Psychometric Evaluation Of The Chinese Version Of The Upper Limb Lymphedema Quality Of Life Scale And Its Preliminary Application In Breast Cancer Related Lymphedema Patients

ObjectiveThe purpose of this study was to evaluate the psychometric properties of the Upper Limb Lymphedema Quality of Life(ULLQoL)Scale in breast cancer-related lymphedema(BCRL)patients.This scale was used as a survey tool to investigate the current status and influencing factors of the quality of life(QoL)in BCRL patients.Methods1.A total of 85 BCRL patients in two tertiary grade A hospitals in Hengyang from August 2018 to March 2019 were enrolled in this research.Forward-backward translation procedure was involved to the process of translate the ULLQoL from English into Chinese.The internal consistency,test-retest reliability,content validity,criterion-related validity,and construct validity of the Chinese version of the Upper Limb Lymphedema Quality of Life Scale(C-ULLQoL)were tested.2.A total of 104 BCRL patients in two tertiary grade A hospitals of Hengyang from March 2019 to January 2020 were enrolled in this research.Participates were received three questionnaires includes the Demographic survey questionnaire,C-ULLQoL,Hospital Anxiety and Depression Scale(HADS)in order to investigate the current status of the QoL and explore the influencing factors in BCRL patients.The correlation between demographic statistics and the QoL of BCRL patients were analyzed by Single factor analysis.The correlation between QoL and anxiety,depression were analyzed by Spearman rank correlation.The dependent variable,multivariate stepwise linear regression analysis was performed to explore the influencing factors of the QoL in BCRL patients.Results1.After two rounds of Deliphi expert consultation method,C-ULLQoL was formed which consist of 14 items and divided into two dimensions.Two factors(65.488% of the variance)were extracted by an EFA.The correlation coefficient between factors was 0.612(P < 0.01),The correlation coefficient between two factors and the scale was 0.934 and 0.839(P < 0.01).Cronbach's alpha of the total C-ULLQoL was 0.930.Cronbach's alpha of each dimension was 0.917 and 0.865.The Guttman partition coefficient ranged from 0.855 to 0.924.Intraclass correlation coefficient ranged from 0.874 to 0.938.The content validity index of each item ranged from 0.80 to 1.00.The negative correlation between the C-ULLQoL and the C-FACT-B(r =-0.611,P < 0.01)were observed.2.104 patients with BCRL were involved in this research.The C-ULLQoL total score was 18(10.25,24.75),and two domains scores were 10(6,14)and 7(5,10).Single factor analysis revealed that the factors affecting QoL included education level,breast surgery,dominant side,and chemotherapy(P<0.05).The positive correlation between QoL and anxiety,depression were observed(P<0.01).Multivariate stepwise linear regression screened anxiety,chemotherapy,depression and dominant side as influence factors of QoL in BCRL patients(P < 0.05).Conclusions1.The C-ULLQoL possessed good validity and reliability.It was suitable for the evaluate the QoL of BCRL patients.2.The QoL of BCRL patients is generally at medium level.The more severe the symptoms of anxiety and depression,the poorer the QoL of BCRL patients.Anxiety,chemotherapy,depression and dominant side are mainly influence factors of QoL.