Introduction

The Functional Living Index–Cancer (FLIC-22) is a self-report instrument specifically developed to assess the health-related quality of life (HRQoL) of individuals living with cancer. Since its introduction, the FLIC has become one of the pioneering patient-reported outcome measures designed to evaluate how cancer and its treatment affect patients’ everyday lives beyond traditional clinical indicators such as survival or disease progression. The questionnaire measures multiple aspects of functioning, recognizing that physical symptoms, emotional well-being, social participation, and the ability to perform daily activities collectively determine a patient’s overall quality of life. The FLIC-22 is widely used in oncology research, clinical practice, and therapeutic outcome evaluation, providing valuable information for patient-centered care and evidence-based clinical decision-making.

Description

The Functional Living Index–Cancer consists of 22 self-report items that assess several key dimensions of quality of life among patients with cancer. The questionnaire evaluates physical functioning, emotional well-being, social functioning, and the ability to perform activities of daily living, providing a multidimensional assessment of how the disease and its treatment influence everyday functioning.

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

The FLIC-22 is designed to provide a holistic evaluation of patients’ functioning, allowing healthcare professionals to identify areas of impairment, monitor changes over time, and assess the impact of therapeutic interventions on overall well-being.

Data Analysis and Interpretation

The Functional Living Index–Cancer produces standardized quantitative data that provide an overall measure of health-related quality of life in individuals diagnosed with cancer. Individual responses are combined to evaluate the patient’s overall functional status and well-being, enabling clinicians and researchers to identify physical, emotional, and social difficulties that may require clinical attention.

The instrument is commonly used to investigate relationships between quality of life and variables such as disease stage, treatment response, symptom burden, pain, fatigue, psychological distress, anxiety, depression, social support, functional independence, and overall health outcomes. Because the FLIC-22 generates standardized psychometric data, it is suitable 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 throughout treatment, rehabilitation, survivorship, or palliative care.

According to the available documentation, the FLIC-22 was developed and validated as a quality-of-life assessment 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 the quality of life of patients living with cancer. Specifically, the instrument identifies physical, emotional, social, and functional problems that influence patients’ daily well-being and overall functioning. The resulting information assists healthcare professionals in monitoring disease progression, evaluating treatment effectiveness, identifying supportive care needs, and adapting therapeutic strategies according to each patient’s individual circumstances. The FLIC-22 also serves as an important outcome measure in oncology research and clinical trials, where patient-reported quality of life has become an essential endpoint alongside traditional medical outcomes.

Scoring

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

Individual responses are summed to calculate an overall quality-of-life score, with higher total scores indicating better health-related quality of life, greater functional capacity, and improved overall well-being. The total score enables clinicians to evaluate patients’ functioning, monitor changes over time, and support individualized treatment planning.

The available documentation does not specify the number of response categories, the exact response format, reverse-scored items, cut-off scores, or score interpretation categories. Therefore, these scoring characteristics cannot be presented and should not be inferred without additional source documentation.

Applications

The Functional Living Index–Cancer is widely applied in medical oncology, radiation oncology, hematology, supportive oncology, psycho-oncology, palliative care, rehabilitation medicine, and clinical research. It is frequently used to evaluate patient-reported outcomes, monitor quality of life during cancer treatment, assess the effectiveness of medical and psychosocial interventions, and identify supportive care needs throughout the cancer continuum. The instrument is also employed in randomized clinical trials, epidemiological studies, survivorship research, and healthcare quality assessment to examine factors influencing patient well-being and functional recovery. Owing to its multidimensional assessment of physical, emotional, social, and functional health, the FLIC-22 remains an important patient-reported outcome measure for advancing personalized oncology care and improving clinical decision-making.