Cross-cultural validation of the McGill Quality of Life questionnaire in Hong Kong Chinese

Abstract

The main focus of palliative care services is to improve patients' quality of life (QOL). The potential value of assessment of QOL in palliative care is being increasingly recognized. The McGill Quality of Life questionnaire (MQOL) is designed specifically for palliative care patients, but its cross-cultural validity needs to be determined before it can be applied in populations of different cultures and ethnic groups. The cross-cultural validity of MQOL was investigated using a translated and modified version in Chinese--the MQOL-HK--in 462 palliative care patients in Hong Kong. Results show that the MQOL-HK is acceptable, valid and reliable. There is good acceptability, construct validity, convergent and divergent validity, test-retest and inter-rater reliability. Our study confirms that QOL does have cross-culturally robust constructs. Principal components analysis shows that the domains of physical, psychological, existential and support are all relevant and applicable in Chinese culture. Multiple regression analysis reveals that existential domain is the most important domain in predicting overall QOL. 'Face', eating and sex are additional facets of QOL that also need to be considered. The worst physical symptom on admission is the item of QOL with the lowest score, which need more care and attention by palliative care workers. A cross-culturally validated QOL instrument cannot just help ensure an accurate evaluation of profile, determinants, and changes of QOL, but is also a valuable asset for future comparison and evaluation of palliative care services and interventions across the world.

A critical analysis of test-retest reliability in instrument validation studies of cancer patients under palliative care: a systematic review

“…Any disagreements in interpretation were resolved by a discussion with a third author (BSRP). There were 4 (12.9%) [11,25,28,40], 17 (54.8%) [10,12-15,18,20,24,26,27,30-32],[34,36-38], and 10 (32.2%) [16,17,19,21-23,29,33,35,39] articles classified as good, fair, and poor, respectively, with regards to the overall quality criteria. No article was classified as excellent according to the aforementioned criteria.…”

Palliative care in old age

“…71 In a multicentre study on palliative care patients' quality of life in Hong Kong, the principal components analysis shows that Chinese patients also share similar domains in quality of life with the West: physical, psychological, the meaning of existence, and support. 74 The findings in the evaluation of handicap are similar. Hong Kong Chinese have a similar valuation as UK subjects on different handicap scenarios.…”

The Study on Evaluation and Improvement of Quality of Life in Patients With Advanced Cancer by China’s Hospice Program

“…3 The certified MQOL-HK questionnaire can be applied to effectively evaluate the QOL of Chinese patients with advanced cancer through the use of 4 domains, the physical domain, psychological domain, existential wellbeing, and support domains, as described previously. 10 Thus, these results indicate that the MQOL-HK scale is applicable for identifying patients' distress levels, which we suggest could lead to providing services accordingly and assessing service efficacy. For a patient with advanced cancer, QOL is a total issue of physical, psychological, social, and spiritual problems according to the WHO definition of palliative care.…”