Purpose

This study aims to adapt and validate the Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire (CCF-CaQL) in Turkish, addressing the significant need for reliable, language-specific QoL measures for colorectal cancer (CRC) in Turkiye. This effort fills a critical gap in CRC patient care, enhancing both patient-provider communication and disease-specific QoL assessment.

Methods

The CCF-CaQL was translated into Turkish, verified for accuracy, and reviewed for clarity and relevance. Eligible patients who underwent colorectal surgery for cancer between July 2021 and July 2022 from six hospitals completed the CCF-CaQL and SF-36 questionnaires. For analysis, confirmatory factor analysis using Smart PLS 4 and descriptive statistics were employed. The questionnaire’s reliability and validity were assessed using Cronbach alpha, composite reliability, and the heterotrait-monotrait (HTMT) ratio, along with multicollinearity checks and factor loadings. Nonparametric resampling was used for precise error and confidence interval calculations, and the Spearman coefficient and split-half method were applied for reliability testing.

Results

In the study involving 244 colorectal cancer patients, confirmatory factor analysis of the CCF-CaQL indicated effective item performance, with one item removed due to lower factor loading. The questionnaire exhibited high internal consistency, evidenced by a Cronbach alpha value of 0.909. Convergent validity was strong, with all average variance extracted (AVE) values exceeding 0.4. Discriminant validity was confirmed with HTMT coefficients below 0.9, and no significant multicollinearity issues were observed (VIF values < 10). Parallel testing with the SF-36 scale demonstrated moderate to very strong correlations, affirming the CCF-CaQL’s comparability in measuring quality of life.

Conclusion

The Turkish version of the CCF-CaQL was validated for assessing quality of life in colorectal cancer patients. This validation confirms its reliability and cultural appropriateness for use in Turkiye. The disease-specific nature of the CCF-CaQL makes it a useful tool in clinical and research settings, enhancing patient care by accurately monitoring treatment effects and interventions in the Turkish colorectal cancer patient population.

中文翻译：

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新克利夫兰诊所结直肠癌生活质量问卷土耳其语版本的信度和效度

目的

本研究旨在改编和验证土耳其语克利夫兰诊所结直肠癌生活质量问卷 (CCF-CaQL)，满足土耳其结直肠癌 (CRC) 对可靠、特定语言的生活质量测量的巨大需求。这项工作填补了 CRC 患者护理的关键空白，加强了患者与提供者之间的沟通和特定疾病的生活质量评估。

方法

CCF-CaQL 被翻译成土耳其语，验证准确性，并审查清晰度和相关性。2021 年 7 月至 2022 年 7 月期间，来自六家医院接受过结直肠癌手术的符合条件的患者完成了 CCF-CaQL 和 SF-36 问卷。为了进行分析，采用了使用 Smart PLS 4 的验证性因素分析和描述性统计。使用 Cronbach α、复合信度和异性状-单性状 (HTMT) 比率以及多重共线性检查和因子负荷来评估问卷的信度和效度。采用非参数重采样进行精确误差和置信区间计算，采用斯皮尔曼系数和分半法进行可靠性检验。

结果

在这项涉及 244 名结直肠癌患者的研究中，CCF-CaQL 的验证性因子分析表明项目表现有效，其中一项由于因子负荷较低而被删除。问卷显示出较高的内部一致性，Cronbach α 值为 0.909。收敛效度很强，所有平均方差提取 (AVE) 值均超过 0.4。HTMT 系数低于 0.9 证实了判别有效性，并且未观察到显着的多重共线性问题（VIF 值 < 10）。与 SF-36 量表的平行测试显示出中等到非常强的相关性，证实了 CCF-CaQL 在测量生活质量方面的可比性。

结论

土耳其版本的 CCF-CaQL 经过验证，可用于评估结直肠癌患者的生活质量。该验证证实了其在土耳其使用的可靠性和文化适宜性。CCF-CaQL 的疾病特异性使其成为临床和研究环境中的有用工具，通过准确监测土耳其结直肠癌患者群体的治疗效果和干预措施来加强患者护理。