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TRANALATION AND PSYCHOMETRIC VALIADATION OF THE SINHALA VERSION OF THE EORTC QLQ-CR29 QUALITY OF LIFE QUESTIONNAIRE
Dakshitha Wickramasinghe^*, Praveen V. Dayasena, Pragathi L. Weerakkody, Sanjeewa Seneviratne, Dharmabandhu N. Samarasekera
Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
Purpose To validate the Sinhalese version of the EORTC QLQ-CR29 quality of life questionnaire for colorectal cancer.
Method We translated and pilot-tested (n=10) the original questionnaire in Sri Lanka. We assessed reliability, factor structure and construct validity in different sub sets of patients grouped according to the EORTC guidelines. The testing was done in two tertiary care hospitals in Sri Lanka: the National Hospital of Sri Lanka and Cancer Hospital Maharagama, simultaneously.
Results Of 110 participants, 103 (93%) returned the questionnaire, and 15 out of 20 (75%) returned the repeat-test questionnaire within a period of two weeks (without significant events affecting quality of life). Out of the original four scales two had better reliability than the original scales (urinary frequency - Cronbach α - 0.82 vs original α - 0.71, blood and mucus in stools α - 0.85 vs original α - 0.56). The defaecation problems scale had sufficient reliability (α - 0.76 vs original α - 0.84). The body image scale showed low reliability (α - 0.33) compared to the original (α - 0.80). However, when one of the 3 items in the scale was omitted, it showed sufficient reliability (α - 0.74).
Factor analysis showed good reliability for overall assessment of the two item scale for stool frequency (α - 0.82) and six item scale for defeacation problems (α - 0.76). Patients with a stoma had a higher reliability in the two-item stool frequency scale (α - 0.90), when compared to non-stoma patients (α - 0.79).
Correlations between all the subscales and the QLQ- C30 subscales were below 0.40, except for body image, which correlated moderately (r- 0.44) with emotional functioning. This confirmed satisfactory overall construct validity
Conclusion The scales for urinary frequency, blood and mucus in stools and defaecation problems which were reliable and had good validity. The six item scale for defaecation problems showed less reliability when assessing patients with stoma however the two item stool frequency scale showed very high reliability in assessing both patients with or without stoma. Body image scale failed to show sufficient reliability with the three-item scale and we suggest to omit one of the items to improve the overall reliability of the questionnaire. Construct validity was comparable to published data.

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