Development of a Japanese Version of the Quality of Life at the End of Life-Cancer Scale

Tadahiro Yamazaki; Seraki Miyamoto; Toshio Matsubara; Hiroshi Yamagata; Hiroshi Kobo; Makoto Otani; Hiroaki Abe; Masahiko Sumitani; Ken Shimizu; Gary Rodin; Kazuhiro Yoshiuchi

doi:10.1016/j.jpainsymman.2023.04.023

Development of a Japanese Version of the Quality of Life at the End of Life-Cancer Scale

J Pain Symptom Manage. 2023 Aug;66(2):e189-e195. doi: 10.1016/j.jpainsymman.2023.04.023. Epub 2023 Apr 28.

Authors

Affiliations

¹ Department of Stress Sciences and Psychosomatic Medicine (T.Y., S.M., M.O., K.Y.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
² Division of Neuropsychiatry, Department of Neuroscience (T.M.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
³ Department of Anesthesiology (H.Y.), Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan; Palliative Care Center (H.Y.), Yamaguchi University Hospital, Yamaguchi, Japan.
⁴ Department of Psycho-Oncology (H.K., K.S.), Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
⁵ Department of Pain and Palliative Medicine (H.A., M.S.), The University of Tokyo Hospital, Tokyo, Japan.
⁶ Department of Supportive Care (G.R.), Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Stress Sciences and Psychosomatic Medicine (T.Y., S.M., M.O., K.Y.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: kyoshiuc-tky@umin.ac.jp.

PMID: 37121525
DOI: 10.1016/j.jpainsymman.2023.04.023

Abstract

Context: The Quality of Life at the End of Life-Cancer Scale (QUAL-EC) is a self-reported instrument to assesses the quality of life of patients with cancer near the end of life.

Objective: To test the reliability and validity of the QUAL-EC-J, a Japanese translated version of the QUAL-EC.

Methods: A total of 179 Japanese patients with advanced cancer completed the QUAL-EC-J, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Rosenberg Self-Esteem Scale, Multidimensional Scale of Perceived Social Support, Functional Assessment of Cancer Therapy-General Scale, and Functional Assessment of Chronic Illness Therapy-Spiritual questionnaires. We performed confirmatory factor analysis of the four structures of the QUAL-EC and exploratory factor analysis of the QUAL-EC-J. Internal consistency was assessed using Cronbach's α coefficient and validity was examined by calculating correlations with relevant scales.

Results: Confirmatory factor analysis showed an inadequate fit to the original QUAL-EC structure. Exploratory factor analysis revealed a three-factor structure of the QUAL-EC-J, with Cronbach's α values of 0.68-0.88. All subscales were negatively correlated with depression and anxiety. Each subscale was correlated with related measures: "symptom control" with "physical well-being"; "acceptance of disease and life" with "social and family well-being" and "meaning/peace"; and "preparation for end of life" with "emotional well-being" and "meaning/peace."

Conclusions: The QUAL-EC-J has a three-factor structure with acceptable reliability and sufficient validity. Differences in the factor structure between the QUAL-EC-J and the QUAL-EC may be due to cultural factors. Study findings suggest that utilization of the QUAL-EC-J could help to improve research and clinical care in advanced cancer in Japan.

Keywords: Advanced cancer; palliative care; psycho-oncology; quality of life.

MeSH terms

Death
East Asian People
Humans
Japan
Neoplasms* / diagnosis
Neoplasms* / psychology
Neoplasms* / therapy
Psychometrics / methods
Quality of Life*
Reproducibility of Results
Surveys and Questionnaires
Translations