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. 2021 Apr 23;19(1):131.
doi: 10.1186/s12955-021-01769-x.

Psychometric properties of the EORTC QLQ-C30 in Uganda

Allen Naamala  1   2 , Lars E Eriksson  3   4   5 , Jackson Orem  6 , Gorrette K Nalwadda  7 , Zarina Nahar Kabir  8 , Lena Wettergren  9   10
Affiliations

Psychometric properties of the EORTC QLQ-C30 in Uganda

Allen Naamala et al. Health Qual Life Outcomes. .

Abstract

Background: Self-reported measures play a crucial role in research, clinical practice and health assessment. Instruments used to assess self-reported health-related quality of life (HRQoL) need validation to ensure that they measure what they are intended to, detect true changes over time and differentiate between subjects. A generic instrument measuring HRQoL adapted for use among people living with cancer in Uganda is lacking; therefore, this study aimed to evaluate the psychometric properties of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 in patients with cancer in Uganda.

Methods: Adult patients with various types of cancer (n = 385) cared for at the Uganda Cancer Institute answered the EORTC QLQ-C30 in Luganda or English language, the two most spoken languages in the country. The two language versions were evaluated with regard to data quality (floor and ceiling effects and missing responses), reliability (internal consistency) and validity (construct, known-group and criterion). Construct validity was examined through confirmatory factor analysis (CFA). Mean scores were compared between groups differing in disease stage to assess known-group validity. Criterion validity was examined according to associations between two QLQ-C30 subscales (Global quality of life and Physical function) and the Karnofsky Performance Scale (KPS).

Results: Floor and ceiling effects were observed for several scales in the Luganda and English versions. All EORTC scales with the exception of Cognitive function (Luganda α = 0.66, English α = 0.50) had acceptable Cronbach's alpha values (0.79-0.96). The CFA yielded good fit indices for both versions (RMSEA = 0.08, SRMR = 0.05 and CFI = 0.93). Known-group validity was demonstrated with statistically significant better HRQoL reported by patients with disease stages I-II compared to those in stages III-IV. Criterion validity was supported by positive correlations between KPS and the subscales Physical function (Luganda r = 0.75, English r = 0.76) and Global quality of life (Luganda r = 0.59, English r = 0.72).

Conclusion: The Luganda and English versions of the EORTC QLQ-C30 appear to be valid and reliable measures and can be recommended for use in clinical research to assess HRQoL in adult Ugandans with cancer. However, the cognitive scale did not reach acceptable internal consistency and needs further evaluation.

Keywords: Cancer; Cancer care; EORTC; Health-related quality of life; Quality of life; Sub-Saharan.

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Conflict of interest statement

The authors declare that they have no competing interests. There are no financial and/or personal relationships between the authors and others that might bias the work.

Figures

Fig. 1
Fig. 1
Model of confirmatory factor analysis (CFA) indicating standardized loadings on the factors of the Luganda version of the EORTC QLQ-C30 (n = 217)
Fig. 2
Fig. 2
Model of confirmatory factor analysis (CFA) indicating standardized loadings on the factors of the English version of the EORTC QLQ-C30 (n = 168)
See this image and copyright information in PMC

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