Validation of EORTC QLQ-C30 questionnaire in its Tunisian version
DOI:
https://doi.org/10.62438/tunismed.v103i4.5260Keywords:
Non small cell lung carcinoma , Quality of life, Validation , EORTC QLQ-C30Abstract
Objective: To test the validity and reliability of The European Organization for Research and Treatment of Cancer (EORTC) core (QLQ-C30) in its Tunisian dialectal version for lung cancer patients.
Methods: A total of 300 patients under a chemotherapy regimen for lung cancer were enrolled in this cross-sectional study. Participants had to answer EORTC QLQ-C30 auto-questionnaire in the Tunisian version, then in the Arabic version 15 days later. Statistical analyses were performed by SPSS 22.
Results: The Tunisian version was found reliable and valid for Tunisian cancer patients. Seven of the 8 multi-item scales of QLQ-C30 had high reliability (Cronbach’s α >0.7). In our analysis, the most determinative subscales of QLQ-C30 on global health were physical functioning, cognitive functioning, fatigue, and dyspnea. Correlation with the Arabic version was nearly a perfect mismatching; all sub-scale mean scores were statistically correlated. The inter-class correlations confirmed the external convergent validity. Discriminant validity was supported since the correlation value of a symptom scale score with other similar scales was higher than any functional scale, and inversely.
Conclusions: The Tunisian version of EORTC QLQ-C30, recently written is a reliable and valid tool to assess the quality of life of Tunisian lung cancer patients.
Downloads
References
Park KU. Assessment of change of quality of life in terminally ill patients under cancer
pain management using the EORTC Core Quality of Life Questionnaire (QLQ-C30) in a
Korean sample. Oncology. 2008;74 Suppl 1:7–12.
Ameri H, Yousefi M, Yaseri M, Nahvijou A, Arab M, Akbari Sari A. Mapping EORTC-QLQC30 and QLQ-CR29 onto EQ-5D-5L in Colorectal Cancer Patients. J Gastrointest Cancer.
Apr 12;
Demirci S, Eser E, Ozsaran Z, Tankisi D, Aras AB, Ozaydemir G, et al. Validation of the
Turkish versions of EORTC QLQ-C30 and BR23 modules in breast cancer patients. Asian
Pac J Cancer Prev APJCP. 2011;12(5):1283–7.
El ayoubi H. Comparison of Reliability and Validity of the Breast Cancer depression
anxiety stress scales (DASS-21) with the Beck Depression Inventory-(BDI-II) and
Hospital Anxiety and Depression Scale (HADS). Int J Behav Res Psychol. 2016;4(4):197–
Gadisa DA, Gebremariam ET, Ali GY. Reliability and validity of Amharic version of EORTC
QLQ-C30 and QLQ-BR23 modules for assessing health-related quality of life among
breast cancer patients in Ethiopia. Health Qual Life Outcomes. 2019 Dec;17(1):182.
Musarezaie A, Khaledi F, Esfahani HN, Ghaleghasemi TM. Factors affecting quality of life and fatigue in patients with leukemia under chemotherapy. J Educ Health Promot.
;3:64.
Pompili C, Koller M, Velikova G, Franks K, Absolom K, Callister M, et al. EORTC QLQ-C30
summary score reliably detects changes in QoL three months after anatomic lung
resection for Non-Small Cell Lung Cancer (NSCLC). Lung Cancer Amst Neth.
;123:149–54.
Oñate-Ocaña LF, Alcántara-Pilar A, Vilar-Compte D, García-Hubard G, Rojas-Castillo E,
Alvarado-Aguilar S, et al. Validation of the Mexican Spanish version of the EORTC C30
and STO22 questionnaires for the evaluation of health-related quality of life in patients
with gastric cancer. Ann Surg Oncol. 2009 Jan;16(1):88–95.
Tan ML, Idris DB, Teo LW, Loh SY, Seow GC, Chia YY, et al. Validation of EORTC QLQC30 and QLQ-BR23 questionnaires in the measurement of quality of life of breast cancer
patients in Singapore. Asia-Pac J Oncol Nurs. 2014 Apr;1(1):22–32.
Tomaszewski KA, Püsküllüoğlu M, Biesiada K, Bochenek J, Nieckula J, Krzemieniecki K.
Validation of the Polish Version of the EORTC QLQ-C30 and the QLQ-OG25 for the
Assessment of Health-Related Quality of Life in Patients with Esophagi-Gastric Cancer. J
Psychosoc Oncol. 2013 Mar;31(2):191–203.
Eberhardt WEE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi A, et al. The IASLC Lung
Cancer Staging Project: Proposals for the Revision of the M Descriptors in the
Forthcoming Eighth Edition of the TNM Classification of Lung Cancer. J Thorac Oncol Off
Publ Int Assoc Study Lung Cancer. 2015 Nov;10(11):1515–22.
Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WEE, et al. The
IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings
in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac
Oncol Off Publ Int Assoc Study Lung Cancer. 2016 Jan;11(1):39–51.
Huijer HAS, Sagherian K, Tamim H. Validation of the Arabic version of the EORTC quality
of life questionnaire among cancer patients in Lebanon. Qual Life Res. 2013
Aug;22(6):1473–81.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. 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. 1993 Mar
;85(5):365–76.
Fayer P, Aaronson NK, Bjordal K, Sullian M. EORTC QLQ-C30 Scoring Manual. [Internet].
EORTC Quality of Life Group, Bressels; 1995. Available from:
https://www.eortc.org/app/uploads/sites/2/2018/02/SCmanual.pdf
Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.
p. (McGraw-Hill series in psychology).
DeVellis RF. Scale development: theory and applications. Fourth edition. Los Angeles:
SAGE; 2017. 262 p.
Hays RD, Hayashi T. Beyond internal consistency reliability: Rationale and user‟s guide
for Multitrait Analysis Program on the microcomputer. Behav Res Methods Instrum
Comput. 1990 Mar 1;22(2):167–75.
Fayers PM, Machin D. Quality of life: The assessment, analysis, and reporting of patient reported outcomes. Third edition. Chichester, West Sussex, UK ; Hoboken, NJ: John Wiley & Sons Inc; 2016.
Everitt B. The Cambridge dictionary of statistics. 2nd ed. Cambridge, UK ; New York:
Cambridge University Press; 2002. 410 p.
Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, et al. Validation of the Korean
version of the EORTC QLQ-C30. Qual Life Res Int J Qual Life Asp Treat Care Rehabil.
May;13(4):863–8.
Shih CL, Chen CH, Sheu CF, Lang HC, Hsieh CL. Validating and Improving the Reliability
of the EORTC QLQ-C30 Using a Multidimensional Rasch Model. Value Health. 2013
Jul;16(5):848–54.
Jaiyesimi AO, Sofela EA, Rufai AA. Health related quality of life and its determinants in
Nigerian breast cancer patients. Afr J Med Med Sci. 2007 Sep;36(3):259–65.
Kootstra J, Hoekstra-Weebers JEHM, Rietman H, de Vries J, Baas P, Geertzen JHB, et al.
Quality of life after sentinel lymph node biopsy or axillary lymph node dissection in stage
I/II breast cancer patients: a prospective longitudinal study. Ann Surg Oncol. 2008
Sep;15(9):2533–41.
Cocks K, Wells JR, Johnson C, Schmidt H, Koller M, Oerlemans S, et al. Content validity
of the EORTC quality of life questionnaire QLQ-C30 for use in cancer. Eur J Cancer Oxf
Engl 1990. 2023 Jan;178:128–38.
Daroszewski C, Stasiewicz M, Jaźwińska-Tarnawska E, Rachwalik A, Mura E, LubochKowal J, et al. Quality of Life in Patients with Advanced Non-Small-Cell Lung Cancer Receiving Palliative Chemotherapy. Adv Exp Med Biol. 2019;1160:11–8.
Chie WC, Yang CH, Hsu C, Yang PC. Quality of life of lung cancer patients: validation of
the Taiwan Chinese version of the EORTC QLQ-C30 and QLQ-LC13. Qual Life Res Int J
Qual Life Asp Treat Care Rehabil. 2004 Feb;13(1):257–62.
Dean GE, Abu Sabbah E, Yingrengreung S, Ziegler P, Chen H, Steinbrenner LM, et al.
Sleeping with the enemy: sleep and quality of life in patients with lung cancer. Cancer
Nurs. 2015 Feb;38(1):60–70.
Brown ML, Lipscomb J, Snyder C. The burden of illness of cancer: economic cost and
quality of life. Annu Rev Public Health. 2001;22:91–113.
Kajimoto Y, Honda K, Suzuki S, Mori M, Tsubouchi H, Nakao K, et al. Association
between financial toxicity and health-related quality of life of patients with gynecologic
cancer. Int J Clin Oncol. 2023 Mar;28(3):454–67.
Shim S, Kang D, Kim N, Han G, Lim J, Kim H, et al. Validation of Korean Version of the
COmprehensive Score for financial Toxicity (COST) Among Breast Cancer Survivors.
Cancer Res Treat. 2022 Jul;54(3):834–41.
Dar MA, Chauhan R, Trivedi V, Kumar R, Dhingra S. Assessing the Prevalence of
Financial Toxicity, its Predictors and Association with Health- Related Quality of Life
Among Radiation Oncology Patients in India: A Cross-Sectional Patient Reported
Outcome Study. Int J Radiat Oncol Biol Phys. 2023 May 1;116(1):157–65.
Belloumi N, Maalej Bellaj S, Bachouche I, Chermiti Ben Abdallah F, Fenniche S.
Comparison of Sleep Quality before and after Chemotherapy in Locally Advanced
Nonsmall Cell Lung Cancer Patients: A Prospective Study. Sleep Disord. 2020 Jul
;2020:1–8.
Asiimwe JB, Nagendrappa PB, Atukunda EC, Kamatenesi MM, Nambozi G, Tolo CU, et al.
Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic
Review and Meta-Analysis. Evid-Based Complement Altern Med ECAM.
;2021:9963038.
Molassiotis A, Fernández-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, et al. Use of
complementary and alternative medicine in cancer patients: a European survey. Ann
Oncol Off J Eur Soc Med Oncol. 2005 Apr;16(4):655–63.
Wode K, Henriksson R, Sharp L, Stoltenberg A, Hök Nordberg J. Cancer patients‟ use of complementary and alternative medicine in Sweden: a cross-sectional study. BMC
Complement Altern Med. 2019 Mar 13;19(1):62.
Additional Files
Published
Issue
Section
Categories
License
Copyright (c) 2025 La Tunisie Médicale

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.