title: Cross-cultural verification of the EORTC QLQ-C15-PAL questionnaire in mainland China.
abstract: BACKGROUND
  Simplified by European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30), EORTC Quality-of-Life Questionnaire Core 15 Palliative Care (QLQ-C15-PAL) is specifically applied to evaluating palliative care patients' quality of life.
  
  
  OBJECTIVE
  This study examined cross-cultural adaptability and validity of QLQ-C15-PAL for evaluating quality of life of palliative care patients with advanced cancer in mainland China.
  
  
  METHODS
  From May to October 2013, 243 palliative care patients in Tianjin Cancer Hospital completed the EORTC QLQ-C30. We extracted QLQ-C15-PAL data for analysis. Physicians completed the Eastern Cooperative Oncology Group Performance Status score and mental state assessment for each patient.
  
  
  RESULTS
  A total of 243 patients completed the study. The compliance rate was high, with missing rate for each item ranging from 0% to 2.1%. In addition to emotional function, the remaining dimensions demonstrated a high reliability (Cronbach's alpha > 0.7). Whether we divided patients into two groups according to their Eastern Cooperative Oncology Group Performance Status or divided patients into three groups according to mental status, both sets of results showed significant differences in QLQ-C15-PAL subscale scores (p < 0.05), indicating that the QLQ-C15-PAL scale could be used to distinguish between the aforementioned subgroups. Overall quality of life was moderately correlated with fatigue (r = -0.406) but weakly correlated with other subscales. The proportion of variance (R(2)) ranged from 0.848 to 0.903, which showed that QLQ-C15-PAL subscale scores explained between 84.8% and 90.3% of the original QLQ-C30 score distribution.
  
  
  CONCLUSIONS
  The Chinese version of the EORTC QLQ-C15-PAL questionnaire has high reliability and validity and is therefore suitable for clinical use in China to determine health-related quality of life in Chinese patients with advanced cancer.
authors.affiliation: Department of Thoracic Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Xiangya Medical School, Central South University, Changsha, People's Republic of China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
authors.affiliation: Tianjin Medical University, Tianjin, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Xiangya Medical School, Central South University, Changsha, People's Republic of China.
authors.forename: Jiahao
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Palliative Care, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of China.
authors.forename: Zhiqin
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Tianjin Medical University, Tianjin, People's Republic of China.
authors.forename: Weilin
authors.initials: W
authors.lastname: Sun
authors.affiliation: Harvard University, Cambridge, MA, USA.
authors.forename: Stephanie Mu-Lian
authors.initials: SM
authors.lastname: Woo
authors.affiliation: Xiangya Medical School, Central South University, Changsha, People's Republic of China.
authors.forename: Chujun
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Cerebral Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: Adam R
authors.initials: AR
authors.lastname: Miller
authors.affiliation: Tianjin Medical University, Tianjin, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.affiliation: Xiangya Medical School, Central South University, Changsha, People's Republic of China.
authors.forename: Xueying
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin, People's Republic of China 13189368@qq.com.
authors.forename: Changli
authors.initials: C
authors.lastname: Wang
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D002173:Cancer Care Facilities; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D011594:Psychometrics / Q000379:methods / Q000592:standards*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
keywords: Cancer; Chinese; EORTC QLQ-C15-PAL; health-related quality of life; mainland China; palliative care; quality of life; validation