Psychology RootsFunctional Living Index – Cancer
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About Functional Living Index – Cancer
Scale Name
Functional Living Index – Cancer
Author Details
H. Schipper
Translation Availability
English
Background/Description
The Functional Living Index – Cancer (FLIC), developed by H. Schipper in 1984, is a self-administered tool designed to evaluate cancer patients’ responses to their illness and treatment, serving as an adjunct to clinical trial assessments of progress and toxicity. Published in Quality of Life Research (1984), the FLIC includes 22 items selected by a panel of patients and health professionals, targeting inpatients and outpatients with diagnosed malignant cancer. Covering the past 2–4 weeks, items use a visual analogue scale (VAS) divided into six categories, where patients mark or often circle a number, scored to the nearest integer (reversing scores for items 3, 6, 8, 10, 12, 15, 16, 18, 19, 22 for higher scores to indicate better health). The total score is recommended, taking less than 10 minutes to complete.
Factor analyses identified four consistent factors (physical well-being, emotional state, sociability, hardship/disruption) and a five-factor solution (adding pain/nausea), validated across samples (mean age ≈ 40–70 years, mixed gender, multi-country). It correlates with health measures (e.g., Beck Depression Inventory 0.72–0.77, Karnofsky Scale 0.62–0.69) and is sensitive to chemotherapy effects. Used in oncology and clinical trials to assess quality of life, access requires permission from Quality of Life Research or the author.
Administration, Scoring and Interpretation
- Obtain the FLIC from Schipper (1984) or Quality of Life Research, ensuring ethical permissions.
- Explain to participants (cancer patients 18+ in inpatient/outpatient settings) that the questionnaire assesses illness/treatment impact, emphasizing confidentiality and voluntary participation.
- Administer the 22-item self-report scale, with patients marking or circling responses on a 6-point VAS reflecting the past 2–4 weeks.
- Estimated completion time is less than 10 minutes.
- Ensure a supportive environment; provide cancer care resources (e.g., support groups) and adapt for accessibility (e.g., large print, assistance) if needed.
Reliability and Validity
The FLIC demonstrates solid psychometric properties (Schipper, 1984). Internal consistency varies (Cronbach’s alpha 0.59–0.90 across factors, N not specified), with overall health at 0.90 and pain at 0.59. Test-retest reliability is not explicitly reported but inferred as moderate (r ≈ 0.70–0.80) based on similar scales. Inter-rater reliability is not applicable due to self-report but is consistent with standardized scoring.
Convergent validity is supported by correlations with the Beck Depression Inventory (0.72–0.77), Karnofsky Scale (0.62–0.69), and McGill Pain Questionnaire (0.55–0.59), though lower with Katz ADL (0.17–0.31). Discriminant validity is evidenced by factor differentiation (e.g., physical vs emotional), with total scores reflecting overall health status. Factor analysis confirms the multi-factor structure, supporting construct validity. The FLIC reliably assesses cancer-related quality of life. Pairing with the FACT scale or Karnofsky Index enhances comprehensive assessment.
Available Versions
22-Items
Reference
Schipper, H., Clinch, J., McMurray, A., & Levitt, M. (1984). Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation. Journal of clinical Oncology, 2(5), 472-483.
Important Link
Scale File:
Frequently Asked Questions
What does the FLIC measure?
It measures cancer patients’ quality of life in response to illness and treatment.
Who is the target population?
Cancer patients (18+) in inpatient or outpatient settings.
How long does it take to administer?
Approximately less than 10 minutes.
Can it inform interventions?
Yes, it assesses quality of life to guide treatment adjustments in clinical trials.
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