J Breast Cancer.  2012 Mar;15(1):43-50. 10.4048/jbc.2012.15.1.43.

Use of the International Classification of Functioning, Disability and Health as a Functional Assessment Tool for Breast Cancer Survivors

• Yang EJ
• Kim BR
• Shin HI
• Lim JY

• KMID: 2286472
• DOI: http://doi.org/10.4048/jbc.2012.15.1.43

Abstract

PURPOSE
To develop a patient self-completed questionnaire from the items of the Brief Core Set Questionnaire for Breast Cancer (BCSQ-BC) and to investigate the prevalence of specific dysfunctions throughout the course of cancer and treatments.
METHODS
From January 2010 to February 2011, 96 breast cancer patients were evaluated with BCSQ-BC developed for clinical application of International Classification of Functioning, Disability and Health (ICF). Quality of life and upper limb dysfunction using disabilities of arm, shoulder and hand (DASH) were assessed. Content validity was evaluated using correlations between BCSQ-BC and European Organization for Research and Treatment of Cancer (EORTC) QLQ and DASH scores. Construct validity was computed using exploratory factor analysis. Kappa statistics were computed for agreement between test-retest ICF data. The level of significance and odds ratios were reported for individuals with early post-acute and long-term context and with total mastectomy and breast conservative surgery.
RESULTS
There was consistently good test-retest agreement in patient-completed questionnaires (kappa value, 0.76). Body function, activity and participation subscales are significantly related with EORTC QLQ and DASH. Problems with activity and participation were strongly associated with physical functional domains of EORTC QLQ (r=-0.708, p<0.001) and DASH (r=0.761, p<0.001). The prevalence of dysfunctions varied with type of surgery and time after cancer. Immobility of joint (15% vs. 7%) and lymphatic dysfunction (17% vs. 3%) were indexed more frequently in extensive surgery cases than in conservative surgery. Muscle power (16% vs. 8%), exercise tolerance functions (12% vs. 4%) and looking after one's health (10% vs. 2%) were impaired within 1 year after surgery, while sleep dysfunction (8% vs. 14%) was a major problem over 1 year after surgery.
CONCLUSION
The BCSQ-BC identifies the problems comprehensively in functioning of patients with breast cancer. We revealed the interaction with the ICF framework adopting a multifactor understanding of function and disability.

Keyword

Breast neoplasms; Function; Rehabilitation; Survivors

MeSH Terms

Arm
Breast
Breast Neoplasms
Exercise Tolerance
Hand
Humans
Joints
Mastectomy, Simple
Muscles
Odds Ratio
Prevalence
Quality of Life
Shoulder
Survivors
Upper Extremity
Surveys and Questionnaires

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