Huang Chi-Cheng, Tu Shih-Hsin, Lien Heng-Hui, Huang Ching-Shui, Wang Pa-Chun, Chie Wei-Chu
Cathay General Hospital SiJhih, New Taipei City, Taiwan.
Qual Life Res. 2015 Aug;24(8):1999-2013. doi: 10.1007/s11136-014-0913-3. Epub 2015 Jan 6.
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).
The Taiwan Chinese version of the EORTC QLQ-C30 was used as the measuring instrument. Higher-order 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.
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 health-related quality-of-life model were proposed as the alterative conceptual structure for the Taiwan Chinese QLQ-C30.
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.
本研究旨在通过分析从台湾主要癌症患者收集的数据，评估欧洲癌症研究与治疗组织生活质量核心问卷30（EORTC QLQ - C30）的概念结构。通过结构方程模型（SEM）探索QLQ - C30潜在的概念结构，包括高阶因子。
使用EORTC QLQ - C30的台湾中文版作为测量工具。测试了高阶模型，包括心理健康/身体健康、心理功能/身体负担、症状负担/功能、单一潜在健康相关生活质量、形成性症状负担/功能和形成性健康相关生活质量。
研究对象包括283例乳腺癌、肺癌和鼻咽癌患者。原始的QLQ - C30多因素结构显示认知功能子量表的组合信度较差。形成性症状/负担模型受模型拟合指数青睐，进一步支持因果指标二元性，但因症状性子量表与潜在因子之间的意外关联而受到影响。提出了具有单一二阶潜在因子的形成性健康相关生活质量，其中症状性子量表仍为形成性。提出了来自正式认知功能子量表的另外两个症状测量指标与形成性健康相关生活质量模型，作为台湾中文版QLQ - C30的替代概念结构。
本研究结果代表了对EORTC QLQ - C30完整的SEM方法。消除认知功能的形成性健康相关生活质量模型以简约的拟合和可解释性增强了台湾中文版的概念结构。
