Weng Yee Chin1, Carlos King Ho Wong1, Cherry Cheuk Wai Ng2, Edmond Pui Hang Choi3, Cindy Lo Kuen Lam1. 1. Department of Family Medicine and Primary Care, University of Hong Kong, Ap lei Chau, Hong Kong. 2. Department of Clinical Psychology, Pok Oi Hospital, Hospital Authority, Pok Oi, Hong Kong. 3. School of Nursing, University of Hong Kong, Pokfulam, Hong Kong.
Abstract
BACKGROUND: The Burden of Treatment Questionnaire (TBQ) assesses the impact of a patient's treatment workload on their quality of life. OBJECTIVES: The aim was to translate and validate the TBQ on Chinese primary care patients with multi-morbidity. METHODS: The English TBQ was translated and back-translated using professional translators. Cognitive debriefing interviews were performed on 15 patients. The resulting instrument was tested on 200 primary care patients with multi-morbidity (>1 chronic disease) to examine its psychometric performance including exploratory factor analysis, confirmatory factor analysis, internal consistency and reliability. The EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L), Short-Form Six-Dimension (SF-6D), WONCA COOP Charts and the Global Health Rating Scale were used to assess convergent and divergent validity. RESULTS: Median age of the respondents was 62 years (range 22-95 years) with a median of four conditions. The median TBQ total score was 16 (interquartile range 7.25-30). There was a significant floor effect (>15%) observed for all items. Spearman's correlations was >0.4 for all items demonstrating adequate internal construct validity. TBQ global score correlated with number of conditions (P = 0.034), EQ-5D-5L (P < 0.001), SF-6D (P < 0.001) and the feelings (P = 0.004), daily activities (P = 0.003) and social activities (P < 0.001) domains of the WONCA COOP. There was no significant correlation between global health rating and TBQ global scores (P = 0.298). Factor analysis demonstrated a three-factor structure. There was good internal consistency (Cronbach's alpha = 0.842) and good test-retest reliability (intra-class correlation coefficient = 0.830). CONCLUSION: The newly translated Chinese version of the TBQ appears to be valid and reliable for use in Cantonese-speaking, adult primary care patients with multi-morbidity.
BACKGROUND: The Burden of Treatment Questionnaire (TBQ) assesses the impact of a patient's treatment workload on their quality of life. OBJECTIVES: The aim was to translate and validate the TBQ on Chinese primary care patients with multi-morbidity. METHODS: The English TBQ was translated and back-translated using professional translators. Cognitive debriefing interviews were performed on 15 patients. The resulting instrument was tested on 200 primary care patients with multi-morbidity (>1 chronic disease) to examine its psychometric performance including exploratory factor analysis, confirmatory factor analysis, internal consistency and reliability. The EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L), Short-Form Six-Dimension (SF-6D), WONCA COOP Charts and the Global Health Rating Scale were used to assess convergent and divergent validity. RESULTS: Median age of the respondents was 62 years (range 22-95 years) with a median of four conditions. The median TBQ total score was 16 (interquartile range 7.25-30). There was a significant floor effect (>15%) observed for all items. Spearman's correlations was >0.4 for all items demonstrating adequate internal construct validity. TBQ global score correlated with number of conditions (P = 0.034), EQ-5D-5L (P < 0.001), SF-6D (P < 0.001) and the feelings (P = 0.004), daily activities (P = 0.003) and social activities (P < 0.001) domains of the WONCA COOP. There was no significant correlation between global health rating and TBQ global scores (P = 0.298). Factor analysis demonstrated a three-factor structure. There was good internal consistency (Cronbach's alpha = 0.842) and good test-retest reliability (intra-class correlation coefficient = 0.830). CONCLUSION: The newly translated Chinese version of the TBQ appears to be valid and reliable for use in Cantonese-speaking, adult primary care patients with multi-morbidity.
Authors: Emily Tsui Yee Tse; Cindy Lo Kuen Lam; Carlos King Ho Wong; Weng Yee Chin; Rebecca S Etz; Stephen J Zyzanski; Kurt C Stange Journal: BMJ Open Date: 2021-09-21 Impact factor: 2.692