Cross cultural adaptation and psychometric evaluation of the Turkish PedsQL™ Brain Tumor Module: Assessing health-related quality of life in children with brain tumors

Abstract

Background: Brain tumors are the most common type of pediatric cancer, significantly impacting children's health-related quality of life (HRQoL). This study aimed to adapt the PedsQL (TM)-BTM to Turkish culture and evaluate its psychometric properties, including reliability, validity, and cross-cultural consistency. Method: A total of 108 children with brain tumors (mean age: 9.1 +/- 4.99 years) and 120 parents participated in the study. The translation process included forward-backward translation, reconciliation, cognitive debriefing, and pilot testing. Internal consistency (Cronbach's alpha), test-retest reliability (ICC), exploratory and confirmatory factor analysis were conducted to evaluate the psychometric properties. Correlations between the PedsQL (TM)-BTM and the Generic Core Scales were examined for criterion validity. Results: Cronbach's alpha ranged from 0.83 to 0.97, indicating excellent internal consistency. Test-retest reliability was robust, with ICC values exceeding 0.80 for most subscales. EFA explained 84.2% of the variance in parent reports and 80.4% in child reports, while CFA confirmed the six-factor structure (child-reported outcomes: RMSEA = 0.069, 90% CI: 0.061-0.076; TLI = 0.862; NFI = 0.92; chi(2) (147) = 1875, p < 0.001; and parent-reported outcomes: RMSEA = 0.063, 90% CI: 0.059-0.069; TLI = 0.858; NFI = 0.93; chi(2) (153) = 1912, p < 0.001). Correlations between the BTM subscales and Generic Core Scales demonstrated strong criterion validity (e.g. Cognitive Problems correlated with School Functioning: r = 0.831, p < 0.05). Conclusions: The Turkish PedsQL (TM)-BTM is a reliable and valid tool for assessing HRQoL in children with brain tumors.