Psychometric validation of the Chinese version of the Edmonton-33 scale in patients with head and neck cancer

Objective: This study aimed to translate the Edmonton-33 scale (E-33) into Chinese and evaluate its reliability and validity in patients with head and neck cancer (HNC). Methods: In Phase 1, the E-33 was translated from English to Chinese using the Brislin double-back translation method. Content validity was evaluated by a panel of experts, and a pilot test was conducted with a small sample of HNC patients. In Phase 2, a cohort of 510 patients from Henan and Hubei provinces was recruited. Psychometric properties were assessed through item analysis; and reliability testing (including Cronbach's alpha, test-retest reliability, and split-half reliability), as well as construct validity (using exploratory and confirmatory factor analysis). Results: The item-level content validity index (I-CVI) ranged from 0.833 to 1.000, and the scale-level content validity index (S-CVI/Ave) was 0.965. The Cronbach's alpha, the test-retest reliability coefficient, and the splithalf reliability values were 0.922, 0.973, and 0.971, respectively. Four main factors were identified using exploratory factor analysis, explaining 77.07% of the total variance. Confirmatory factor analysis showed good fit indices: chi 2/df = 1.626, RMSEA = 0.048, NFI = 0.936, RFI = 0.930, IFI = 0.974, TLI = 0.972, and CFI = 0.974. Conclusions: The Chinese version of the Edmonton-33 scale (CE-33) demonstrated high reliability and validity, suggesting its potential as a valuable self-report tool for assessing functional outcomes in Chinese-speaking HNC patients.