Assessment of the relationship between three cancer survivor well-being tools.

74 Background: In 1999, the National Comprehensive Cancer Network issued guidelines for improving well-being of cancer survivors. Three tools, the Eastern Cooperative Oncology Group Performance Status (ECOGPS), the National Comprehensive Cancer Network Distress Thermometer (NCCNDT), and the Subjective Happiness Scale (SHS), are currently being used in a rural oncology survivorship clinic to assess patients' well-being. The question arose whether all three tools are necessary for adequate patient assessment.

METHODS: Charts were reviewed on patients seen in a cancer survivorship clinic between January 1, 2015 and January 31, 2016. Well-being measures included the ECOGPS, the NCCNDT, and the SHS, all of which have been validated in prior studies. Patient demographics and well-being measures were captured in a database. Patient identifiers were removed to protect privacy. Data was stratified by age, gender, type and stage of cancer, and treatment type. ECOGPS, NCCNDT, and SHS scores were analyzed using Spearman rho to determine the relationships, if any, among the scores. A strong relationship was present if the correlation coefficient was > ± 0.7. A moderate relationship was present if the correlation coefficient was ± 0.4 to ± 0.7.

RESULTS: An analysis of all patient visits (n = 158) showed no strong or moderate correlations between performance and happiness (rs = -0.207), performance and distress (rs = 0.393), or distress and happiness (rs = -0.383). However, in subgroup analyses, a strong correlation was seen between happiness and performance for ages18-39 (rs = 0.830) and for those 6-12 months post-treatment (rs = -0.714). A strong correlation was also seen between distress and happiness for thoracic (rs = -0.801) and head and neck (rs = -0.847) cancer types, as well as those 1-3 years (rs = -0.718) and 3-5 years (rs = -.0754) post-treatment. A positive correlation was seen between performance and happiness for men (rs = 0.341), whereas females saw a negative correlation (rs = -0.349).

CONCLUSIONS: Results indicate that these tools capture different aspects of patients' well-being. Continued use of all three is recommended. Results obtained from stratified groups may be used for future studies.