Development of the Functional Assessment of Chronic Illness Therapy – Liver Transplantation (FACT-LT) scale

Abstract

Introduction. This study aims to propose a first development of the FACT-Liver Transplantation (FACT-LT) scale that assess the major concerns, both physical and emotional, of patients before and after Orthotopic Liver transplantation (OLT) due to acute and chronic liver failure and for Hepatocellular carcinoma.

Methods. The FACT-LT was developed in two phases. In Phase I, items were generated: 1) through interview to 10 OLT experts and 15 candidates for or recipients of OLT (oncological, non-oncological) that identified relevant topics; 2) from the FACIT item bank. In Phase II, a questionnaire to assess item frequency, applicability, and comprehension were administered to 20 OLT experts and to assess item difficulty, embarrassment, content irrelevance to 30 transplanted or candidate patients (15 oncological, 15 non-oncological).

Results. In the Phase I, 44 items were formulated/reviewed, and 30 items were retained. All the healthcare professionals interviewed rejected the suggestion to develop two different modules for cancer and non-cancer patients. In the Phase II, the majority of the experts and patients expressed overall satisfaction with the questionnaire, indicating that the items were relevant, comprehensible and not embarrassing (range 75% - 99%). The first version of the FACT-LT includes 28 items encompassing four QOL domains: 5 items relating to Physical Well-Being, 8 to Functional Well-Being, 13 to Emotional Well-Being, and 2 to Social/Family Well-Being.

Conclusion. The preliminary results obtained are encouraging, however further studies are needed to proceed with the FACT-LT validation process.