Introduction

The Functional Living Index–Cancer (FLIC-22) is a self-report psychometric instrument developed to assess the health-related quality of life (HRQoL) of individuals living with cancer. As advances in cancer treatment have significantly improved survival rates, evaluating patients’ quality of life has become an essential component of comprehensive oncology care. Beyond measuring clinical outcomes such as disease progression or survival, the FLIC-22 provides valuable insight into how cancer and its treatment affect patients’ physical functioning, emotional well-being, social participation, and ability to perform everyday activities. The instrument is widely used in oncology research and clinical practice to monitor patient outcomes, evaluate treatment effectiveness, and support patient-centered decision-making.

Description

The Functional Living Index–Cancer consists of 22 self-report items that assess multiple dimensions of quality of life among individuals diagnosed with cancer. The questionnaire evaluates key aspects of daily functioning, including physical functioning, emotional well-being, social functioning, and the individual’s ability to carry out routine daily activities.

Participants complete the questionnaire by rating each item using a Likert-type response scale. However, the available documentation does not specify the number of response categories or the exact response options used in the original instrument. Consequently, these details cannot be presented or inferred.

The multidimensional structure of the FLIC-22 enables clinicians and researchers to obtain a comprehensive picture of how cancer and its treatment influence patients’ daily lives, making it suitable for both routine clinical assessment and clinical research.

Data Analysis and Interpretation

The Functional Living Index–Cancer generates standardized quantitative data that provide an overall measure of health-related quality of life in individuals with cancer. Individual responses are combined to evaluate the patient’s level of functioning and overall well-being, allowing clinicians to identify areas requiring additional support and to monitor changes throughout the disease trajectory.

The instrument is frequently used to examine relationships between quality of life and variables such as treatment response, symptom burden, functional status, psychological distress, anxiety, depression, fatigue, pain, social support, survival outcomes, and overall health status. Because the FLIC-22 produces standardized psychometric data, it is appropriate for descriptive statistical analyses, reliability assessment using Cronbach’s alpha, exploratory and confirmatory factor analysis (EFA and CFA), correlation analysis, multiple regression, mediation and moderation analysis, structural equation modeling (SEM), multilevel analysis, and longitudinal studies evaluating changes in quality of life during treatment, survivorship, or palliative care.

According to the available documentation, the FLIC-22 was developed and validated as a quality-of-life instrument for patients with cancer. However, the available documentation does not report specific numerical reliability or validity coefficients; therefore, no psychometric values should be inferred.

Purpose

The primary purpose of the Functional Living Index–Cancer is to provide a comprehensive assessment of health-related quality of life among individuals living with cancer. Specifically, the instrument is designed to identify physical, emotional, social, and functional problems that affect patients’ daily lives and overall well-being. The information obtained supports clinicians in monitoring disease progression, evaluating treatment outcomes, identifying supportive care needs, and tailoring therapeutic strategies according to each patient’s individual circumstances. The FLIC-22 also serves as an important outcome measure in clinical trials and health services research evaluating the effectiveness of cancer treatments and supportive interventions.

Scoring

The Functional Living Index–Cancer consists of 22 items, with each item rated using a Likert-type response scale.

The available documentation does not specify the number of response categories or the exact response format used in the original questionnaire. Individual item scores are combined to generate an overall quality-of-life score, with higher total scores indicating better health-related quality of life and greater functional well-being.

The total score assists healthcare professionals in understanding patients’ functional status and overall well-being while supporting treatment planning and ongoing clinical monitoring.

The available documentation does not provide information regarding reverse-scored items, cut-off scores, score classifications, or interpretation thresholds. Consequently, these scoring characteristics should not be inferred without additional source documentation.

Applications

The Functional Living Index–Cancer is widely used in clinical oncology, medical oncology, radiation oncology, hematology, palliative care, supportive oncology, psycho-oncology, and clinical research. It is particularly valuable for assessing patient-reported outcomes, monitoring changes in quality of life during cancer treatment, evaluating rehabilitation and supportive care interventions, and measuring the effectiveness of therapeutic strategies in clinical trials. The instrument is also employed in epidemiological research, survivorship studies, and healthcare evaluation to investigate factors influencing quality of life across different cancer populations. Owing to its comprehensive assessment of physical, emotional, social, and functional well-being, the FLIC-22 remains an important patient-reported outcome measure for advancing personalized cancer care and improving clinical decision-making.