Purpose: The constitution of social circles around patients treated for cancer of the upper aerodigestive tract (UADT) has a major influence on factors that affect quality of life (QOL) but is poorly assessed, mainly due to a lack of tools. The objective of this study is to develop a questionnaire that assesses the constitution of social circles in a population treated for UADT cancer and to analyze the construct (structural and clinical validity) and criterion validity. Methods: The Evaluation of the Constitution of Social Circles (ECSC) questionnaire was developed in French by a committee of experts. Structural validity was analyzed using inter-item correlations. The scores of a group of patients treated for UADT cancer were compared with those of a group of healthy subjects (clinical validity). For criterion validity, the ECSC scores were compared to those from various questionnaires that assess social functioning (QFS), psychological status (HAD), perceived speech impairment (PHI), and QOL (EORTC QLQ-H&amp;N35) in patients. Results: Structural validity shows low to moderate inter-item correlations which is consistent with the construction of the questionnaire not assessing underlying concepts. Clinical validity was satisfactory regarding the frequency of contact (p = 0.01), satisfaction with the frequency of contact in the private circle (p = 0.03), and the size of the social circles of family and friends (p ≤ 0.01). Criterion validity was adequate with moderate correlations between the ECSC scores and the QFS sub-scores of interest (rs > 0.56, p < 0.05). Anxiety (HAD) had a low correlation (|rs| = 0.46, p < 0.05) with satisfaction with exchanges and the frequency of contact with family. Satisfaction with exchanges with the private circle was moderately correlated with the EORTC QLQ-H&amp;N35 score (rs = 0.56, p = 0.01) and showed a negative trend on the PHI (rs < −0.39, p ≥ 0.05). Conclusion: While the test-retest reliability is yet to be evaluated and the sample size should be increased, this preliminary study shows that the ECSC is a valid tool for assessing the constitution of social circles in patients treated for UADT cancer. It highlights the links between social circles and their functional impact on communication and QOL.

1.
World Health Organization
.
International classification of functioning, disability and health: ICF
.
World Health Organization
;
2001
. Available from: https://apps.who.int/iris/handle/10665/42407.
2.
Wilson
IB
,
Cleary
PD
.
Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes
.
JAMA
.
1995 Jan 4
;
273
(
1
):
27359
65
.
3.
Felce
D
,
Perry
J
.
Quality of life: its definition and measurement
.
Res Dev Disabil
.
1995 Jan
;
16
(
1
):
51
74
.
4.
Karimi
M
,
Brazier
J.
Health
,
health-related quality of life, and quality of life: what is the difference
.
Pharmacoeconomics
.
2016 Jul
18
;34(
7
):
645
9
.
5.
Hays
R
,
Reeve
B
.
Measurement and modeling of health-related quality of life
. In:
Killewo
J
,
Heggenhougen
HK
,
Quah
SR
, editors.
International encyclopedia of public health
.
San Diego
:
Academic Press, Elsevier
;
2008
. p.
241
52
. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780123739605003361.
6.
Torrance
GW.
.
Utility approach to measuring health-related quality of life
.
J Chronic Dis
.
1987 Jan
;
40
(
6
):
593
603
.
7.
Ebrahim
S.
.
Clinical and public health perspectives and applications of health-related quality of life measurement
.
Soc Sci Med
.
1995 Nov
;
41
(
10
):
1383
94
.
8.
Jacobson
BH
,
Johnson
A
,
Grywalski
C
,
Silbergleit
A
,
Jacobson
G
,
Benninger
MS
,
.
The Voice Handicap Index (VHI)
.
Am J Speech Lang Pathol
.
1997 Aug
;
6
(
3
):
66
70
.
9.
Rinkel
RN
,
Verdonck-de Leeuw
IMV
,
van Reij
EJ
,
Aaronson
NK
,
Leemans
CR
.
Speech Handicap Index in patients with oral and pharyngeal cancer: better understanding of patients’ complaints
.
Head Neck
.
2008 Jul
;
30
(
7
):
868
74
. http://dx.doi.org/10.1002/hed.20795.
10.
Bjordal
K
,
Hammerlid
E
,
Ahlner-Elmqvist
M
,
de Graeff
A
,
Boysen
M
,
Evensen
JF
,
.
Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35
.
J Clin Oncol
.
1999 Mar
;
17
(
3
):
1008
19
.
11.
Groenvold
M
,
Klee
MC
,
Sprangers
MAG
,
Aaronson
NK
.
Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient-observer agreement
.
J Clin Epidemiol
.
1997
;
50
(
4
):
441
50
. http://dx.doi.org/10.1016/s0895-4356(96)00428-3.
12.
Cella
DF
,
Tulsky
DS
,
Gray
G
,
Sarafian
B
,
Linn
E
,
Bonomi
A
,
.
The functional assessment of cancer therapy scale: development and validation of the general measure
.
J Clin Oncol
.
1993 Mar
;
11
(
3
):
570
9
.
13.
Murphy
BA
,
Ridner
S
,
Wells
N
,
Dietrich
M
.
Quality of life research in head and neck cancer: a review of the current state of the science
.
Crit Rev Oncol Hematol
.
2007
;
62
(
3
):
251
67
. http://dx.doi.org/10.1016/j.critrevonc.2006.07.005.
14.
Rathod
S
,
Livergant
J
,
Klein
J
,
Witterick
I
,
Ringash
J
.
A systematic review of quality of life in head and neck cancer treated with surgery with or without adjuvant treatment
.
Oral Oncol
.
2015 Oct
;
51
(
10
):
888
900
. http://dx.doi.org/10.1016/j.oraloncology.2015.07.002.
15.
Ra
H
,
Rogers
SN
,
Patterson
JM
.
A systematic scoping review to map the evidence for peer-to-peer support in patients with head and neck cancer on quality of life
.
BAHNO Conference. Virtual Event
.
2021
. Available from: https://www.bahnomeeting.com/bahno-conference/.
16.
Wang
Y
,
Zhu
L
,
Yuan
F
,
Kang
L
,
Jia
Z
,
Chen
D
,
.
The relationship between social support and quality of life: evidence from a prospective study in chinese patients with esophageal carcinoma
.
Iran J Public Health
.
2015
;
44
(
12
):
1603
12
.
17.
Bilal
S
,
Doss
JG
,
Cella
D
,
Rogers
SN
.
Quality of life associated factors in head and neck cancer patients in a developing country using the FACT-H&N
.
J Craniomaxillofac Surg
.
2015 Mar
;
43
(
2
):
274
80
. http://dx.doi.org/10.1016/j.jcms.2014.11.024.
18.
Bidart
C
,
Degenne
A
,
Grosetti
M
.
La vie en Réseau. Dynamique des relations sociales. Le Lien Social
.
Presses Universitaires de France
;
2011
.
19.
Kawachi
I.
.
Social ties and mental health
.
J Urban Heal Bull New York Acad Med
.
2001 Sep
1
;78(
3
):
458
67
.
20.
Kroenke
CH
.
A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival
.
Transl Behav Med
.
2018
;
8
(
4
):
629
42
. http://dx.doi.org/10.1093/tbm/ibx061.
21.
Pearlin
LI
,
Johnson
JS
.
Marital status, life-strains and depression
.
Am Sociol Rev
.
1977 Oct
;
42
(
5
):
704
.
22.
Fratiglioni
L
,
Wang
H
,
Ericsson
K
,
Maytan
M
,
Winblad
B
.
Influence of social network on occurrence of dementia: a community-based longitudinal study
.
Lancet
.
2000 Apr
;
355
(
9212
):
1315
9
.
23.
Payne
N
,
Palmer Kelly
E
,
Pawlik
TM
.
Assessing structure and characteristics of social networks among cancer survivors: impact on general health
.
Support Care Cancer
.
2019
;
27
(
8
):
3045
51
. http://dx.doi.org/10.1007/s00520-018-4620-4.
24.
Cohen
S
,
Doyle
WJ
,
Skoner
DP
,
Rabin
BS
,
Gwaltney
JMM
.
Social ties and susceptibility to the common cold
.
JAMA
.
1997 Jun
25
;277(
24
):
1940
.
25.
Mowbray
O
,
Quinn
A
,
Cranford
JA
.
Social networks and alcohol use disorders: findings from a nationally representative sample
.
Am J Drug Alcohol Abuse
.
2014
;
40
(
3
):
181
6
. http://dx.doi.org/10.3109/00952990.2013.860984.
26.
Eadie
T
,
Faust
L
,
Bolt
S
,
Kapsner-Smith
M
,
Pompon
RH
,
Baylor
C
,
.
Role of psychosocial factors on communicative participation among survivors of head and neck cancer
.
Otolaryngol Head Neck Surg
.
2018 Aug
20
;159(
2
):
266
73
.
27.
Danker
H
,
Wollbrück
D
,
Singer
S
,
Fuchs
M
,
Brähler
E
,
Meyer
A
.
Social withdrawal after laryngectomy
.
Eur Arch Otorhinolaryngol
.
2010 Apr
;
267
(
4
):
593
600
.
28.
Kroenke
CH
,
Kwan
ML
,
Neugut
AI
,
Ergas
IJ
,
Wright
JD
,
Caan
BJ
,
.
Social networks, social support mechanisms, and quality of life after breast cancer diagnosis
.
Breast Cancer Res Treat
.
2013
;
139
(
2
):
515
27
. http://dx.doi.org/10.1007/s10549-013-2477-2.
29.
Karnell
LH
,
Funk
GF
,
Hoffman
HT
.
Assessing head and neck cancer patient outcome domains
.
Head Neck
.
2000
;
22
(
1
):
6
11
. http://dx.doi.org/10.1002/(sici)1097-0347.
30.
St-Jean-Trudel
E
,
Guay
S
,
Marchand
A
,
O’Connor
K
.
Elaboration and validation of a questionnaire measuring social support in situations of anxiety with a population of university students
.
Sante Ment Que
.
2005
;
30
(
2
):
43
60
. http://dx.doi.org/10.7202/012138ar.
31.
Bruchon-Schweitzer
M
,
Rascle
N
,
Gelie
F
,
Fortier
C
,
Sifakis
Y
,
Constant
A
.
Le questionnaire de soutien social de Sarason (SSQ6). Une adaptation française
.
Psychol Française
.
2003
;
48
(
3
):
41
53
.
32.
Weissman
MM
,
Sholomskas
D
,
John
K
.
The assessment of social adjustment. An update
.
Arch Gen Psychiatry
.
1981 Nov
;
38
(
11
):
1250
.
33.
Furman
W
,
Buhrmester
D
.
The network of relationships inventory: behavioral systems version
.
Int J Behav Dev
.
2009 Sep
;
33
(
5
):
470
8
.
34.
Blackstone
S
,
Hunt Berg
M
.
Social networks: a communication inventory for individuals with severe communication challenges and their communication partners
.
Monterey, CA
:
Augmentative Communication
;
2003
.
35.
Zanello
A
,
Weber Rouget
B
,
Gex-Fabry
M
,
Maercker
A
,
Guimon
J
.
Validation du Questionnaire de fonctionnement social (QFS), un autoquestionnaire mesurant la fréquence et la satisfaction des comportements sociaux d’une population adulte psychiatrique
.
L’Encéphale
.
2006
;
32
(
1
):
45
59
. http://dx.doi.org/10.1016/s0013-7006(06)76136-x.
36.
Sprecher
S
,
Felmlee
D
,
Orbuch
TL
,
Willetts
MC
.
Social networks and change in personal relationships
.
Stability and change in relationships
.
Cambridge University Press
;
2002
. p.
257
84
. Available from: https://www.cambridge.org/core/product/identifier/CBO9780511499876A022/type/book_part.
37.
Blackstone
S
.
Interaction with the partners of AAC consumers: part I – interaction
.
Augment Commun News
.
1991
;
4
:
1
3
.
38.
Mokkink
LB
,
Terwee
CB
,
Patrick
DL
,
Alonso
J
,
Stratford
PW
,
Knol
DL
,
.
The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes
.
J Clin Epidemiol
.
2010
;
63
(
7
):
737
45
. http://dx.doi.org/10.1016/j.jclinepi.2010.02.006.
39.
Zigmond
A
,
Snaith
R
.
The hospital anxiety and depression scale
.
Acta Psychiatr Scand
.
1983
;
67
(
6
):
361
70
.
40.
Balaguer
M
,
Farinas
J
,
Fichaux-Bourin
P
,
Puech
M
,
Pinquier
J
,
Woisard
V
.
Validation of the French versions of the speech handicap index and the phonation handicap index in patients treated for cancer of the oral cavity or oropharynx
.
Folia Phoniatr Logop
.
2020
;
72
(
6
):
464
77
.
41.
Aarstad
HJ
,
Østhus
AA
,
Aarstad
HH
,
Lybak
S
,
Aarstad
AKH
.
EORTC Quality of Life Questionnaire Head and Neck (H&N)-35 scores from H&N squamous cell carcinoma patients obtained at diagnosis and at 6, 9 and 12 months following diagnosis predict 10-year overall survival
.
Eur Arch Otorhinolaryngol
.
2019
;
276
(
12
):
3495
505
. http://dx.doi.org/10.1007/s00405-019-05630-2.
42.
Karnell
LH
,
Christensen
AJ
,
Rosenthal
EL
,
Magnuson
JS
,
Funk
GF
.
Influence of social support on health-related quality of life outcomes in head and neck cancer
.
Head Neck
.
2007 Feb
;
29
(
2
):
143
6
. http://dx.doi.org/10.1002/hed.20501.
43.
Mukaka
MM
.
Statistics corner: a guide to appropriate use of correlation coefficient in medical research
.
Malawi Med J
.
2012
;
24
(
3
):
69
71
.
44.
Soum-Pouyalet
F
,
Hubert
A
,
Dilhuydy
JM
,
Kantor
G
.
Prise en compte de l’entourage des patients atteints de cancer: un aperçu mondial des programmes et des actions d’information et de soutien
.
Oncologie
.
2005
;
7
(
4
):
323
8
. http://dx.doi.org/10.1007/s10269-005-0223-z.
45.
Adams
RN
,
Mosher
CE
,
Winger
JG
,
Abonour
R
,
Kroenke
K
.
Cancer-related loneliness mediates the relationships between social constraints and symptoms among cancer patients
.
J Behav Med
.
2018
;
41
(
2
):
243
52
. http://dx.doi.org/10.1007/s10865-017-9892-5.
46.
Anthoine
E
,
Moret
L
,
Regnault
A
,
Sébille
V
,
Hardouin
J-B
.
Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures
.
Health Qual Life Outcomes
.
2014 Dec
;
12
(
1
):
176
.
47.
Davies
K
,
Maharani
A
,
Chandola
T
,
Todd
C
,
Pendleton
N
.
The longitudinal relationship between loneliness, social isolation, and frailty in older adults in England: a prospective analysis
.
Lancet Healthy Longev
.
2021
;
2
(
2
):
e70
7
. http://dx.doi.org/10.1016/s2666-7568(20)30038-6.
48.
Rogers
SN
,
El-Sheikha
J
,
Lowe
D
.
The development of a patients concerns inventory (PCI) to help reveal patients concerns in the head and neck clinic
.
Oral Oncol
.
2009 Jul
;
45
(
7
):
555
61
. http://dx.doi.org/10.1016/j.oraloncology.2008.09.004.
49.
Balaguer
M
,
Champenois
M
,
Farinas
J
,
Pinquier
J
,
Woisard
V
.
The (head and neck) carcinologic handicap index: validation of a modular type questionnaire and its ability to prioritise patients’ needs
.
Eur Arch Otorhinolaryngol
.
2021 Apr
;
278
(
4
):
1159
69
.
50.
Ekberg
O
,
Hamdy
S
,
Woisard
V
,
Wuttge-Hannig
A
,
Ortega
P
.
Social and psychological burden of dysphagia: its impact on diagnosis and treatment
.
Dysphagia
.
2002 Apr
;
17
(
2
):
139
46
.
You do not currently have access to this content.