School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
College of Nursing and Midwifery, Charles Darwin University, Darwin, NT, Australia.
BMC Palliat Care. 2019 Aug 6;18(1):68. doi: 10.1186/s12904-019-0450-5.
To determine the validity, reliability and acceptability of the Mandarin Chinese version of the Problems and Needs in Palliative Care questionnaire-short version (PNPC-sv) for measuring problems and palliative care needs among patients with advanced cancer.
This was a validation study using a forward- and backward- translation procedure, a panel of experts and a cross-sectional study design. The Mandarin Chinese version of the PNPC-sv was translated by four independent translators. The translated Chinese version was further reviewed by an expert panel to identify its content validity. A pilot test was conducted in 10 advanced cancer patients to preliminarily assess the face validity, readability and clarity of the pre-final version of the PNPC-sv. 178 patients with advanced cancer, regardless of their gender and types of cancer diagnosis, were further recruited through a convenience sampling from three tertiary hospitals in China to assess the psychometric properties of the PNPC-sv Mandarin Chinese version. Content validity was measured using the content validity index (CVI). Construct validity was estimated via confirmatory factor analysis and the contrasted groups approach. Concurrent validity was identified by analysing the correlations between the EORTC Quality-of-Life Questionnaire-Core 30 (EORTC QLQ-C30) and the PNPC-sv. Reliability of the PNPC-sv was examined with the internal consistency reliability and item-to-total correlations. Several closed-ended and open-ended questions were designed to explore its acceptability.
174 patients completed the questionnaires. High content and face validity were determined after the two rounds of assessment with the expert panel and the patients. An excellent CVI of 1.0 was achieved and patients rated the PNPC-sv as a useful instrument for assessing their problems and needs (mean score = 7.99, 0-10 scale) and reported the items were not particularly sensitive and easy to understand. The majority of the fit indexes meet the critical criteria, with the Chi-square divided by degrees of freedom (x/df) being 1.58 and 2.05, and the root mean squared error of approximation (RMSEA) being 0.06 and 0.07 for the problem part and need-for-care part, respectively. In relation to the contrasted groups analysis, it clearly discriminated the differences on the sub-scores of Activities of Daily Life (ADL), spiritual and psychological problems and needs between male and female patients; ADL, physical, social and financial problems and needs between age groups; and autonomic problems and needs between patients with different cancer stages. Statistically significant correlations (p < 0.05) were detected between the PNPC-sv and the EORTC QLQ-C30 in the majority of the sub-scores (positive correlations) and total scores (negative correlations). The Cronbach's alpha of the total scale was 0.88 and 0.91 for the problem part and need-for-care part, respectively. The Cronbach's alpha of the subscales were generally above 0.70. Item-to-total correlations were generally acceptable, with the majority of the values being above 0.40. The PNPC-sv questionnaire was reported to be convenient and easy to understand, and the average time for completing was 11 min.
The Mandarin Chinese version of the PNPC-sv is a valid, reliable and user-friendly instrument for measuring problems and palliative care needs among patients with advanced cancer. Further research is needed to further examine its psychometric properties particular internal structure in a larger patient sample.
为了确定简体中文版晚期癌症患者问题和姑息治疗需求问卷简表（PNPC-sv）中文版测量晚期癌症患者问题和姑息治疗需求的有效性、信度和可接受性。
本研究采用正向和反向翻译程序、专家小组和横断面研究设计进行验证研究。简体中文版 PNPC-sv 由四位独立翻译翻译。经专家小组进一步评审，以确定其内容效度。在 10 例晚期癌症患者中进行了预试验，以初步评估 PNPC-sv 预终版的表面效度、可阅读性和清晰度。通过便利抽样从中国的三家三级医院招募了 178 例晚期癌症患者，无论其性别和癌症诊断类型如何，以评估 PNPC-sv 简体中文版的心理测量特性。内容效度采用内容效度指数（CVI）进行测量。通过验证性因子分析和对比组方法评估结构效度。通过分析 EORTC 生活质量问卷核心 30 项（EORTC QLQ-C30）和 PNPC-sv 之间的相关性来确定同时效度。通过内部一致性信度和条目与总分的相关性来检验 PNPC-sv 的可靠性。设计了几个封闭式和开放式问题来探讨其可接受性。
174 例患者完成了问卷调查。经过两轮专家小组和患者评估，确定了高内容和表面效度。取得了优异的 CVI 为 1.0，患者认为 PNPC-sv 是评估他们的问题和需求的有用工具（平均得分为 7.99，0-10 分），并报告说这些项目并不特别敏感，易于理解。大多数拟合指标符合关键标准，问题部分和护理需求部分的卡方自由度比（x/df）分别为 1.58 和 2.05，近似误差均方根（RMSEA）分别为 0.06 和 0.07。关于对比组分析，它清楚地区分了男性和女性患者在日常生活活动（ADL）、精神和心理问题和需求方面的差异；年龄组之间在 ADL、身体、社会和财务问题和需求方面的差异；以及不同癌症阶段的患者之间在自主问题和需求方面的差异。在大多数亚量表（正相关）和总分（负相关）中，PNPC-sv 与 EORTC QLQ-C30 之间检测到具有统计学意义的相关性（p<0.05）。总量表的克朗巴赫α系数分别为 0.88 和 0.91，问题部分和护理需求部分。子量表的克朗巴赫α系数通常在 0.70 以上。条目与总分的相关性通常是可以接受的，大多数值都在 0.40 以上。PNPC-sv 问卷被报告为方便和易于理解，平均完成时间为 11 分钟。
简体中文版 PNPC-sv 是一种有效的、可靠的、用户友好的工具，可用于测量晚期癌症患者的问题和姑息治疗需求。需要进一步研究以在更大的患者样本中进一步检验其心理测量特性，特别是内部结构。
