A Cross-Cultural Adaptation And Validation Study Of The Chinese Version Of The Bladder Cancer Index

Objective(s):The aim of this study was to translate the Bladder Cancer Index(BCI)into Chinese according to the guidelines for the process of cross-cultural adaptation of self-report measures,and assessed its feasibility and psychometric properties.Methods:The study was divided into two parts.The first part was that developed a Chinese version of the BCI,which based on Beaton’s guidelines for the process of cross-cultural adaptation of self-report measures,including 6 stages:initial translation,synthesis,back translation,expert committee review,pretesting and submission and appraisal of all written reports by developers.The second part was psychometric properties assessment of the Chinese version of the BCI,220 bladder cancer patients who meet the inclusion and exclusion criteria were selected by convenient sampling method for an anonymous questionnaire survey.Feasibility,validity,reliability,ceiling and floor effects were estimated.Results:The results of the Part I:The Chinese version of the BCI consists of 36items,covering three primary domains:urinary,bowel and sexual.Each domain consists of two subdomains(function and bother).The results of the Part II:250 questionnaires were distributed totally,effective responses were obtained from 220 bladder cancer patients(88.0%).220 questionnaires were validated,the main results of the study were as follows:(1)Content validity:the I-CVI of the Chinese version of the BCI was between 0.80 and 1.00,and the S-CVI/UA and S-CVI/Ave were 0.92 and 0.98;(2)Criterion validity:the correlations of the BCI subdomain and the FACT-Bl and EQ-5D-5L was ranged from-0.04 to 0.39;(3)Structural validity:the correlation analysis results showed that the correlation between the subdomains of the same domain of the BCI were 0.87,0.80 and 0.83(P<0.05)respectively,the correlations between the function subdomains and bother subdomains of the different domains were between 0.07 and 0.32.The confirmatory factor analysis results showed that~2/(91)was 1.510,RMSEA was 0.048,CFI was 0.945,TLI was0.940,GFI was 0.816,and SRMR was 0.054,The standardized factor load was between0.22 and 0.96;(4)convergent validity:AVE of each subdomain of Chinese version of the BCI was between 0.45 and 0.74,and CR was between 0.75 and 0.93;(5)Known-group validity:the scores of the urinary function,bowel habit and sexual function domain of patients with different surgical operations were statistically significant,and the scores of the urinary function and bowel habit domain of patients with different stages were statistically significant;(6)Reliability:the Cronbach’sαof the 3 domains of the Chinese version of BCI and each subdomain was between 0.746 and 0.938,and the ICC ranged from 0.682 to 0.831;The floor/ceiling effect ranged from 0 to 1.4%and from 0 to15.5%.Conclusion(s):The Chinese version of the BCI was basically consistent with the English version in terms of domain division and item content,including 3 domains,6 subdomains and 36 items.The BCI was shown to be reliable and have good validity.These findings support its utilization,as a valuable and comprehensive tool for estimating the health-related quality of life of patients with bladder cancer.