Development Of Quality Of Life Scale For Stomach Cancer Patients

Objective: To develop a Chinese quality of life (QOL) instrument and to sinicize EORTC QLQ-STO22 for forming homologous Chinese version, which can be used to appraise the quality of life for patients with stomach cancer and to evaluate curative effect.Methods: According to the definition of quality of life from WHO, we drew off the theoretical scheme about the measurement instrument for stomach cancer. Based on reviewing literature, learning the related knowledge including psychology and sociology and referring to the generally accepted general scales for all cancer patients and special scales for stomach cancer patients, we extensively consulted the ideas and suggestions from nominal group (including the clinical experts on tumor therapy and some cancer patients) and adopted the method of qualitative interview combining significance score in order to form a questionnaire for pilot testing. Then we investigated 448 cancer patients (including 43 stomach cancer patients) in the Third Affiliated Hospital of Kunming Medical College by using this questionnaire. Four methods had been used to screen and analyze the items of the general module such as coefficient of variation, factor analysis, clustering analysis and correlation analysis. The later two methods had been used to screen and analyze the items of the special module. After screening, the reserved items were discussed and the formal scale named the QLICP-ST (quality of life instruments for cancer patients-stomach cancer) was formed. The validity, reliability and responsiveness of the formal scale were evaluated by QOL data measured from 86 in-patients of stomach cancer. Chinese version of the EORTC QLQ-STO22 was developed by translation and back-translation and cultural adaptation, and evaluated by QOL data measured from 86 in-patients of stomach cancer.Results: (1) 40 of 78 items was retained. QLICP-ST included five domains: physical function, psychological function, social function, general symptom and side effect and special symptom for stomach cancer, while the former four domains made up of the general module for all cancer patients and the last domain formed the special module for stomach cancer patients. The test-retest correlation coefficients of all domains and overall scale all were larger than 0.90. The paired t-test indicated no statistically significant change between the first time and the second time (p>0.05).Cronbach's α coefficients of all domains were from 0.70 to 0.86 and those of general module and the overall scale respectively were 0.90 and 0.91.Split-halfreliability coefficient of all domains were from 0.73 to 0.92. Those of general module and the overall scale respectively were 0.91 and 0.94. 10 common factors were extracted and the cumulative variance was 67.32%. After Varimax orthogonal rotation, we found the results were coincident with the theoretical scheme. The correlation coefficients between the former four domains and the general module all were larger than 0.65. The correlation coefficients between all domains and the overall scale all were larger than 0.65. Besides, it was inferred from the correlation analysis that there were strong correlation between items and their own domains; conversely there were weak correlation between items and other domains. The correlation coefficient between overall scale and the criterion (the global health status domain of the Chinese version of EORTC QLQ-C30) was 0.671.QLICP-ST could distinguish the difference of the quality of life for patients who belonged to different clinical stage and find the changes of quality of life after cure (except the social function domain).(2) Chinese version of EORTC QLQ-STO22 still was made up of five domains(dysphagia, pain, reflux symptoms, eating restrictions, anxiety) and four simple item(having a dry mouth, taste, body image, hair loss) and included 22 items. The test-retest correlation coefficients of all domains were larger than 0.70. The paired t-test indicated no statistically significant change between the first time and the second time (p>0.05).Cronbach's a coefficients of all domains were larger than OJO.Split-hatf reliability coefficient of all domains were larger than 0.70. There were more strong correlation between items and their own domains than between items and other domains. 9 common factors were extracted and the cumulative variance was 82.28%. After Varimax orthogonal rotation, we found the results were coincident with the theoretical scheme. Chinese version of EORTC QLQ-STO22 could find the change of the other domains except the body image domain after cure.Conclusions: QLICP-ST and Chinese version of the EORTC QLQ-STO22 both are reliable, valid and sensitive. The two scales can comprehensively, detailed and accurately interpret the connotation about the quality of life for stomach cancer patients. They can be used to determine and estimate the quality of life for stomach cancer patients.