Conceptual structure of the Taiwan Chinese version of the EORTC QLQ-C30

• Published in: Quality of life research Vol. 24; no. 8; pp. 1999 - 2013
• Main Authors: Huang, Chi-Cheng, Tu, Shih-Hsin, Lien, Heng-Hui, Huang, Ching-Shui, Wang, Pa-Chun, Chie, Wei-Chu
• Format: Journal Article
• Language: English
• Published: Cham Springer 01.08.2015; Springer International Publishing; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Asian Continental Ancestry Group; Breast Neoplasms - psychology; Cancer; Cancer therapies; Chinese languages; Cognition - physiology; Cognitive ability; Female; Health care; Health Status; Hospitals; Humans; INSTRUMENT DEVELOPMENT; Lung Neoplasms - psychology; Male; Measuring instruments; Medicine; Medicine & Public Health; Mental Health; Middle Aged; Nasopharyngeal Neoplasms - psychology; Preventive medicine; Public Health; Quality of Life; Quality of Life Research; Questionnaires; Reproducibility of Results; Sociology; Structural equation modeling; Surveys and Questionnaires; Taiwan; Validation studies; Validity; Young Adult; Taiwan; Taiwan Chinese; Conceptual structure; Higher-order factor; Quality of life; EORTC QLQ-C30; Cancer
• ISSN: 0962-9343; 1573-2649; 1573-2649
• DOI: 10.1007/s11136-014-0913-3

Objective This study aimed to evaluate the conceptual structure of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) by analyzing data collected from patients with major cancers in Taiwan. The conceptual structure underlying QLQ-C30, including higher-order factors, was explored by structural equation modeling (SEM). Methods The Taiwan Chinese version of the EORTC QLQ-C30 was used as the measuring instrument. Higherorder models, including mental health/physical health, mental function/physical burden, symptom burden/function, single latent health-related quality of life, formative symptom burden/function, and formative health-related quality of life, were tested. Results Study subjects included 283 patients with breast, lung, and nasopharyngeal cancers. The original QLQ-C30 multi-factorial structure demonstrated poor composite reliability of the cognitive function subscale. The formative symptom/burden model was favored by model fit indices, further supporting causal-indicator duality, but was compromised by unexpected associations between symptomatic subscales and latent factors. The formative health-related quality of life was proposed with a single second-order latent factor where symptomatic subscales remained formative. Two additional symptom measures from the formal cognitive function subscale with the formative healthrelated quality-of-life model were proposed as the alterative conceptual structure for the Taiwan Chinese QLQC30. Conclusions Results of the current study represent the complete SEM approach for the EORTC QLQ-C30. The formative health-related quality-of-life model with elimination of cognitive function enhances the conceptual structure of the Taiwan Chinese version with parsimonious fit and interpretability.