Nurse researchers are reporting that they have started the validation process for using the Dermatology Life Quality Index (DLQI) as a means to better assess how breast radiodermatitis may affect quality of life (QOL) for women with breast cancer. The current analysis, which was published in Breast Cancer: Basic and Clinical Research, was designed to better understand the skin-related and global quality of life in women with breast radiodermatitis.

“It is important to use reliable and valid instruments in the clinical and research settings. Nurses play an important role in clinical care and should have an active role in validating instruments used to provide nursing care, said study investigator Laura Curr Beamer, RN, assistant professor of nursing at the School of Nursing & Health Studies, Northern Illinois University, DeKalb.

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THE STUDY

As part of this investigation, 40 women (mean age 58 years) completed the DLQI instrument weekly while they were undergoing external radiotherapy. At week 5 of treatment, 78% of participants (n = 31) provided narrative feedback on how each DLQI item affected her life. The researchers examined responses for agreement between participants’ DLQI numerical ratings and their narrative feedback. All the women had stage 0 to III breast cancer, 97% were non-Hispanic white, and 74% had some level of college education. A significant number of women (42%) worked in a professional occupation and 45% earned more than $75,000 annually.

Most of the women were not current smokers (94%), 39% were of normal weight, and 39% were obese. In this cohort, 33 women received normofractionated doses of 180-200 cGy and 7 women received accelerated external beam treatment using fractions of 266 cGy.

For the study, the participants completed the DLQI at baseline then weekly while undergoing radiotherapy. Radiodermatitis intensity was expected to peak at the fifth week of therapy, so the participants were asked to provide written feedback on the DLQI items; 31 of the 40 women provided usable narrative responses at week 5. They were also asked which item was most important to them and why, and if they had any additional comments.

The orginal 10-item instrument was previously piloted with 20 patients, then revised slightly and piloted again with another 20 patients. The 10 scaled items on the DLQI focus on physical sensations; embarrassment; interference with activities at home; clothing selection; impact on social activities; difficulty participating in a sport; preventing work or school attendance; causing a problem with relationships among close friends, relatives, or a partner; sexual difficulties; and impact of treatment on life and lifestyle.