Cross-cultural Adaptation and Validation of the Geriatric 8 Screening Tool in Chinese Older Inpatients with Cancer

Abstract

Abstract Background: Frailty is emerging as an important determinant of human health. The Geriatric 8 (G8) questionnaire, originally produced in English, is a common frailty screening tool designed specifically for older cancer patients. However, this tool has not yet been applied in China, partly due to a lack of a Chinese version. Therefore, this study aimed to translate the original G8 questionnaire into Chinese and validate its psychometric properties in Chinese older inpatients with cancer. Methods: The Chinese version of the G8 (C-G8) questionnaire was generated using Brislin’s model of translation. The psychometric properties of the C-G8, including content validity, known-group divergent validity, convergent validity, internal consistency, test-retest reliability, and inter-rater reliability, were all examined. Results: A total of 296 eligible subjects were consecutively enrolled in this cross-sectional study. The content validity index of the C-G8 were 0.8~1 at the item level and 0.975 at the scale level, respectively. The C-G8 identified more frail individuals among these older participants (>75 years) compared to their younger counterparts (65~75 years) (frailty prevalence: 87.1% vs. 70.9%, P=0.010). In addition, the convergent validity of the C-G8 was tested by correlating it with the FRAIL scale (r=-0.592, P<0.001), indicating a moderate correlation between these two instruments in screening frailty. Nevertheless, the C-G8 had a lower internal consistency (Cronbach’s α coefficient=0.501) but higher test-retest reliability and inter-rater reliability (intraclass correlation coefficient=0.913 and 0.993, respectively, P<0.001). Conclusion: The C-G8 questionnaire was demonstrated to have acceptable validity and reliability and hence could be applied to Chinese older cancer patients.