# Adaptation and validation of the Chinese version of the Hospice Comfort Questionnaire-Patient (HCQ-P)

## TL;DR

This study adapts and validates a hospice comfort questionnaire for Chinese patients, ensuring it is reliable and effective in assessing comfort levels.

## Contribution

The study provides a culturally adapted and psychometrically validated Chinese version of the HCQ-P for hospice care.

## Key findings

- The Chinese HCQ-P showed excellent internal consistency with a Cronbach’s α of 0.94.
- Test-retest reliability was high with an ICC of 0.93.
- Confirmatory factor analysis confirmed the questionnaire’s statistical robustness in the Chinese hospice context.

## Abstract

The Hospice Comfort Questionnaire-Patients (HCQ-P) is widely used to assess patient’s comfort levels in hospice care. This research aimed to culturally adapt the HCQ-P for the Chinese context and validate its psychometric properties to ensure its applicability and effectiveness in China.

This research was conducted in two main phases: (1) translation and cross-cultural adaptation of the HCQ-P into Chinese, (2) evaluation of the psychometric properties through expert consultations and a cross-sectional survey among 360 hospice care patients. The evaluation included determining floor and ceiling effects, evaluating internal consistency using Cronbach’s α, and testing test-retest reliability with the intra-class correlation coefficient (ICC). Content validity was assessed using the content validity index (CVI), and construct validity was tested through confirmatory factor analysis (CFA).

The HCQ-P was successfully translated and culturally adapted into Chinese, with no significant floor or ceiling effects detected. The overall Cronbach’s α for the HCQ-P was 0.94, demonstrating excellent internal consistency, while dimension-specific alphas ranged from 0.77 to 0.84. The overall ICC was 0.93, indicating high test-retest reliability, with individual dimensions ranging from 0.77 to 0.81. Both item-level and scale-level CVIs reached 1, reflecting unanimous expert agreement on content relevance. Significant factor loadings in the CFA confirm that the HCQ-P is statistically robust and well-aligned with the cross-cultural and clinical contexts of Chinese hospice care.

The Chinese version of the HCQ-P exhibits robust psychometric properties, making it a valid and reliable instrument for assessing patient comfort in Chinese hospice care settings.