Psychometric properties of the Chinese version of the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) measuring
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RESEARCH
Open Access
Psychometric properties of the Chinese version of the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) measuring health-related quality of life Yan Ding1*, Yan Hu2 and Ingalill R Hallberg3
Abstract Background: The Functional Assessment of Cancer Therapy (FACT) is one of the most commonly used self-report instruments for evaluation of health-related quality of life in oncology patients. However, cultural considerations necessitate testing of the subscales in different populations. We sought to qualitatively and quantitatively investigate the applicability and psychometric properties of the Chinese version of the FACT-Cervix (FACT-Cx) in Chinese women with cervical cancer. Methods: Ten personal interviews were conducted in order to explore patients’ opinions about the scale and its items in depth. In addition the questionnaire was administered to 400 women with cervical cancer to test its psychometric properties. Reliability was assessed using Cronbach’s alpha coefficient and item-subscale correlation while validity was evaluated using factor analysis and known-group validity. Results: Some items related to sex and the ability to give birth were questioned in the personal interviews, mostly regarding their significance and acceptance in the Chinese cultural context. The Cronbach’s alphas of FACT-Cx and the subscales were greater than 0.7, except for the cervical-cancer-specific subscale which was 0.57. Factor analysis demonstrated that the FACT-G construct generally paralleled the original. There were significant differences in the FACT-Cx and some subscales between those receiving and not receiving treatment and among the patients with different performance status. Conclusions: In general, psychometric properties of the Chinese version supported its use with cervical cancer patients in Mainland China. Further work is needed to improve the psychometric adequacy of the cervical-cancer-specific subscale and adjust it to cultural considerations. Keywords: Health-related quality of life, FACT-Cx, FACT-G, Chinese version, Psychometric properties, Cervical cancer
Background Cervical cancer is the second most common cancer among women worldwide. About 83% of cases occur in developing countries, such as China and India, representing 15% of women’s cancers [1]. Current Chinese estimates indicate that cervical cancer is the 5th most frequent cancer among women aged 15–44 years [1]. The increased survival rate due to medical developments * Correspondence: [email protected] 1 Nursing Department, Obstetrics and Gynecology Hospital of Fudan University, No. 419 Fang Xie Road, Shanghai 200011, China Full list of author information is available at the end of the article
means that women with cervical cancer will probably have a life expectancy of more than twenty years after diagnosis and treatment. Having to live with cervical cancer and the outcomes of the treatment, how the women can reclaim or keep their quality of life are increasingly becoming as important as how to prolong survival. In addit
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