Chen Zhihan, Li Yanjia, Xie Zhishan, Tang Siyuan, Xiao Jinnan
Xiangya School of Nursing, Central South University, NO. 172 Rd, Changsha, 410013, China.
BMC Nurs. 2024 Jun 20;23(1):413. doi: 10.1186/s12912-024-02071-z.
Given the lack of valid and reliable instruments for evaluating the quality of communication between physicians and cancer patients and their family caregivers in China, this study translated and culturally adapted the Quality of Communication questionnaires for cancer patients (QOC-P) and their family caregivers (QOC-F) for use in the Chinese context and evaluated their psychometric properties.
The QOC-P and QOC-F were translated following an adapted version of Brislin's translation model and culturally adapted according to a Delphi expert panel. We pretested and refined the Chinese versions of the QOC-P and QOC-F among 16 dyads of patients and their family caregivers. Subsequently, we administered the questionnaires to 228 dyads of patients and their family caregivers who were recruited from six tertiary hospitals. The content validity, construct validity, convergent validity, and reliability of the QOC-P and QOC-F were examined.
Through exploratory factor analysis, The QOC-P and QOC-F were divided into two dimensions: general communication and end-of-life communication. The Cronbach's coefficients ranged from 0.905 to 0.907 for the two subscales of the QOC-P and from 0.908 to 0.953 for the two subscales of the QOC-F. The two-week test-retest reliability was acceptable for both the QOC-P and QOC-F, with intraclass correlation coefficients of 0.993 and 0.991, respectively. The scale content validity index (QOC-P: 0.857, QOC-F: 1.0) and split-half reliability (QOC-P: 0.833, QOC-F: 0.935) were satisfactory. There was a negative correlation with anxiety and depression for both the QOC-P (r = -0.233 & -0.241, p < 0.001) and QOC-F (r = -0.464 & -0.420, p<0.001). The QOC-P showed a negative correlation with decision regret (r = -0.445, p<0.001) and a positive correlation with shared decision-making (r = 0.525, p<0.001), as hypothesized.
The QOC-P and QOC-F show acceptable psychometric properties for evaluating the quality of communication between physicians and cancer patients and their family caregivers in both clinical and research contexts. Future studies should use more diverse and inclusive samples to test the structure of the Chinese version of the QOC-P and QOC-F with confirmatory factor analysis.
鉴于中国缺乏评估医生与癌症患者及其家庭照顾者之间沟通质量的有效且可靠的工具，本研究对癌症患者沟通质量问卷（QOC - P）及其家庭照顾者问卷（QOC - F）进行了翻译和文化调适，以适用于中国背景，并评估其心理测量学特性。
按照Brislin翻译模型的改编版本对QOC - P和QOC - F进行翻译，并根据德尔菲专家小组进行文化调适。我们在16对患者及其家庭照顾者中对QOC - P和QOC - F的中文版进行了预测试和完善。随后，我们向从六家三级医院招募的228对患者及其家庭照顾者发放了问卷。对QOC - P和QOC - F的内容效度、结构效度、收敛效度和信度进行了检验。
通过探索性因素分析，QOC - P和QOC - F分为两个维度：一般沟通和临终沟通。QOC - P两个子量表的Cronbach系数在0.905至0.907之间，QOC - F两个子量表的Cronbach系数在0.908至0.953之间。QOC - P和QOC - F的两周重测信度均可接受，组内相关系数分别为0.993和0.991。量表内容效度指数（QOC - P：0.857，QOC - F：1.0）和分半信度（QOC - P：0.833，QOC - F：0.935）令人满意。QOC - P（r = -0.233 & -0.241，p < 0.001）和QOC - F（r = -0.464 & -0.420，p < 0.001）与焦虑和抑郁均呈负相关。如假设所示，QOC - P与决策后悔呈负相关（r = -0.445，p < .001），与共同决策呈正相关（r = 0.525，p < 0.001）。
QOC - P和QOC - F在临床和研究背景下评估医生与癌症患者及其家庭照顾者之间的沟通质量时，显示出可接受的心理测量学特性。未来的研究应使用更多样化和包容性的样本，通过验证性因素分析来检验中文版QOC - P和QOC - F的结构。
