scholarly journals Cross-cultural adaption, translation and validation of the Toronto extremity salvage score (TESS) for patients in German-speaking countries

2021 ◽  
Author(s):  
Carmen Trost ◽  
Christoph Hofer ◽  
Tanja Stamm ◽  
Reinhard Windhager ◽  
Gerhard M. Hobusch
Keyword(s):  
Soft Tissue ◽  
Correlation Coefficient ◽  
Intraclass Correlation ◽  
Test Reliability ◽  
Physical Component Score ◽  
Limb Salvage Surgery ◽  
Cultural Adaption ◽  
Sf 36 ◽  
Toronto Extremity Salvage Score ◽  
Extremity Salvage

Summary Objective The preferred treatment for malignant bone and soft tissue tumors is limb salvage surgery; the Toronto extremity salvage score (TESS) is commonly used to measure physical functioning of the affected extremity. The aims of this study were to translate and culturally adapt the German version of the TESS, as well as to explore its convergent reliability, validity and re-test reliability. Study design Patients (n = 50) 32 lower extremity (LE) and 18 upper extremity (UE) were asked to fill out the German TESS two times (t1: clinical visit, t2: regular email) and the SF-36 once. Methods The TESS questionnaires were translated from English into German, back translated into English, and culturally adapted. The reliability was assessed with Cronbach’s alpha (α). The validity was measured with the SF-36 physical component score and TESS using the Spearman rank correlation coefficient (r). Furthermore, the test-retest reliability was calculated with the intraclass correlation coefficient (ICC). Results Internal consistency for both questionnaires was excellent (LE t1: α = 0.924, t2: α = 0.952; UE t1: α = 0.957, t2: α = 0.898). A statistically significant correlation was found between the SF-36 physical component scale and the German TESS (LE r = 0.741, UE r = 0.713). The ICC between baseline (t1) and re-test (t2) was 0.952 and 0.871 for the lower and upper extremities, respectively. Conclusion Initial evidence demonstrated that the German TESS is a valid and reliable instrument for use with patients after surgical treatment of malignant bone or soft tissue sarcoma.

scholarly journals Cross-Cultural Adaptation, Translation, and Validation of the Toronto Extremity Salvage Score for Extremity Bone and Soft Tissue Tumor Patients in Netherlands

Sarcoma ◽  
2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Julie J. Willeumier ◽  
C. W. P. G. van der Wal ◽  
Robert J. P. van der Wal ◽  
P. D. S. Dijkstra ◽  
Thea P. M. Vliet Vlieland ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Physical Function ◽  
Short Form ◽  
Intraclass Correlation ◽  
Retest Reliability ◽  
Sf 36 ◽  
Toronto Extremity Salvage Score ◽  
Patient Reported ◽  
Test Retest Reliability ◽  
Extremity Salvage

Purpose. The aim of this study was to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) to Dutch and to validate the translated version. Methods. The TESS lower and upper extremity versions (LE and UE) were translated to Dutch according to international guidelines. The translated version was validated in 98 patients with surgically treated bone or soft tissue tumors of the LE or UE. To assess test-retest reliability, participants were asked to fill in a second questionnaire after one week. Construct validity was determined by computing Spearman rank correlations with the Short Form- (SF-) 36. Results. The internal consistency (0.957 and 0.938 for LE and UE, resp.) and test-retest reliability (intraclass correlation coefficients 0.963 and 0.969 for LE and UE, resp.) were good for both questionnaires. The Dutch LE and UE TESS versions correlated most strongly with the SF-36 physical function dimension (r=0.737 for LE, 0.726 for UE) and the physical component summary score (r=0.811 and 0.797 for LE and UE). Interpretation. The Dutch TESS questionnaire for lower and upper extremities is a consistent, reliable, and valid instrument to measure patient-reported physical function in surgically treated patients with a soft tissue or bone tumor.

scholarly journals Translation and Cross-Cultural Adaptation of the Persian Version of Minnesota Living With Heart Failure Questionnaire (MLHFQ)

2020 ◽  
Author(s):  
Behrouz Attarbashi Moghadam ◽  
Hasan Tamartash ◽  
Sara Fereydunnia ◽  
Mahdieh Ravand
Keyword(s):  
Heart Failure ◽  
Correlation Coefficient ◽  
Short Form ◽  
Intraclass Correlation ◽  
Validity And Reliability ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Persian Version ◽  
Sf 36 ◽  
Heart Failure Questionnaire

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) has been developed to measure health-related quality of life (HRQoL) status of Heart Failure (HF) patients. The aim of this study was to translate MLHFQ into the Persian version and assess the validity and reliability of the translated version. We used a forward-backward procedure for translation. In a cross-sectional study, 105 HF patients and 50 healthy subjects were selected to assess the reliability and construct validity of the instrument. The face and content validity were used to assess the questionnaire validity. Validity was examined on the HF patients group, using the Persian version of the Short form-36 health survey (SF-36) Questionnaire. In order to assess the questionnaire’s reliability, the Intraclass correlation coefficient (ICC) and Cronbach’s alpha were calculated. Test-retest reliability was examined by re-administering the MLHFQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all 2 domains were higher than 0.91, P≤0.000). Internal consistency for Physical domain (PD), emotional domain (ED) and total scores using Cronbach’s alpha were 0.90, 0.84 and 0.92, respectively. ICC for PD, ED and total scores were 0.95, 0.94, and 0.97, respectively. Good and very good Pearson's Correlation Coefficient was seen between MLHFQ and SF-36 (r= -0.47 to -0.775, P≤0.000 for PD; r= -0.47 to -0.65, P≤0.000 for ED). The Persian version of the MLHFQ had satisfactory reliability and validity for assessing HRQoL status of Iranian HF patients. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(7):435-441.

scholarly journals Μελέτη της ποιότητας ζωής πριν και μετά από χειρουργική αντιμετώπιση της νοσογόνου παχυσαρκίας

2013 ◽  
Author(s):  
Βασίλειος Χαραλαμπάκης
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Mixed Effect Model ◽  
Mixed Effect ◽  
Cronbach Alpha ◽  
Effect Model ◽  
Sf 36

Ο όρος «Ποιότητα Ζωής» (ΠΖ) αναφέρεται στη συνολική ευζωία του ατόμου η οποία περιλαμβάνει τη συναισθηματική, κοινωνική και φυσική συνιστώσα της ζωής. Όταν, όμως, ο όρος χρησιμοποιείται στο χώρο της ιατρικής και της περίθαλψης αναφέρεται στο κατά πόσο η ευζωία του ατόμου επηρεάζεται σε βάθος χρόνου από μια ασθένεια, αναπηρία ή διαταραχή.Η νοσογόνος παχυσαρκία επηρεάζει την ποιότητα ζωής. Η αξιολόγησή της έχει προσελκύσει σημαντική προσοχή και επιτυγχάνεται μέσω ειδικών εργαλείων μέτρησης, όπως είναι το ερωτηματολόγιο ΠΖ Moorehead-Ardelt II (MAII). Αποτελεί ένα ερωτηματολόγιο ειδικό για την παχυσαρκία που έχει δημιουργηθεί και σταθμιστεί στην Αγγλική γλώσσα και χρησιμοποιείται ευρέως στο χώρο της Βαριατρικής Χειρουργικής. Σύμφωνα με τα διεθνή δεδομένα των μελετών στάθμισης, η υιοθέτηση ενός ερωτηματολογίου σε μια άλλη από την αρχική γλώσσα, προϋποθέτει εφαρμογή προτυποποιημένης μεθοδολογίας για τη μετάφραση και τον έλεγχο της διατήρηση των ψυχομετρικών ιδιοτήτων του. Συνεπώς, η δημιουργία μιας έγκυρης μετάφρασης και η αξιολόγηση των ιδιοτήτων της Ελληνικής έκδοσης του ΜΑΙΙ, κρίθηκαν απαραίτητες πριν από την ευρεία εφαρμογή του ερωτηματολογίου σε βαριατρικούς ασθενείς. Αυτό επιτεύχθηκε μέσω της στάθμισής του με τη χρήση της Ελληνικής έκδοσης του υβριδικού ερωτηματολογίου ΠΖ SF-36 και μιας Οπτικής Αναλογικής Κλίμακας (VAS). Ο βαθμός ομοιογένειας εκτιμήθηκε με το συντελεστή συσχέτισης Cronbach alpha και η επαναληψιμότητα με το συντελεστή ενδοσυσχέτισης intraclass correlation coefficient (ICC). Η δομική εγκυρότητα του ερωτηματολογίου αξιολογήθηκε με τη χρήση δοκιμασίας Pearson μεταξύ των τιμών του ΜΑΙΙ και αυτών του SF-36 και της VAS.Συνολικά 175 ασθενείς εντάχθηκαν στη μελέτη. Η επαναληψιμότητα ελέγχθηκε σε δείγμα 40 ασθενών με μεσοδιάστημα 15 ημερών. Αναδείχθηκε ένας πολύ καλός βαθμός ομοιογένειας με συντελεστή Cronbach alpha της τάξης του 0,85. Παρατηρήθηκε εξαιρετική επαναληψιμότητα με συνολική ICC της τάξης του 0,981. Η σημαντική συσχέτιση μεταξύ της Ελληνικής έκδοσης του ΜΑΙΙ καθώς και κάθε ερώτησης αυτού και του SF-36 και της VAS αποδεικνύουν υψηλή δομική εγκυρότητα. Η αρνητική συσχέτιση μεταξύ της συνολικής βαθμολογίας του μεταφρασμένου ΜΑΙΙ και του ΔΜΣ επιβεβαίωσαν την υψηλή κλινική εγκυρότητά του.Μετά από αυτή την προσεκτική διαδικασία, δημιουργήθηκε η Ελληνική έκδοση του ερωτηματολογίου ΜΑΙΙ και αποδείχθηκε η εγκυρότητα και αξιοπιστία της, στη μέτρηση της ΠΖ σε νοσογόνα παχύσαρκους ασθενείς, πριν και μετά από βαριατρική επέμβαση.Το δεύτερο στάδιο αυτής της μελέτης περιελάμβανε την κλινική εφαρμογή του μεταφρασμένου ερωτηματολογίου για την προοπτική, διαχρονική αξιολόγηση της ΠΖ σε ασθενείς που επρόκειτο να υποβληθούν σε λαπαροσκοπική επιμήκη γαστρεκτομή (LSG). Η ΠΖ θεωρείται μείζον μέσο αξιολόγησης του βαριατρικού αποτελέσματος, όμως προοπτικά δεδομένα των αλλαγών της ΠΖ μετά από LSG σπανίζουν στη βιβλιογραφία.Στη μελέτη εντάχθηκαν προοπτικά, διαδοχικοί νοσογόνα παχύσαρκοι ασθενείς που προσήλθαν σε μια περίοδο 30 μηνών προκειμένου να υποβληθούν σε LSG. Το ερωτηματολόγιο ΜΑΙΙ και μια 10-βάθμια VAS προσφέρθηκαν στους ασθενείς προεγχειρητικά και στους 6, 12 και 24 μήνες μετεγχειρητικά. Τα πλήρη σωματομετρικά δεδομένα καθώς και οι συνοδές παθήσεις καταγράφηκαν σε όλα τα χρονικά σημεία.Στη μελέτη περιελήφθησαν συνολικά 111 ασθενείς (60 γυναίκες και 51 άνδρες, μέσης ηλικίας 36,8±9,2 έτη). Δεν σημειώθηκε κανένας θάνατος ενώ το συνολικό ποσοστό επιπλοκών ανήλθε στο 15,3%. Ο μέσος προεγχειρητικός ΔΜΣ ήταν 49,1±7,5kg/m2 και η % απώλεια του πλεονάζοντος ΔΜΣ (%EBL) ήταν 51,1±14,9% στους 6, 64,2±17,9% στους 12 και 66,4±18% στους 24 μήνες αντίστοιχα. Όλες οι σχετιζόμενες με την παχυσαρκία παθήσεις βελτιώθηκαν σημαντικά. Η μέση συνολική βαθμολογία του ΜΑΙΙ ήταν -0,40±1,30 προεγχειρητικά και αυξήθηκε σε 1,75±0,83, 2,18±0,80 και 1,95±0,71 στους 6, 12 και 24 μήνες μετεγχειρητικά (p<0.001). Η βαθμολογία της VAS αυξήθηκε από 2,8±1,4 προεγχειρητικά σε 9,1±1,1, 9,2±1,1 και 9,0±1,3 στους 6, 12 και 24 μήνες μετεγχειρητικά. Η βελτίωση της βαθμολογία του ΜΑΙΙ διατηρήθηκε καλύτερα στις γυναίκες στους 24 μήνες, παρά το γεγονός ότι ο τελικός ΔΜΣ ήταν συγκρίσιμος στα 2 φύλα. Ο ΔΜΣ δε σχετιζόταν σημαντικά με τη βαθμολογία ΜΑΙΙ σε κάθε χρονικό σημείο της μελέτης. Η %EBL, το γυναικείο φύλο, ο μικρότερος αριθμός συνοδών παθήσεων και η ίαση του ΣΔ2 και της υπνικής άπνοιας αποτέλεσαν σημαντικούς προγνωστικούς παράγοντες υψηλής ΠΖ στο τέλος της μελέτης, όπως προέκυψε από πολυπαραγοντική ανάλυση παλινδρόμησης και από την ανάλυση Mixed effect model. Ενδιαφέρον ήταν ότι οι ασθενείς που απαλλάχθηκαν από το σακχαρώδη διαβήτη, παρουσίασαν υψηλές τιμές ΠΖ παρά το γεγονός ότι η %EBL ήταν σημαντικά μικρότερη.Η LSG αποτελεί μια ασφαλή και αποτελεσματική βαριατρική επέμβαση με αποδεκτή νοσηρότητα, ικανοποιητική και διατηρούμενη απώλεια σωματικού βάρους καθώς και σημαντική βελτίωση της ΠΖ, ειδικά σε ασθενείς στους οποίους βελτιώνονται οι συνοδές παθήσεις. Το μεταβολικό αποτέλεσμα της Βαριατρικής Χειρουργικής φαίνεται οτι είναι περισσότερο σημαντικό από την απώλεια βάρους, όσον αφορά στη βελτίωση της ΠΖ. Η ανάλυση της ΠΖ είναι σημαντική για μια πλήρη αξιολόγηση του βαριατρικού αποτελέσματος, ενώ επιτρέπει την αναγνώριση υποομάδων ασθενών που θα ωφεληθούν τα μέγιστα από τη βαριατρική επέμβαση καθώς και εκείνων που θα χρειαστούν κάποιας μορφής παρέμβαση κατά τη μετεγχειρητική παρακολούθηση, προκειμένου να διατηρήσουν το βέλτιστο αποτέλεσμα ΠΖ. Η σημασία του μεταβολικού αποτελέσματος της LSG στην ΠΖ αποκαλύπτει ενδιαφέροντες δρόμους για το μέλλον της Βαριατρικής Χειρουργικής.

scholarly journals Functional Outcome After Lower Extremity Soft Tissue Sarcoma Treatment: A Pilot Study Based on Translated and Culturally Adapted Measures

2018 ◽  
Vol 108 (2) ◽  
pp. 164-171
Author(s):  
G. Kask ◽  
I. Barner-Rasmussen ◽  
J. Repo ◽  
C. Blomqvist ◽  
E. Tukiainen
Keyword(s):  
Pilot Study ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Lower Extremity ◽  
Functional Outcome ◽  
Soft Tissue Sarcomas ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Toronto Extremity Salvage Score ◽  
Extremity Salvage

Background and Aims: The present standard of care in treating lower extremity soft tissue sarcomas is function-sparing, limb-preserving resection and reconstruction with or without oncological therapy. The aim of this pilot study was to test the suitability and adequacy of the Finnish translations of two functional outcome questionnaires (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society score) and to perform a preliminary investigation of functional outcomes of Finnish lower-limb soft tissue sarcoma patients after operative treatment. Materials and Methods: Between June 2015 and December 2015, consecutive surgically treated outpatients were asked to participate in the study. Demographic, clinical, surgical, and oncological outcome data were collected. Two functional outcome questionnaires were used (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores). A comparative analysis is presented. Results: A total of 19 lower-limb soft tissue sarcoma patients with a mean follow-up time of 2 years and 10 months were included. All (n = 19) invited patients participated in the study. Mean age was 62.3 years. In total, 13 had high-grade sarcomas. Eight wounds were closed directly, four used skin grafts, and five required flap reconstructions. One patient required a tumor prosthesis, and one required a rotationplasty. A total of 14 patients received oncological therapy. No problems or difficulties were reported in using and completing the Finnish versions of the Toronto Extremity Salvage Score or Musculoskeletal Tumor Society questionnaires. The overall Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores were 88 and 76, respectively. Conclusion: This pilot study suggests that the Finnish versions of the Toronto Extremity Salvage Score and Musculoskeletal Tumor Society questionnaires are suitable for measuring functional outcome after lower extremity soft tissue sarcomas treatment. Functional outcomes vary from moderate to excellent.

scholarly journals Translation and cross-cultural adaptation of the Scleroderma Health Assessment Questionnaire to Brazilian Portuguese

2014 ◽  
Vol 132 (3) ◽  
pp. 163-169 ◽  
Author(s):  
Aline Cristina Orlandi ◽  
Fernanda Pontes Cardoso ◽  
Lucas Macedo Santos ◽  
Vaneska da Graça Cruz ◽  
Anamaria Jones ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Cultural Adaptation ◽  
External Validity ◽  
Health Assessment Questionnaire ◽  
Intraclass Correlation ◽  
Health Assessment ◽  
Pearson’S Correlation Coefficient ◽  
Sf 36 ◽  
Assessment Questionnaire

CONTEXT AND OBJECTIVE:Systemic sclerosis is an autoimmune disease characterized by abnormalities of vascularization that may cause fibrosis of the skin and other organs and lead to dysfunction. It is therefore essential to have tools capable of evaluating function in individuals with this condition. The aim of this study was to translate the Scleroderma Health Assessment Questionnaire (SHAQ) into Portuguese, adapt it to Brazilian culture and test its validity and reliability.DESIGN AND SETTING:The validation of SHAQ followed internationally accepted methodology, and was performed in university outpatient clinics.METHODS:SHAQ was translated into Portuguese and back-translated. In the cultural adaptation phase, it was applied to 20 outpatients. Items not understood by 20% of the patients were modified and applied to another 20 outpatients. Twenty patients were interviewed on two different occasions to determine the validity and reliability of the questionnaire: two interviewers on the first occasion and one interviewer 14 days later. To determine the external validity, comparisons were made with Health Assessment Questionnaire (HAQ), Disabilities of the Arm, Shoulder and Hand (DASH) and short form-36 (SF-36).RESULTS:In the interobserver evaluation, Pearson's correlation coefficient and the intraclass correlation coefficient were both 0.967. In the intraobserver evaluation, Pearson's correlation coefficient was 0.735 and the intraclass correlation coefficient was 0.687. Regarding external validity, SHAQ scores were statistically correlated with all measurements, except the general health domain of SF-36 and the work-related score (Q2) of DASH.CONCLUSION:The Brazilian version of SHAQ proved to be valid and reliable for assessing function in patients with diffuse systemic sclerosis.

scholarly journals Cross-cultural adaptation and validity of the Chinese version of the Oxford elbow score

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
James Reeves Mbori Ngwayi ◽  
Jie Tan ◽  
Ning Liang ◽  
Emmanuel Gildas Eric Sita ◽  
Daniel Edward Porter
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Internal Consistency ◽  
Intraclass Correlation ◽  
Chinese Version ◽  
Expert Committee ◽  
Social Psychological ◽  
Sf 36 ◽  
Patient Reported ◽  
Chinese Mandarin

Abstract Background The Oxford Elbow score (OES) is a patient-reported outcome measure designed to evaluate patients before and after elbow surgery. Although various translated versions of the score are available, there is no Chinese mandarin version. The aim of this study was to develop a Chinese language version of the OES and evaluate its psychometric properties for clinical use. Methods The English version of the OES was forward translated into Chinese, followed by a backward translation into English. Then a final Chinese version was produced following expert committee discussions and pilot study of 11 patients. A smart device compatible electronic version of the OES was designed and completed by 70 patients with elbow pathology alongside the Quick-Dash and the SF-36. Reliability was assessed by measuring intraclass correlation coefficient (ICC) for test-retest reliability and Cronbach’s alpha for internal consistency. Spearman’s correlation coefficient was used to test the construct validity. Confirmatory factor analysis (CFA) was performed to evaluate the 3-factor structure of the OES. Results The overall Cronbach’s α coefficient was 0.906 and for the 3 different domains Function, Pain, and Social-psychological was 0.806, 0.796, and 0.776 respectively. The overall intraclass correlation coefficient was 0.764 and for the three different domains Function, Pain, and Social-psychological was 0.764, 0.624, and 0.590 respectively. The Spearman’s coefficient for correlation, between the QuickDASH and OES domains Function, Pain, and Social-psychological, was − 0.824, − 0.734, and − 0.622 respectively, showing strong correlation (r > 0.5; p < 0.01). There were moderate correlations between OES domains and the physical functioning, role physical, and strong correlations with bodily pain subscales of the PCS domain of the SF-36; results were insignificant for all other subscales. Conclusion Our translated Chinese mandarin OES version (mainland) was reliable and valid, suitable for evaluating elbow disorders in the Chinese population. Reliability was measured using both the Cronbach’s α for internal consistency and the intraclass correlation. Results were classified as “excellent” and were similar to results from the original OES. Electronic PROMs were used instead of the traditional paper-based PROMs for collection of data which was well tolerated by patients.

scholarly journals Patient assessment of constipation quality of life questionnaire: validity and reliability for Indonesian population

2019 ◽  
Vol 28 (4) ◽  
pp. 345-50
Author(s):  
Murdani Abdullah ◽  
Hasan Maulahela ◽  
Amanda Pitarini Utari ◽  
Pratiwi Dyah Kusumo ◽  
Amin Soebandrio ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Psychometric Evaluation ◽  
Average Score ◽  
Patient Assessment ◽  
Cronbach's Alpha ◽  
Sf 36

BACKGROUND Constipation is a condition commonly encountered by physicians, causing a significant reduction in patients’ quality of life. Therefore, successful management of constipation should also include increase the quality of life. The Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire is a questionnaire developed to address this issue. However, this questionnaire had not been translated into the Indonesian language. This study was aimed to adapt PAC-QOL into Indonesian culture and perform the psychometric evaluation. METHODS Translation and cultural adaptation were performed based on the linguistic validation guidelines by Acquadro et al in 2012. To perform the psychometric evaluation, a total of 64 subjects in Petamburan district in Jakarta, Indonesia, were recruited from February to March 2018. Test-retest reliability was assessed by completing the PACQOL twice with one-week interval. Subjects also completed the Short Form 36 (SF-36) Health Survey Questionnaire to assess concurrent validity. Internal consistency was analyzed with Cronbach’s alpha value (>0.7) and the intraclass correlation coefficient. RESULTS The mean (standard deviation) overall average score was 1.52 (0.66), while the Cronbach’s alpha value for the overall average score was 0.910. Concurrently, the intraclass correlation coefficient for the overall score was 0.87. Simultaneously, several experts judged content validity to be adequate. All the questions had significant correlations with their respective domains. Moreover, each domain of PAC-QOL also had a significant correlation with several SF-36 domains. CONCLUSIONS The psychometric evaluation performed in this study demonstrated that the Indonesian version of the PAC-QOL was valid and reliable, suggesting that this questionnaire can be used in daily clinical practice.

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