Annals of Surgical Oncology

, Volume 22, Supplement 3, pp 848–854 | Cite as

Development and Validation of a Disease-Specific Instrument to Measure Diet-Targeted Quality of Life for Postoperative Patients with Esophagogastric Cancer

  • Michitaka Honda
  • Takafumi Wakita
  • Yoshihiro Onishi
  • Souya Nunobe
  • Akinori Miura
  • Tatsuto Nishigori
  • Hiroshi Kusanagi
  • Takatsugu Yamamoto
  • Alexander Boddy
  • Shunichi Fukuhara
Gastrointestinal Oncology



Patients who have undergone esophagectomy or gastrectomy have certain dietary limitations because of changes to the alimentary tract. This study attempted to develop a psychometric scale, named “Esophago-Gastric surgery and Quality of Dietary life (EGQ-D),” for assessment of impact of upper gastrointestinal surgery on diet-targeted quality of life.


Using qualitative methods, the study team interviewed both patients and surgeons involved in esophagogastric cancer surgery, and we prepared an item pool and a draft scale. To evaluate the scale’s psychometric reliability and validity, a survey involving a large number of patients was conducted. Items for the final scale were selected by factor analysis and item response theory. Cronbach’s alpha was used for assessment of reliability, and correlations with the short form (SF)-12, esophagus and stomach surgery symptom scale (ES4), and nutritional indicators were analyzed to assess the criterion-related validity.


Through multifaceted discussion and the pilot study, a draft questionnaire comprising 14 items was prepared, and a total of 316 patients were enrolled. On the basis of factor analysis and item response theory, six items were excluded, and the remaining eight items demonstrated strong unidimensionality for the final scale. Cronbach’s alpha was 0.895. There were significant associations with all the subscale scores for SF-12, ES4, and nutritional indicators.


The EGQ-D scale has good contents and psychometric validity and can be used to evaluate disease-specific instrument to measure diet-targeted quality of life for postoperative patients with esophagogastric cancer.


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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Michitaka Honda
    • 1
  • Takafumi Wakita
    • 2
  • Yoshihiro Onishi
    • 3
  • Souya Nunobe
    • 1
  • Akinori Miura
    • 4
  • Tatsuto Nishigori
    • 5
  • Hiroshi Kusanagi
    • 6
  • Takatsugu Yamamoto
    • 7
  • Alexander Boddy
    • 8
  • Shunichi Fukuhara
    • 9
    • 10
  1. 1.Department of Gastroenterological Surgery, Cancer Institute Hospital, Gastroenterological CenterJapanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Department of SociologyKansai UniversityOsakaJapan
  3. 3.Institute for Health Outcomes & Process Evaluation Research (iHope International)KyotoJapan
  4. 4.Department of SurgeryTokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalTokyoJapan
  5. 5.Department of SurgeryTenri HospitalNaraJapan
  6. 6.Department of SurgeryKameda Medical CenterChibaJapan
  7. 7.Department of Internal MedicineTeikyo University School of MedicineTokyoJapan
  8. 8.Department of SurgeryUniversity Hospitals of Leicester NHS TrustLeicesterUK
  9. 9.Department of Healthcare Epidemiology, Graduate School of Medicine and Public HealthKyoto UniversityKyotoJapan
  10. 10.Center for Innovative Research for Community and Clinical ExcellenceFukushima Medical UniversityFukushimaJapan

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