Cross-cultural verification of the EORTC QLQ-C15-PAL questionnaire in mainland China

Lei Zhang; Ning Wang; Jing Zhang; Jiahao Liu; Zhiqin Luo; Weilin Sun; Stephanie Mu-Lian Woo; Chujun Chen; Kai Zhang; Adam R Miller; Hui Guo; Xueying Zhang; Changli Wang

doi:10.1177/0269216315593671

Cross-cultural verification of the EORTC QLQ-C15-PAL questionnaire in mainland China

Palliat Med. 2016 Apr;30(4):401-8. doi: 10.1177/0269216315593671. Epub 2015 Jun 29.

Authors

Lei Zhang¹, Ning Wang², Jing Zhang³, Jiahao Liu², Zhiqin Luo⁴, Weilin Sun³, Stephanie Mu-Lian Woo⁵, Chujun Chen², Kai Zhang⁶, Adam R Miller⁷, Hui Guo³, Xueying Zhang², Changli Wang⁸

Affiliations

¹ Department of Thoracic Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin, People's Republic of China.
² Xiangya Medical School, Central South University, Changsha, People's Republic of China.
³ Tianjin Medical University, Tianjin, People's Republic of China.
⁴ Department of Palliative Care, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China.
⁵ Harvard University, Cambridge, MA, USA.
⁶ Department of Cerebral Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China.
⁷ School of Medicine, Indiana University, Indianapolis, IN, USA.
⁸ Department of Thoracic Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin, People's Republic of China 13189368@qq.com.

PMID: 26121985
DOI: 10.1177/0269216315593671

Abstract

Background: Simplified by European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30), EORTC Quality-of-Life Questionnaire Core 15 Palliative Care (QLQ-C15-PAL) is specifically applied to evaluating palliative care patients' quality of life.

Aim: This study examined cross-cultural adaptability and validity of QLQ-C15-PAL for evaluating quality of life of palliative care patients with advanced cancer in mainland China.

Participants and design: From May to October 2013, 243 palliative care patients in Tianjin Cancer Hospital completed the EORTC QLQ-C30. We extracted QLQ-C15-PAL data for analysis. Physicians completed the Eastern Cooperative Oncology Group Performance Status score and mental state assessment for each patient.

Results: A total of 243 patients completed the study. The compliance rate was high, with missing rate for each item ranging from 0% to 2.1%. In addition to emotional function, the remaining dimensions demonstrated a high reliability (Cronbach's alpha > 0.7). Whether we divided patients into two groups according to their Eastern Cooperative Oncology Group Performance Status or divided patients into three groups according to mental status, both sets of results showed significant differences in QLQ-C15-PAL subscale scores (p < 0.05), indicating that the QLQ-C15-PAL scale could be used to distinguish between the aforementioned subgroups. Overall quality of life was moderately correlated with fatigue (r = -0.406) but weakly correlated with other subscales. The proportion of variance (R(2)) ranged from 0.848 to 0.903, which showed that QLQ-C15-PAL subscale scores explained between 84.8% and 90.3% of the original QLQ-C30 score distribution.

Conclusion: The Chinese version of the EORTC QLQ-C15-PAL questionnaire has high reliability and validity and is therefore suitable for clinical use in China to determine health-related quality of life in Chinese patients with advanced cancer.

Keywords: Cancer; Chinese; EORTC QLQ-C15-PAL; health-related quality of life; mainland China; palliative care; quality of life; validation.

Publication types

Validation Study

MeSH terms

Activities of Daily Living / psychology*
Cancer Care Facilities
China
Female
Humans
Male
Middle Aged
Neoplasms / psychology*
Palliative Care / psychology*
Psychometrics / methods
Psychometrics / standards*
Quality of Life / psychology*
Reproducibility of Results
Sickness Impact Profile*
Surveys and Questionnaires