| Objective:Research on health-related quality of life (HRQOL) in adolescents with obesity began relatively late in China, and still lacks of appropriate instrument even now. This paper intends to develop a Chinese adaptation of the Youth Quality of life-Weight Module (YQOL-W), a weight-specific instrument designed by Seattle Quality of Life Group, University of Washington, through combining cognitive interviews in the target population with individual interviews of weight-specific life experience of Chinese youth concerning their sense of self, social interaction, and relationship to environment, which also can provide the evidence for content validity.Methods:The Chinese version of the YQOL-W was developed according to the guidelines of linguistic validation, including forward translation, backward translation and cognitive interviews. The questionnaire was translated into Chinese by two independent translators, and then translated back into English. After translation disparities had been reconciled, the final Chinese questionnaire was tested. Cognitive interviews were conducted in the target population for the cultural adaptation of the scale. Stratified and theoretical sampling identified participants. Semi-structured interviews probed youth’s perceptions of their weight quality of life and explored how these adolescents view their weight-specific quality of life. An adaptation of grounded theory based on expert opinion and scientific literature was use to focus the study design, identify concepts in the data, and interpret results. The interviews were recorded and the responses were transcribed verbatim. Interviews were coded in Atlas ti5.7.1. Pairs of researchers identify themes and coded transcripts. Sense of Self, Social Relationships, and Environmental Influences (YQOL-W sub-domains) were theme categories for weight-specific perceptions. Researchers matched selected text in the data to existing YQOL-W items and themes. New concepts were elicited and new items were developed to complement the existing YQOL-W items.Results:Most of the items can be translated into Chinese with little difficulty and can be expressed in Chinese accurately, while some items were amended according to the results of the two cognitive interviews.22semi-structured interviews were conducted within urban, country, and immigrant obese, overweight, and normal weight youth aged from11to18years in Hangzhou. The weight-related quotations from the22qualitative interviews resulted in129text fragments, sentences and paragraphs, of which19classified as’Self (14.7%),54as’Social relationships’(41.9%), and56as "Environment’(43.4%). As14texts did not match with the concepts of the YQOL-W,5new items were added, revised and formed through a third round of cognitive interviews in the target population.Conclusions:In summary, this paper developed a culturally sensitive, self-reported QoL measurement instrument specific to weight through developing the Chinese version of the YQOL-W from the source version with five new items added by combining the subjective experience of the Chinese youth, their concepts about the YQOL-W with the characteristics of the Chinese language. The instrument can be used to evaluate weight-management treatment, and inform how the youth view and evaluate the importance of weight, weight loss, and the stigma of overweight in their lives. Meanwhile, it would provide a gauge for evaluating the associations of weight with environment and behavior. Further studies should be carried out in order to explore the validity, reliability and responsiveness of the instrument. |
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