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. 2025 Jun 10:13:e19562.
doi: 10.7717/peerj.19562. eCollection 2025.

Adaptation and validation of the Chinese version of the Hospice Comfort Questionnaire-Patient (HCQ-P)

Nana Xu  1   2 , Xu Yan  1 , Xiaohong Ou  3 , Jun Ren  2 , Qiaoqin Wan  1
Affiliations

Adaptation and validation of the Chinese version of the Hospice Comfort Questionnaire-Patient (HCQ-P)

Nana Xu et al. PeerJ. .

Abstract

Objective: The Hospice Comfort Questionnaire-Patients (HCQ-P) is widely used to assess patient's comfort levels in hospice care. This research aimed to culturally adapt the HCQ-P for the Chinese context and validate its psychometric properties to ensure its applicability and effectiveness in China.

Methods: This research was conducted in two main phases: (1) translation and cross-cultural adaptation of the HCQ-P into Chinese, (2) evaluation of the psychometric properties through expert consultations and a cross-sectional survey among 360 hospice care patients. The evaluation included determining floor and ceiling effects, evaluating internal consistency using Cronbach's α, and testing test-retest reliability with the intra-class correlation coefficient (ICC). Content validity was assessed using the content validity index (CVI), and construct validity was tested through confirmatory factor analysis (CFA).

Results: The HCQ-P was successfully translated and culturally adapted into Chinese, with no significant floor or ceiling effects detected. The overall Cronbach's α for the HCQ-P was 0.94, demonstrating excellent internal consistency, while dimension-specific alphas ranged from 0.77 to 0.84. The overall ICC was 0.93, indicating high test-retest reliability, with individual dimensions ranging from 0.77 to 0.81. Both item-level and scale-level CVIs reached 1, reflecting unanimous expert agreement on content relevance. Significant factor loadings in the CFA confirm that the HCQ-P is statistically robust and well-aligned with the cross-cultural and clinical contexts of Chinese hospice care.

Conclusions: The Chinese version of the HCQ-P exhibits robust psychometric properties, making it a valid and reliable instrument for assessing patient comfort in Chinese hospice care settings.

Keywords: Cross-cultural adaptation; Hospice care; Hospice comfort questionnaire; Psychometric properties.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Flowchart of the translation and cross-cultural adaptation process of HCQ-P from the original English version.
Figure 2
Figure 2. Confirmatory factor analysis.
See this image and copyright information in PMC

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