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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

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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References

  1. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J (2016) Cancer statistics in China. CA Cancer J Clin 66(2):115–132

    Article  PubMed  Google Scholar 

  2. Lavaf A, Genden EM, Cesaretti JA, Packer S, Kao J (2008) Adjuvant radiotherapy improves overall survival for patients with lymph node-positive head and neck squamous cell carcinoma. Cancer 112(3):535–543

    Article  PubMed  Google Scholar 

  3. Sanguineti G, Forastiere AA (2008) Determining the survival benefit of adjuvant radiotherapy in patients with node-positive head and neck cancer. Nat Clin Pract Oncol 5(12):694–695

    Article  PubMed  Google Scholar 

  4. De Sanctis V, Bossi P, Sanguineti G, Trippa F, Ferrari D, Bacigalupo A et al (2016) Mucositis in head and neck cancer patients treated with radiotherapy and systemic therapies: literature review and consensus statements. Crit Rev Oncol Hematol 100:147–166

    Article  PubMed  Google Scholar 

  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):372–384

    Article  PubMed  Google 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):877–883

    Article  PubMed  Google 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):290–300

    PubMed  Google Scholar 

  8. Ganzer H, Touger-Decker R, Parrott JS, Murphy BA, Epstein JB, Huhmann MB (2013) Symptom burden in head and neck cancer: impact upon oral energy and protein intake. Support Care Cancer 21(2):495–503

    Article  PubMed  Google Scholar 

  9. Kubrak C, Olson K, Jha N, Scrimger R, Parliament M, McCargar L, Koski S, Baracos VE et al (2013) Clinical determinants of weight loss in patients receiving radiation and chemoirradiation for head and neck cancer: a prospective longitudinal view. Head Neck 35(5):695–703

    Article  PubMed  Google Scholar 

  10. Kubrak C, Olson K, Baracos VE (2013) The head and neck symptom checklist©: an instrument to evaluate nutrition impact symptoms effect on energy intake and weight loss. Support Care Cancer 21(11):3127–3136

    Article  PubMed  Google Scholar 

  11. Langius JA, Bakker S, Rietveld DH, Kruizenga HM, Langendijk JA, Weijs PJ, Leemans CR et al (2013) Critical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapy. Br J Cancer 109(5):1093–1099

    Article  CAS  PubMed  PubMed Central  Google 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):26–37

    PubMed  Google 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):1355–1361

    Article  PubMed  Google Scholar 

  14. Schmidt KN, Olson K, Kubrak C, Parliament M, Ghosh S (2013) Validation of the Head and Neck Patient Symptom Checklist as a nutrition impact symptom assessment tool for head and neck cancer patients. Support Care Cancer 21(1):27–34

    Article  PubMed  Google Scholar 

  15. Mundform DJ, Shaw DG, Ke TL (2005) Minimum sample size recommendations for conducting factor analysis. IJT 5(2):159–168

    Google Scholar 

  16. Mallick S, Benson R, Rath GK (2016) Radiation induced oral mucositis: a review of current literature on prevention and management. Eur Arch Otorhinolaryngol 273(9):2285–2293

    Article  PubMed  Google Scholar 

  17. Ruo Redda MG, Allis S (2006) Radiotherapy-induced taste impairment. Cancer Treat Rev 32(7):541–547

    Article  PubMed  Google Scholar 

  18. Maes A, Huygh I, Weltens C, Vandevelde G, Delaere P, Evers G, Van den Bogaert W (2002) De Gustibus: time scale of loss and recovery of tastes caused by radiotherapy. Radiother Oncol 63(2):195–201

    Article  PubMed  Google Scholar 

  19. Bauer J, Capra S, Ferguson M (2002) Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785

    Article  CAS  PubMed  Google Scholar 

  20. Ottery FD (1994) Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol 21(6):770–778

    CAS  PubMed  Google 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):234–239

    Article  PubMed  Google 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):365–376

    Article  CAS  PubMed  Google Scholar 

  23. Rw B (1970) Back-translation for cross-culture research. J Cross-Cult Psychol 3(1):185–216

    Google Scholar 

  24. Kubrak C, Jensen L (2007) Critical evaluation of nutrition screening tools recommended for oncology patients. Cancer Nurs 30(5):E1–E6

    Article  PubMed  Google Scholar 

  25. Cook DA, Beckman TJ (2006) Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med 119(2):166.e7–166.16

    Article  Google Scholar 

  26. Mohamad MM, Sulaiman NL, Sern LC, Salleh KM (2015) Measuring the validity and reliability of research instruments. Procedia Soc Behav Sci 204:164–171

    Article  Google Scholar 

  27. Baracos VE (2006) Cancer-associated cachexia and underlying biological mechanisms. Annu Rev Nutr 26:435–461

    Article  CAS  PubMed  Google Scholar 

  28. Epstein JB, Huhmann MB (2011) Dietary and nutritional needs of patients undergoing therapy for head and neck cancer. J Am Dent Assoc 142(10):1163–1167

    Article  PubMed  Google Scholar 

  29. Datema FR, Ferrier MB, Baatenburg de Jong RJ (2011) Impact of severe malnutrition on short-term mortality and overall survival in head and neck cancer. Oral Oncol 47(9):910–914

    Article  PubMed  Google Scholar 

  30. Vera-Llonch M, Oster G, Hagiwara M, Sonis S (2006) Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma. Cancer 106(2):329–336

    Article  PubMed  Google Scholar 

  31. Sapir E, Tao Y, Feng F, Samuels S, El Naqa I, Murdoch-Kinch CA, Feng M, Schipper M, Eisbruch A (2016) Predictors of dysgeusia in patients with oropharyngeal cancer treated with chemotherapy and intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 96(2):354–361

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Medical & Surgical Nursing, School of Nursing, Peking University, #38 Xueyuan Road, Haidian District, Beijing, 100191, China

    Sanli Jin, Qian Lu, Dong Pang & Hangjing Cui

  2. Department of Radiation Oncology, Peking University Cancer Hospital, #52 Fucheng Road, Haidian District, Beijing, 100142, China

    Yan Sun, Shaowen Xiao & Baomin Zheng

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  1. Sanli Jin
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  2. Qian Lu
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  3. Dong Pang
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  4. Yan Sun
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  5. Shaowen Xiao
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  6. Baomin Zheng
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  7. Hangjing Cui
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Correspondence to Qian Lu.

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Jin, S., Lu, Q., Pang, D. et al. 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. Support Care Cancer 27, 4705–4711 (2019). https://doi.org/10.1007/s00520-019-04784-3

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  • DOI: https://doi.org/10.1007/s00520-019-04784-3

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