Cross-cultural development of the EORTC QLQ-SWB36: A stand-alone measure of spiritual wellbeing for palliative care patients with cancer

1. Bella Vivat
   1. School of Health Sciences and Social Care, Brunel University, UK
2. Teresa Young
   1. Mount Vernon Cancer Centre, Northwood, UK
3. Fabio Efficace
   1. Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Italy
4. Valgerđur Sigurđadóttir
   1. Palliative Care Unit, National University Hospital, Iceland
5. Juan Ignacio Arraras
   1. Oncology Departments, Hospital de Navarra, Spain
6. Guđlaug Helga Åsgeirsdóttir
   1. Palliative Care Unit, National University Hospital, Iceland
7. Anne Brédart
   1. Psycho-Oncology Unit, Institut Curie, France
8. Anna Costantini
   1. Psycho-Oncology Unit, Sant’Andrea Hospital, 2nd Faculty of Medicine, Sapienza University of Rome, Italy
9. Kunihiko Kobayashi
   1. Department of Respiratory Medicine, Saitama International Medical Centre, Japan
10. Susanne Singer
    1. Medical Psychology and Medical Sociology, University of Leipzig, Germany
11. on behalf of the EORTC Quality of Life Group

1. Bella Vivat, School of Health Sciences and Social Care, Brunel University, Uxbridge, Middlesex UB8 3PH, UK. Email: bella.vivat@brunel.ac.uk

Abstract

Background: No existing stand-alone measures of spiritual wellbeing have been developed in cross-cultural and multiple linguistic contexts.

Aim: Cross-cultural development of a stand-alone European Organisation for Research and Treatment of Cancer (EORTC) measure of spiritual wellbeing for palliative care patients with cancer.

Design: Broadly following EORTC Quality of Life Group (QLG) guidelines for developing questionnaires, the study comprised three phases. Phase I identified relevant issues and obtained the views of palliative care patients and professionals about those issues. Phase II operationalised issues into items. Phase III pilot-tested those items with palliative care patients. Amendments to the guidelines included an intermediate Phase IIIa, and debriefing questions specific to the measure.

Setting/participants: Phase III pilot-testing recruited 113 people with incurable cancer from hospitals and hospices in six European countries and Japan.

Results: A provisional 36-item measure ready for Phase IV field-testing, the EORTC QLQ-SWB36, has been developed. Careful attention to translation and simultaneous development in multiple languages means items are acceptable and consistent between different countries and languages. Phase III data from 113 patients in seven countries show that the items are comprehensible across languages and cultures. Phase III patient participants in several countries used the measure as a starting point for discussing the issues it addresses. 

Conclusion: The EORTC QLG’s rigorous cross-cultural development process ensures that the EORTC QLQ-SWB36 identifies key issues for spiritual wellbeing in multiple cultural contexts, and that items are comprehensible and consistent across languages. Some cross-cultural differences were observed, but data were insufficient to enable generalisation. Phase IV field-testing will investigate these differences further.

• Cancer
• cross-cultural comparison
• palliative care
• quality of life
• questionnaire
• spirituality
• spiritual wellbeing