Validation of the Chinese version of the Head and Neck Patient Symptom Checklist for measuring nutrition impact symptoms during radiotherapy in patients with head and neck cancer
The Head and Neck Patient Symptom Checklist (HNSC) is a valid tool for measuring nutrition impact symptoms (NIS) specific to head and neck cancer (HNC) patients. This study aimed to translate the HNSC into Chinese and to evaluate its psychometric properties in Chinese HNC patients treated with radiotherapy.
The HNSC was translated into Chinese following standard forward- and back-translation procedures. Three instruments, the Chinese version of HNSC, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and Patient-Generated Subjective Global Assessment (PG-SGA), were answered by 116 HNC patients, of whom 11 were submitted to the test–retest in 3–7 days. The criterion and convergent validities were confirmed by measuring the relations of the HNSC score with the PG-SGA and EORTC QLQ-C30, respectively. The discriminant validity was evaluated through known group analysis. Reliability was evaluated by means of Cronbach’s alpha and test–retest using the correlation coefficient.
Criterion validity was 0.767 for intensity dimension and 0.795 for interference dimension, respectively. Convergent validity was confirmed by the significant correlations between the HHSC score and most domains of QLQ-C30. The comparison among the groups demonstrated good discriminant validity. The Cronbach’s alpha was 0.787 for intensity dimension and 0.797 for interference dimension, respectively. The test–retest reliability was 0.845 for intensity dimension and 0.883 for interference dimension, respectively.
The Chinese version of HNSC demonstrated favorable validity and reliability. It can be used in identification of NIS and development of symptom management program in HNC patients in China.
KeywordsHead and neck cancer Nutrition impact symptom Head and Neck Patient Symptom Checklist Reliability Validity
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The corresponding author has full control of all primary data and agrees to allow the journal to review the data if requested.
- 5.Schindler A, Denaro N, Russi EG, Pizzorni N, Bossi P, Merlotti A, Spadola Bissetti M, Numico G, Gava A, Orlandi E, Caspiani O, Buglione M, Alterio D, Bacigalupo A, de Sanctis V, Pavanato G, Ripamonti C, Merlano MC, Licitra L, Sanguineti G, Langendijk JA, Murphy B (2015) Dysphagia in head and neck cancer patients treated with radiotherapy and systemic therapies: literature review and consensus. Crit Rev Oncol Hematol 96(2):372–384CrossRefGoogle Scholar
- 6.Farhangfar A, Makarewicz M, Ghosh S, Jha N, Scrimger R, Gramlich L, Baracos V et al (2014) Nutrition impact symptoms in a population cohort of head and neck cancer patients: multivariate regression analysis of symptoms on oral intake, weight loss and survival. Oral Oncol 50(9):877–883CrossRefGoogle Scholar
- 7.Kubrak C, Olson K, Jha N, Jensen L, McCargar L, Seikaly H, Harris J, Scrimger R, Parliament M, Baracos VE et al (2010) Nutrition impact symptoms: key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment. Head Neck 32(3):290–300Google Scholar
- 12.Murphy BA, Dietrich MS, Wells N, Dwyer K, Ridner SH, Silver HJ, Gilbert J, Chung CH, Cmelak A, Burkey B, Yarbrough WG, Sinard R, Netterville J (2010) Reliability and validity of the Vanderbilt Head and Neck Symptom Survey: a tool to assess symptom burden in patients treated with chemoradiation. Head Neck 32(1):26–37Google Scholar
- 13.Rosenthal DI, Mendoza TR, Chambers MS, Burkett VS, Garden AS, Hessell AC, Lewin JS, Ang KK, Kies MS, Gning I, Wang XS, Cleeland CS (2008) The M. D. Anderson symptom inventory–head and neck module, a patient-reported outcome instrument, accurately predicts the severity of radiation-induced mucositis. Int J Radiat Oncol Biol Phys 72(5):1355–1361CrossRefGoogle Scholar
- 15.Mundform DJ, Shaw DG, Ke TL (2005) Minimum sample size recommendations for conducting factor analysis. IJT 5(2):159–168Google Scholar
- 20.Ottery FD (1994) Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol 21(6):770–778Google Scholar
- 21.Gabrielson DK, Scaffidi D, Leung E, Stoyanoff L, Robinson J, Nisenbaum R, Brezden-Masley C, Darling PB et al (2013) Use of an abridged scored Patient-Generated Subjective Global Assessment (abPG-SGA) as a nutritional screening tool for cancer patients in an outpatient setting. Nutr Cancer 65(2):234–239CrossRefGoogle Scholar
- 22.Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefGoogle Scholar
- 23.Rw B (1970) Back-translation for cross-culture research. J Cross-Cult Psychol 3(1):185–216Google Scholar