# Cross-cultural adaptation and psychometric validation of the Chinese quality-of-life questionnaire for patients with systemic sclerosis

## TL;DR

This paper adapts and validates a quality-of-life questionnaire for systemic sclerosis patients in China, ensuring it is reliable and effective for use in clinical settings.

## Contribution

The paper provides a cross-culturally adapted and validated Chinese version of the SScQoL questionnaire.

## Key findings

- The Chinese version of SScQoL has high content validity with item-level CVI ranging from 0.83 to 1.00.
- The questionnaire demonstrates strong reliability with a total Cronbach’s α of 0.922 and test-retest reliability of 0.969.
- Exploratory factor analysis confirmed five dimensions with a cumulative variance contribution rate of 65.761%.

## Abstract

Patients with systemic sclerosis (SSc) frequently experience symptoms such as pain, fatigue, and functional impairments, leading to a significant decline in their quality of life (QoL). Accurately evaluating the QoL of SSc patients is crucial for developing personalized treatment plans and enhancing prognosis. The Systemic Sclerosis Quality of Life Questionnaire (SScQoL), an internationally recognized SSc-specific tool, is commonly used for QoL assessment. However, this questionnaire has not undergone cross-cultural adaptation in China, and its reliability and validity require further validation.

To localize the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) into Chinese and assess its reliability and validity.

Following the principles of scale introduction, the Beaton model was employed to translate and back-translate the English version. The scale underwent cross-cultural adaptation through expert consultation, resulting in the Chinese version of the SScQoL test. From August 2023 to December 2024, a convenience sampling method was used to recruit 160 patients with systemic sclerosis from two hospitals for questionnaire surveys to evaluate questionnaire reliability and validity.

SScQoL comprises five dimensions and 29 items. The content validity index (CVI) at the item level ranges from 0.83 to 1.00, and the CVI at the scale level is 0.97. Exploratory factor analysis identified five common factors, with a cumulative variance contribution rate of 65.761%. The Cronbach’s α coefficient for the total scale is 0.922, and the Cronbach’s α coefficients for the five dimensions range from 0.756 to 0.942. The test-retest reliability for the total scale is 0.969; for the five dimensions, it ranges from 0.710 to 0.961.

SScQoL is a reliable and effective tool for evaluating patients’ quality of life with systemic sclerosis. This tool can support nurses and researchers and help them formulate targeted strategies, thereby significantly improving patients’ quality of life with systemic sclerosis.