Psychometric Properties of the FACIT-Pal 14 Administered in an Outpatient Palliative Care Clinic

Abstract

Background:

The Functional Assessment of Chronic Illness Therapy-Palliative (FACIT-Pal) 14 instrument measures the quality of life in palliative care patients but its psychometric properties are not well characterized.

Objectives:

To establish the reliability and validity of the FACIT-Pal 14 in an outpatient palliative care clinic population.

Methods:

The FACIT-Pal 14 was administered to 227 patients in an outpatient palliative care clinic at a large, urban academic medical center. Internal consistency reliability was assessed with Crohnbach’s α, and principal component analysis was used to investigate for multiple underlying latent variables. Construct validity was tested by comparing mean scores in various subgroups.

Results:

The FACIT-Pal 14 has Crohnbach’s α of 0.76, which increases to 0.79 if 2 items are removed. Principal component analysis supports a single latent variable underlying the instrument. Significantly lower mean scores were found in patients with Eastern Cooperative Oncology Group (ECOG) functional status 3 to 4 compared with patients with ECOG functional status 1-2 (P = .007), in patients with life expectancy under 6 months compared to those with 6 months or greater (P = .003), and in patients referred to clinic for pain and symptom management compared with patients referred for other reasons (P = .038). Instrument scores did not significantly differ between men and women or between white and nonwhite patients (P = .525 and P = .263, respectively).

Conclusions:

In an outpatient palliative care clinic population, the FACIT-Pal 14 has good internal consistency, but removal of 2 items would improve consistency. One latent variable underlies the instrument and there is evidence of construct validity.