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      Cultural Adaptation and Validation of the Moroccan Version of the EORTC QLQ-CR29 in Patients with Colorectal Cancer

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          Abstract

          The increasing incidence of colorectal cancer in Morocco has generated a need for a disease-specific quality-of-life measuring instrument. The present study aims to translate and evaluate the reliability and validity of the Moroccan Arabic version of the EORTC QLQ-C29 measure in Moroccan subjects with colorectal cancer (CRC).

          Methods:

          Following translation to Moroccan Arabic, The QLQ-C30 and QLQ-C29 were administered to 135 patients treated for colorectal cancer (CRC) at the national oncology institute of Rabat, in the period from February 2016 to June 2018. Statistical analysis included reliability, convergent, and discriminant validity as well as known-groups comparisons.

          Results:

          (89 %) patients completed the questionnaires of the EORTC QLQ C-29 and EORTC QLQ C-30. The test –retest, administered to 25 patients and the ICCs for each item ranged from 0.61 to 0.93 indicating good to excellent reproducibility. The internal consistency coefficients for body image, urinary frequency, stool frequency scales were acceptable (Cronbach’s alpha ≥ 0.70), while the blood and mucus in the stool dimensions had lower reliability (0.65). Multi-trait scaling analysis showed that multi-item scales met standards of convergent and discriminate validity. All Correlations between the EORTC QLQ C-29 and EORTC QLQ C-30 scores were low (r < 40). The known- group comparisons showed differences between group of patients based on tumor location and with/ without a stoma.

          Conclusion:

          The Moroccan Arabic Dialectal version of the QLQ-C 29 is a valid and reliable measure of health related quality of life (HRQOL) in patients with colorectal cancer.

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          Most cited references25

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          Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures

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            The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology.

            In 1986, the European Organization for Research and Treatment of Cancer (EORTC) initiated a research program to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. We report here the results of an international field study of the practicality, reliability, and validity of the EORTC QLQ-C30, the current core questionnaire. The QLQ-C30 incorporates nine multi-item scales: five functional scales (physical, role, cognitive, emotional, and social); three symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality-of-life scale. Several single-item symptom measures are also included. The questionnaire was administered before treatment and once during treatment to 305 patients with nonresectable lung cancer from centers in 13 countries. Clinical variables assessed included disease stage, weight loss, performance status, and treatment toxicity. The average time required to complete the questionnaire was approximately 11 minutes, and most patients required no assistance. The data supported the hypothesized scale structure of the questionnaire with the exception of role functioning (work and household activities), which was also the only multi-item scale that failed to meet the minimal standards for reliability (Cronbach's alpha coefficient > or = .70) either before or during treatment. Validity was shown by three findings. First, while all interscale correlations were statistically significant, the correlation was moderate, indicating that the scales were assessing distinct components of the quality-of-life construct. Second, most of the functional and symptom measures discriminated clearly between patients differing in clinical status as defined by the Eastern Cooperative Oncology Group performance status scale, weight loss, and treatment toxicity. Third, there were statistically significant changes, in the expected direction, in physical and role functioning, global quality of life, fatigue, and nausea and vomiting, for patients whose performance status had improved or worsened during treatment. The reliability and validity of the questionnaire were highly consistent across the three language-cultural groups studied: patients from English-speaking countries, Northern Europe, and Southern Europe. These results support the EORTC QLQ-C30 as a reliable and valid measure of the quality of life of cancer patients in multicultural clinical research settings. Work is ongoing to examine the performance of the questionnaire among more heterogenous patient samples and in phase II and phase III clinical trials.
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              Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines

              Clinicians and researchers without a suitable health-related quality of life (HRQOL) measure in their own language have two choices: (1) to develop a new measure, or (2) to modify a measure previously validated in another language, known as a cross-cultural adaptation process. We propose a set of standardized guidelines for this process based on previous research in psychology and sociology and on published methodological frameworks. These guidelines include recommendations for obtaining semantic, idiomatic, experiential and conceptual equivalence in translation by using back-translation techniques and committee review, pre-testing techniques and re-examining the weight of scores. We applied these guidelines to 17 cross-cultural adaptation of HRQOL measures identified through a comprehensive literature review. The reporting standards varied across studies but agreement between raters in their ratings of the studies was substantial to almost perfect (weighted kappa = 0.66-0.93) suggesting that the guidelines are easy to apply. Further research is necessary in order to delineate essential versus optional steps in the adaptation process.
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                Author and article information

                Journal
                Asian Pac J Cancer Prev
                Asian Pac J Cancer Prev
                APJCP
                Asian Pacific Journal of Cancer Prevention : APJCP
                West Asia Organization for Cancer Prevention (Iran )
                1513-7368
                2476-762X
                April 2022
                : 23
                : 4
                : 1379-1385
                Affiliations
                [1] Department of Surgical, National Institute of Oncology, Rabat, Morocco.
                Author notes
                [* ]For Correspondence: yacirelalami@yahoo.fr
                Article
                10.31557/APJCP.2022.23.4.1379
                9375622
                35485700
                22f2e6de-a421-437b-b9fc-7ba7801a8613

                This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. https://creativecommons.org/licenses/by-nc/4.0/

                History
                : 4 January 2022
                : 19 April 2022
                Categories
                Research Article

                eortc qlq-c29,colorectal carcinoma,validation,morocco
                eortc qlq-c29, colorectal carcinoma, validation, morocco

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