Internal consistency of the traditional Chinese character version of the functional assessment of cancer therapy - Head and neck (FACT-H&N)

Background: This study investigated the internal consistency of the Functional Assessment of Cancer Therapy - Head and Neck (FACT-H&N) translated version in traditional Chinese characters (TChi). The FACT-H&N quality of life instrument is composed of the FACT-General (FACT-G) assessing four primary areas of well-being (physical, social/family, emotional, and functional) and 11 additional items specific to H&N cancer patients. Methods: Two hundred and three patients with H&N cancer were recruited at a medical center in northwestern Taiwan. All completed the TChi FACT-H&N along with demographic and clinical questionnaires written in traditional Chinese characters. Several psychometric properties of the TChi FACT-H&N were examined, including Cronbach's alpha coefficients. Results: Most of the 203 enrolled patients were men (78%). The median age was 52.5 years (range 23-81 years) and the median number of years of education was 9. All patients had a Karnofsky score of 70 or higher. The results showed that the TChi FACT-H&N scales demonstrated acceptable internal consistency. Translation of the physical and functional concepts was most straightforward. Translation of emotional items, however, posed some difficulties. The social/ family well-being subscale was problematic, as expected, based upon observations of cultural differences in social values and functioning. We also noted that concerns about hearing were different between patients with nasopharyngeal carcinoma (NPC) and those with other H&N cancers. Conclusion: The TChi FACT-H&N is reliable. Items related to problems with hearing should be added to better evaluate the quality of life in patients with NPC.