Psychometric Properties of the FACIT-Pal 14 Administered in an Outpatient Palliative Care Clinic

Background: The Functional Assessment of Chronic Illness Therapy-Palliative (FACIT-Pal) 14 instrument measures the quality of life in palliative care patients but its psychometric properties are not well characterized. Objectives: To establish the reliability and validity of the FACIT-Pal 14 in an outpatient palliative care clinic population. Methods: The FACIT-Pal 14 was administered to 227 patients in an outpatient palliative care clinic at a large, urban academic medical center. Internal consistency reliability was assessed with Crohnbach's , and principal component analysis was used to investigate for multiple underlying latent variables. Construct validity was tested by comparing mean scores in various subgroups. Results: The FACIT-Pal 14 has Crohnbach's of 0.76, which increases to 0.79 if 2 items are removed. Principal component analysis supports a single latent variable underlying the instrument. Significantly lower mean scores were found in patients with Eastern Cooperative Oncology Group (ECOG) functional status 3 to 4 compared with patients with ECOG functional status 1-2 (P = .007), in patients with life expectancy under 6 months compared to those with 6 months or greater (P = .003), and in patients referred to clinic for pain and symptom management compared with patients referred for other reasons (P = .038). Instrument scores did not significantly differ between men and women or between white and nonwhite patients (P = .525 and P = .263, respectively). Conclusions: In an outpatient palliative care clinic population, the FACIT-Pal 14 has good internal consistency, but removal of 2 items would improve consistency. One latent variable underlies the instrument and there is evidence of construct validity.