• Vol. 38 No. 3, 225–229
  • 15 March 2009

Measurement Properties of the Chinese Language Version of the Functional Assessment of Cancer Therapy-General in a Singaporean Population

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ABSTRACT

Introduction: Health-related quality of life is an important aspect of health outcome. The assessment of it must be done by validated instruments. There is no published data on the validity, reliability and sensitiveness to change of the official Chinese translation of the Functional Assessment of Cancer Therapy-General (version 4; FACT-G). Materials and Methods: A Chinese questionnaire package comprising the FACT-G and Functional Living Index-Cancer (FLIC, which was translated, modified and validated in Singapore) was filled in by 165 ethnic Chinese patients recruited from the National Cancer Centre, Singapore. Four weeks later, the patients were assessed again by a postal questionnaire survey. Results: The FACT-G and FLIC total scores were strongly correlated (r = 0.85). The Physical, Social/Family, Emotional and Functional Well-being scales of the FACT-G converged to and diverged from FLIC components as conceptually expected. The FACT-G and its 4 scales also demonstrated known-groups validity in differentiating patients with different performance status (each P <0.001). Their internal consistency ranged from 0.81 to 0.93 and test-retest reliability ranged from 0.74 to 0.85. The FACT-G and its Physical, Emotional and Functional Well-being scales showed trends of change in relation to change in performance status. The Social/Family Well-being scale was sensitive to decline but not improvement in performance status. Conclusions: The Chinese version of the FACT-G can be used to assess overall level and some specific aspects of health-related quality of life. However, researchers should be cautious in using this instrument to specifically investigate the social aspect of quality of life.


Health-related quality of life (HRQoL) is an increasingly important concern in the care of cancer patients. In the approval of oncology drugs, the United States (US) Food and Drug Administration (FDA) and European Agency for the Evaluation of Medicinal Products consider HRQoL an important end-point.1 Most HRQoL instruments are developed in English, although about one-fifth of the world’s population is ethnic Chinese.2 Patients in many cancer centres in North America and Europe have a variety of ethnic and language backgrounds.3 The Singapore 2000 census shows that 77% of the population were ethnic Chinese.4 Among the ethnic Chinese, 32% used only Chinese language and 48% used both Chinese and English. Using Chinese as a primary language is especially common among those who were aged 55 or above,5 who have a higher risk of developing cancer than their younger counterparts.

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