Translation and validation of tools for assessing health-related quality of life and male sexual function in Hong Kong Chinese patients during transitional cancer survivorship

Relationship between body image and health-related quality of life in Chinese cancer survivors during the transitional cancer survivorship

BACKGROUND

Previous research has documented the negative impact of cancer treatment on body image and health-related quality of life among survivors, and the positive relationship between those factors. However, existing evidence is mainly based on Western studies of female survivors, and there is thus a huge knowledge gap in research on non-Western cancer survivors.

OBJECTIVES

The aim of the study was to assess body image and health-related quality of life, and explore their relationship, among Chinese cancer survivors during transitional survivorship.

METHODS

Chinese cancer survivors with various diagnoses at the oncology outpatient clinic of a regional hospital in Hong Kong were invited to complete a self-reported survey on socio-demographic and clinical data, the instrument of Quality of Life in Adult Cancer Survivors and Body Image Scale.

RESULTS

A convenience sample of 402 Chinese cancer survivors was recruited, with a mean age of 54.4 years, the majority female (70.4%). In general, participants reported satisfactory body image but only fair health-related quality of life. Hierarchical multiple regression showed that body image was independently associated with both generic and cancer-specific health-related quality of life after controlling for socio-demographic and clinical characteristics (B = 9.572, P < 0.001; B = 5.165, P < 0.001).

CONCLUSIONS

Addressing body image may be an effective approach to enhancing Chinese cancer survivors' health-related quality of life during their transitional survivorship. Since there is a lack of attention given to body image in local clinical settings, early assessment and appropriate interventions should be considered.

Development of a Quality of Sexual Life Questionnaire for Breast Cancer Survivors in Mainland China

BACKGROUND There is a great need for a quality of sexual life questionnaire (QVS) in breast cancer survivors (BCSs) based on the Chinese social culture since the imported tools lack localization verification. To develop a QVS in BCSs and determine its validity and reliability. MATERIAL AND METHODS In the qualitative study, a total of 21 BCSs were interviewed by purposive sampling and snowball sampling; and in the quantitative study, a total of 249 BCSs, who were admitted and received outpatient follow-up, were investigated. Regarding construct validity, factor analysis was performed. The female sexual function index (FSFI), self-rating depression scale (SDS), and Locke-Wallace marital adjustment test (LWMAT) were used to evaluate criterion validity. Cronbach's alpha coefficient was used as an index of internal consistency. To evaluate test-retest reliability, 50 patients were re-evaluated after 1 week. RESULTS We put 28 items in the factor analysis model: (1) 5 factors were extracted by exploratory factor analysis (EFA), with a cumulative contribution of 60.37%; (2) the confirmatory factor analysis (CFA) showed that the path coefficients among the factors were all above 0.5, and the standardized load coefficients of the most items were above 0.5; (3) the Cronbach's alpha coefficient was 0.929 for the overall questionnaire, and ranged from 0.571 to 0.869 for the 5 factors; (4) the correlation coefficients between the overall questionnaire and the FSFI, SDS, and LWMAT were 0.582, -0.456 and 0.515, respectively (P<0.01); and (5) the test-retest correlation coefficient was 0.816, and the split-half-reliability coefficient was 0.899. CONCLUSIONS The QVS in BCSs has good reliability and validity, and can be used to assess the quality of sexual life among BCSs in Mainland China.

Methodological study to evaluate the psychometric properties of FACIT-CD in a sample of Brazilian women with cervical intraepithelial neoplasia

BACKGROUND

The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. The aim of this study was to evaluate the psychometric properties of the FACIT-CD questionnaire in Brazilian women diagnosed with CIN.

METHODS

The properties of the FACIT-CD questionnaire were tested on a sample of 439 women seen at the Department of Prevention of Barretos Cancer Hospital, including 329 patients who were diagnosed with CIN and 110 women who were not diagnosed with the disease. The analysed parameters included internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient), structural validity, convergent validity (correlation with the SF-12 and EORTC QLQ-CX24 questionnaires), discriminant validity (according to disease status, and self-rating of health), sensitivity, and responsiveness.

RESULTS

The Cronbach alpha values ​​of the FACIT-CD scales were higher than 0.70 with the exception of the relationship scale (0.66). The FACIT-CD reproducibility was satisfactory, with variation in the intraclass correlation coefficients ranging between 0.50 and 0.83, although the 95% confidence interval (CI) was lower than 0.40 (0.33-0.64) on the treatment satisfaction scale. Regarding structural validity, only one item on the physical well-being scale was not kept in the original domain. The expected correlations between the FACIT-CD and SF-12 were not confirmed, whereas the correlations between the FACIT-CD and EORTC QLQ-CX24 were confirmed. The questionnaire was able to discriminate the groups according to disease status and self-rating of health. The sensitivity was low for the relationship scale and moderate for the other scales. The responsiveness of the FACIT-CD questionnaire varied between the groups that denominate the self-perception of health as no change, improvement or worsening.

CONCLUSION

Our results are encouraging and indicate that the FACIT-CD questionnaire is a promising tool for the analysis of the quality of life of women with CIN.