.
  28. Andrich D and Hagquist C. “Real and artificial differential item functioning”. Journal of Educational and Behavioral Statistics 37 (2012): 387-416.
  29. Polit D and Beck C. “Nursing research: generating and assessing evidence for nursing practice., Philadelphia, Lippincott Williams and Wilkins (2008). 
  30. Pretorius S. SA's real level of literacy. The Citizen (2013).
Citation: Jacoba Johanna Maria Jansen van Rensburg., et al. “Development of an Appropriate Quality of Life Instrument for Cancer Patients in South Africa”. EC Nursing and Healthcare 2.9(2020): 01-13.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

May Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the May issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before May 25, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.