Development and Preliminary Validation of the Questionnaire “Evaluation of the Constitution of Social Circles” in Patients Treated for Cancer of the Upper Aerodigestive Tract

Abstract

<b><i>Purpose:</i></b> The constitution of social circles around patients treated for cancer of the upper aerodigestive tract (UADT) has a major influence on factors that affect quality of life (QOL) but is poorly assessed, mainly due to a lack of tools. The objective of this study is to develop a questionnaire that assesses the constitution of social circles in a population treated for UADT cancer and to analyze the construct (structural and clinical validity) and criterion validity. <b><i>Methods:</i></b> The Evaluation of the Constitution of Social Circles (ECSC) questionnaire was developed in French by a committee of experts. Structural validity was analyzed using inter-item correlations. The scores of a group of patients treated for UADT cancer were compared with those of a group of healthy subjects (clinical validity). For criterion validity, the ECSC scores were compared to those from various questionnaires that assess social functioning (QFS), psychological status (HAD), perceived speech impairment (PHI), and QOL (EORTC QLQ-H&amp;N35) in patients. <b><i>Results:</i></b> Structural validity shows low to moderate inter-item correlations which is consistent with the construction of the questionnaire not assessing underlying concepts. Clinical validity was satisfactory regarding the frequency of contact (<i>p</i> = 0.01), satisfaction with the frequency of contact in the private circle (<i>p</i> = 0.03), and the size of the social circles of family and friends (<i>p</i> ≤ 0.01). Criterion validity was adequate with moderate correlations between the ECSC scores and the QFS sub-scores of interest (rs &#x3e; 0.56, <i>p</i> &#x3c; 0.05). Anxiety (HAD) had a low correlation (|rs| = 0.46, <i>p</i> &#x3c; 0.05) with satisfaction with exchanges and the frequency of contact with family. Satisfaction with exchanges with the private circle was moderately correlated with the EORTC QLQ-H&amp;N35 score (rs = 0.56, <i>p</i> = 0.01) and showed a negative trend on the PHI (rs &#x3c; −0.39, <i>p</i> ≥ 0.05). <b><i>Conclusion:</i></b> While the test-retest reliability is yet to be evaluated and the sample size should be increased, this preliminary study shows that the ECSC is a valid tool for assessing the constitution of social circles in patients treated for UADT cancer. It highlights the links between social circles and their functional impact on communication and QOL.