# Validation and Cultural Adaptation of the Serbian Version of the Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire: A Comprehensive Psychometric Evaluation

## TL;DR

This study validated a Serbian version of a questionnaire to assess quality of life in colorectal cancer patients, ensuring it works well culturally and psychometrically.

## Contribution

The study provides a culturally adapted and validated Serbian version of the CCF-CaQL questionnaire for colorectal cancer patients.

## Key findings

- The Serbian CCF-CaQL showed high internal consistency (Cronbach’s alpha = 0.85).
- It demonstrated significant correlations with the FACT-C questionnaire, confirming validity.
- Known-groups validity revealed distinct QoL scores based on clinical factors like tumor location and stoma presence.

## Abstract

Backround/Objectives: Colorectal cancer presents a significant quality of life (QoL) challenge as a result of both the disease and its treatments. This study aimed to validate and culturally adapt the Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire (CCF-CaQL) for Serbian-speaking colorectal cancer patients. Methods: The CCF-CaQL offers a detailed assessment of the physical, emotional, social, and functional impacts of the disease. This study, conducted at the University Clinical Center of Serbia, involved 150 colorectal cancer patients undergoing treatment. The translation and adaptation process followed the EORTC Quality of Life Group’s guidelines, ensuring cultural relevance and comprehensibility. Statistical analyses, including Cronbach’s alpha for internal consistency and Pearson’s correlation for concurrent validity, reliability, and known-groups validity, were performed using SPSS and R software. Results: The Serbian version of the CCF-CaQL maintains strong psychometric properties with high internal consistency (Cronbach’s alpha = 0.85) and significant correlations with the FACT-C questionnaire, confirming its validity. Known-groups validity showed distinct variations in QoL scores based on tumor location, stoma presence, and neoadjuvant therapy status, highlighting its sensitivity to different clinical conditions. Conclusions: The CCF-CaQL questionnaire has been skillfully translated, culturally adapted, and carefully validated through psychometric evaluations for Serbian patients diagnosed with colorectal cancer.