Quality of life assessment and depression screening in the gynecologic oncology clinic

Abstract

5149 Background: It is difficult to assess a patient's quality of life (QOL) and mood status during a busy clinic, yet QOL can influence the decision to continue therapy, especially during palliation. The objective of this study was to determine how standardized tools for depression screening and QOL assessment could be integrated in a routine clinic visit. Method: Patients with gynecologic cancers completed a QOL assessment with a 100 mm LASA scale and the Karnofsky performance status prior to three consecutive clinic visits for chemotherapy. Before the 2nd and 3rd visit they also completed the Functional Assessment of Cancer Therapy (FACT-G) and Center for Epidemiologic-Depression (CES-D) scale. After each visit questions about patient satisfaction were answered on a 5 point Lickert scale and the physician completed the LASA scale and the Karnofsky performance status assessment. After the 3rd visit the physician viewed the FACT-G and CES-D results and discussed them with the patient. Descriptive statistics and t-test were used for evaluation. Results: 25 patients completed all three assessments, 22 were treated for recurrent disease. The mean LASA scale values as rated the patient at the first second and third clinic visit respectively were 68, 71 and 76; values determined by the physician were 73, 74 and 77; the most similar assessment by the patient and physician occurred after the third visit. The mean FACT-G score was 75 before the 2nd and 78 before the 3rd visit. The mean CES-D score was 19 before the 2nd and 17 before the 3rd visit. After the 2nd visit 18 patients felt that answering the questions made them more aware of their QOL; 20 patients reported feeling this way after the 3rd visit. Four patients did not like completing the questionnaires. Patients felt their needs were addressed with a score of 4.76 after the 1st and 4.96 after the 3rd visit (p=0.01); the score regarding patient satisfaction increased from 4.43 to 4.69 (p= 0.04). The average time needed for answering all questions was 9 minutes. Conclusion: It is possible to integrate quality of life assessment with the FACT-G and depression screening with the CES-D into a routine oncology clinic visit. No significant financial relationships to disclose.