Content validation of the EORTC QLQ-C15-PAL with advanced cancer patients and health care professionals from palliative care services in Chile

Abstract

Background The assessment of patients’ quality of life (QOL) is essential when evaluating the outcome of palliative care; however, no instruments have been validated for measuring symptoms and QOL in patients receiving palliative care in Chile. We aimed to investigate the content validity of the EORTC Quality of Life Questionnaire Core 15 Palliative Care (QLQ-C15-PAL), replicating the methods used previously to shorten the EORTC Quality of Life Questionnaire Core 30 (QLQ-C30) for use among patients in palliative care. Methods This cross-sectional study was conducted from October to November 2017 in four palliative care services. Patients with advanced cancer and health care professionals (HCPs) were invited to individual interviews to determine the relevance, appropriateness and relative importance of the 30 items of the QLQ-C30 for evaluating the outcome of palliative care, and whether relevant additional issues should be included. Results A total of 48 patients and 35 HCPs participated. The most important dimensions selected were pain, physical functioning, sleeping difficulties, emotional functioning, nausea/vomiting, fatigue, social functioning, lack of appetite, role functioning and constipation. Qualitative data identified important additional issues not covered by the questionnaire such as satisfaction with care, emotions and psychological support, as well as linguistic issues in the dyspnea and constipation items. Conclusions The EORTC QLQ-C15-PAL showed good content validity in the assessment of symptoms and QOL of advanced cancer patients; therefore, we recommend the use of this questionnaire in palliative care in Chile. Dyspnea and constipation items were revised by the EORTC group. More research is needed to add a social dimension for a comprehensive assessment of patients’ QOL.

Validación de la escala QLQ-C15 PAL, para evaluar calidad de vida en pacientes en cuidados paliativos, al español colombiano

“…La validación del EORTC QLQ-C15-PAL para Colombia demostró propiedades psicométricas satisfactorias al aplicarse en pacientes con enfermedad oncológica avanzada; estos hallazgos son similares a los encontrados en un estudio realizado en Chile (20) . La correlación inter-escalas demuestra que el EORT QLQ 15 PAL presenta consistencia entre las escalas que lo componen.…”

Cancer‐related fatigue measures in palliative care: A psychometric systematic review

“…European Organisation for Research and Treatment of Cancer Quality of Life 15‐item Questionnaire for Palliative Care was the second instrument included in the largest number of studies, 14 in total (Alawneh et al, 2016; Arraras et al, 2014; Golčić et al, 2018; Groenvold et al, 2006; Leppert & Majkowicz, 2013; Miyashita et al, 2015; Miyazaki et al, 2012; Nunes, 2014; Ozcelik et al, 2016; Raman et al, 2016; Rojas‐Concha et al, 2020; Shin et al, 2011; Suárez‐del‐Real et al, 2011; Zhang et al, 2016) and for which more psychometric properties were measured: content validity, structural validity, internal consistency, cross‐cultural validity, reliability, criterion validity, hypotheses testing and responsiveness (all except for measurement error). The content validity was classified as ‘inadequate’ for the two studies where it was evaluated (Groenvold et al, 2006; Rojas‐Concha et al, 2020). Structural validity was rated as ‘adequate’ or ‘very good’ and was present in three of the studies (Alawneh et al, 2016; Miyashita et al, 2015; Nunes, 2014).…”

“…The structural validity was 'inadequate'. As a result, an exploratory factorial analysis was carried out, and three factors were identified by means of the Scree test: 'physical subscale' (the first subscale consisted of seven items that were related to the physical sensations of fatigue; easily tired, having urge to lie down, exhausted, heavy and tired, fed-up, reluctant and fatigue you do not know what to do with yourself), 'affective subscale' (the second subscale consisted of four items that assessed affective activity; energetic feeling, interest in something, ability to concentrate and encourage yourself to do something) and 'cognitive subscale' (the third subscale consisted of four items that assessed attention and memory; careless, instrument included in the largest number of studies, 14 in total (Alawneh et al, 2016;Arraras et al, 2014;Golči c et al, 2018;Groenvold et al, 2006;Leppert & Majkowicz, 2013;Miyashita et al, 2015;Miyazaki et al, 2012;Nunes, 2014;Ozcelik et al, 2016;Raman et al, 2016;Rojas-Concha et al, 2020;Shin et al, 2011;Suárez-del-Real et al, 2011;Zhang et al, 2016) and for which more psychometric properties were measured: content validity, structural validity, internal consistency, cross-cultural validity, reliability, criterion validity, hypotheses testing and responsiveness (all except for measurement error). The content validity was classified as 'inadequate'…”

“…for the two studies where it was evaluated (Groenvold et al, 2006;Rojas-Concha et al, 2020). Structural validity was rated as 'adequate' or 'very good' and was present in three of the studies (Alawneh et al, 2016;Miyashita et al, 2015;Nunes, 2014).…”

Correction to: Content validation of the EORTC QLQ-C15-PAL with advanced cancer patients and health care professionals from palliative care services in Chile

“…Following publication of the original article [ 1 ], the authors identified an error in Table 3 . The footnotes were missing.…”