Conceptual structure of the Taiwan Chinese version of the EORTC QLQ-C30

Chi Cheng Huang, Shih Hsin Tu, Heng Hui Lien, Ching Shui Huang, Pa Chun Wang, Wei Chu Chie

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Objective: This study aimed to evaluate the conceptual structure of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) by analyzing data collected from patients with major cancers in Taiwan. The conceptual structure underlying QLQ-C30, including higher-order factors, was explored by structural equation modeling (SEM). Methods: The Taiwan Chinese version of the EORTC QLQ-C30 was used as the measuring instrument. Higher-order models, including mental health/physical health, mental function/physical burden, symptom burden/function, single latent health-related quality of life, formative symptom burden/function, and formative health-related quality of life, were tested. Results: Study subjects included 283 patients with breast, lung, and nasopharyngeal cancers. The original QLQ-C30 multi-factorial structure demonstrated poor composite reliability of the cognitive function subscale. The formative symptom/burden model was favored by model fit indices, further supporting causal–indicator duality, but was compromised by unexpected associations between symptomatic subscales and latent factors. The formative health-related quality of life was proposed with a single second-order latent factor where symptomatic subscales remained formative. Two additional symptom measures from the formal cognitive function subscale with the formative health-related quality-of-life model were proposed as the alterative conceptual structure for the Taiwan Chinese QLQ-C30. Conclusions: Results of the current study represent the complete SEM approach for the EORTC QLQ-C30. The formative health-related quality-of-life model with elimination of cognitive function enhances the conceptual structure of the Taiwan Chinese version with parsimonious fit and interpretability.

Original languageEnglish
Pages (from-to)1999-2013
Number of pages15
JournalQuality of Life Research
Issue number8
Publication statusPublished - Aug 21 2015


  • Cancer
  • Conceptual structure
  • Higher-order factor
  • Quality of life
  • Taiwan Chinese

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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