A Psychometric Evaluation of the Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-Pal) Scale With Palliative Care Samples in Three African Countries

Richard Siegert, Lucy Selman, Irene J Higginson, Zippy Ali, Richard A Powell, Eve Namisango, Faith Mwangi-Powell, Liz Gwyther, Nancy Gikaara, Richard Harding

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Context
Although sub-Saharan Africa suffers the greatest burden of progressive illness, there are few outcome measures with adequate properties to measure needs and outcomes.

Objectives
To examine the psychometric properties of the FACIT-Pal among people receiving palliative care in three African countries.

Methods
Adult patients in South Africa, Kenya and Uganda gave self-report data to the core FACIT-G plus Pal subscale. Data were subjected to 1) Factor analysis, 2) corrected item-total correlations and 3) Cronbach’s alpha for full scale and subscales.

Results
The resulting four factors bear a strong similarity to the original FACT-G in our sample of 461: physical symptoms, functional wellbeing, friends and family, and emotional well-being. Cronbach’s α for the full 27-item scale was 0.90 and for the Physical Well-Being, Social/Family Well-Being, Emotional Well-Being and Functional Well-Being subscales it was 0.83, 0.78, 0.80 and 0.87 respectively. Varimax rotation of the 19 item FACIT-Pal scale showed three clear, interpretable factors. Factor 1 a sense of purpose and meaning in life, Factor 2 physical symptoms, and Factor 3 social integration. For the 19 item FACIT- Pal, Cronbach’s α was 0.81 and individual corrected item-total correlations ranged from 0.24 – 0.61. Cronbach’s α for the eight items comprising Factor 1 (Meaning in Life) was 0.83. For the other two factors it was 0.70 (Physical Symptoms, 6 items) and 0.68 (Social Integration, 3 items).

Conclusion
The FACT-Pal is a reliable multidimensional scale for people with life-limiting, incurable diseases in sub-Saharan Africa, and the observed factors are interpretable and clinically meaningful.
Original languageEnglish
Pages (from-to)983-991
Number of pages9
JournalJournal of Pain and Symptom Management
Volume48
Issue number5
DOIs
Publication statusPublished - Nov 2014

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