Quality of life patient/cancer survivor version in Chinese cancer survivors: A validation study

Hai-Ying Wang; Stephen Wai Hang Kwok; Xian-Liang Liu; Tao Wang; Daniel Bressington; Yushan Shen; Qing Zhang; Hou-Qiang Huang; Jing-Yu Tan

doi:10.1016/j.apjon.2023.100255

Quality of life patient/cancer survivor version in Chinese cancer survivors: A validation study

Asia Pac J Oncol Nurs. 2023 Jun 5;10(8):100255. doi: 10.1016/j.apjon.2023.100255. eCollection 2023 Aug.

Authors

Hai-Ying Wang¹, Stephen Wai Hang Kwok², Xian-Liang Liu¹, Tao Wang¹, Daniel Bressington², Yushan Shen³, Qing Zhang³, Hou-Qiang Huang³, Jing-Yu Tan²

Affiliations

¹ School of Nursing (Brisbane Centre), Faculty of Health, Charles Darwin University, Brisbane, QLD, Australia.
² School of Nursing, Faculty of Health, Charles Darwin University, Ellengowan Drive, Casuarina, NT, Australia.
³ Affiliated Hospital of Southwest Medical University, Luzhou, China.

Abstract

Objective: To validate the Chinese version of the Quality of Life (QoL) Patient/Cancer Survivor Version (QOLCSV-C) for measuring QoL in Chinese cancer survivors.

Methods: The study followed a seven-step research practice guideline for cross-cultural research instrument validation study including translation, adaptation, and psychometric assessment. A forward- and backward-translation procedure was approached, followed by cultural adaptation and acceptability assessment. For its psychometric properties, its concurrent validity with the Functional Assessment of Cancer Therapy-General (FACT-G) was examined with correlation analysis. The internal consistency (Cronbach's alpha) and item-total and item-subtotal correlations of the QOLCSV-C were obtained. Factor analyses were conducted. Floor and ceiling effects and the discriminant performance of the selected variables on QOLCSV-C score were also examined.

Results: The QOLCSV-C was translated from the 41-item QOLCSV with four domains: psychological, physical, spiritual and social well-being. The content validity was excellent (CVI = 1.00). Time spent to complete the QOLCSV-C was about 10 min. The QOLCSV-C was found easy to use, appropriate in length, and reflective of their QoL. The strong correlation between QOLCSV-C and FACT-G indicates a satisfactory concurrent validity (Spearman's rho = 0.765, P < 0.001, n = 205). The overall internal consistency of the QOLCSV-C (Cronbach's alpha = 0.888) and the split-half reliability (Spearman-Brown r = 0.918) were excellent. Most of the items show moderate to strong item-total correlation. The exploratory factor analysis revealed a four-factor solution, and confirmatory factor analysis has a satisfactory model fit with indicative items. None of the total scores of QOLCSV-C reveal the floor or ceiling effect. For discriminant performance, variables demonstrating significant between-group differences include sleep quality, pain, fatigue, nausea, physical health, and financial burden.

Conclusions: The QOLCSV-C is a reliable and valid instrument for measuring the QoL in Chinese cancer survivors. Future studies can explore the factor structure, gender universal or specific items, and significant predictors of QoL of cancer survivors in different cultures.

Keywords: Cancer survivors; Measurement instrument; Quality of life; Validation study.