Development and validation of the Nightingale Symptom Assessment Scale (N-SAS) and predictors of the quality of life of the cancer patients in Turkey.

Abstract: Purpose: Treatment-related side effects have an adverse impact on the health-related quality of life (HRQoL) of cancer patients undergoing chemotherapy. This study is a description of the validity and responsiveness demonstrated by a new cancer and cancer treatment-specific symptom scale – the Nightingale Symptom Assessment Scale (N-SAS) - which was developed and validated to address the QoL of Turkish cancer patients. Method: The comprehensiveness and clarity of the scale was assessed using 10 patients and pilot testing was carried out with 179 patients. A sample of 374 cancer patients who had received chemotherapy participated in the main study. Descriptive statistics were calculated and comparative tests and factor analysis were performed. Results: The internal reliability of N-SAS was examined and the validity of this scale was determined by correlation with FACT-G. The scale showed high internal reliability, Cronbach''s α for the subscales varied between 0.81 and 0.87 and was 0.93 for the tool. Longitudinal analyses showed that changes in N-SAS scores were strongly correlated with changes in FACT-G. Multivariate analysis revealed that having a metastatic cancer diagnosis, having a low level of income, receiving taxane-based therapy and being a woman were the most important predictive factors for the well-being of the cancer patients in this study. Conclusions: The high correlation with the FACT-G suggests that the new scale is a valid instrument that can be used to evaluate the effect of antineoplastic therapies on a cancer patient''s QoL and can help guide nursing care as well as track the improvement of patients'' HRQoL. [Copyright &y& Elsevier]