Validation of the Mandarin Chinese version of the Oxford Knee Score in breast cancer survivors

Daniel Liu, Yu-Yan Huang, Alison Wang, Alex Molassiotis, Liqun Yao, Hou-Qiang Huang, Si-Lin Zheng, Jing-Yu Tan

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Abstract

Introduction
The Oxford Knee Score (OKS) is a well-validated questionnaire for measuring knee pain and function in individuals after total knee replacement or with knee osteoarthritis. However, its psychometric properties in breast cancer patients with arthralgia symptoms due to cancer treatments have not yet been established. Aim: To investigate the psychometric properties of the OKS Mandarin Chinese version in Chinese breast cancer survivors.

Methods
The study setting was the Affiliated Hospital of Southwest Medical University, Sichuan, China. All participants completed a set of scales, including the Nordic Musculoskeletal Questionnaire (NMQ), the Brief Pain Inventory (BPI), the Functional Assessment of Cancer Therapy-Breast (FACT-B) and RAND 36-Item Health Survey (SF-36). Participants were also asked to complete other questionnaires to assess the specific joint symptoms, such as knee, hip, hand and foot, based on the NMQ initial assessment results. This validation study only analysed data from those breast cancer survivors who reported knee arthralgia
and completed the OKS. The internal consistency reliability of the OKS was tested using Cronbach’s alpha coefficient. The convergent validity of the OKS was evaluated using Spearman’s correlations. The discriminate performance of the OKS was tested using sub-group analysis of breast cancer survivors with different cancer stages, exercise levels and occupations, as well as with or without arthritis.

Results
One hundred and fifty-nine breast cancer survivors were analysed. The internal consistency of the OKS Mandarin Chinese version (Cronbach’s alpha = 0.90) was excellent. Cronbach’s alpha coefficients became slightly lower (0.89) after removing item 1,2,3,5,6,7,9 or 12. Convergent validity of the OKS was supported by significant correlations between the OKS and the FACT-B, the SF-36, and the BPI. The difference in OKS total scores between the breast cancer survivors with different occupations (p = 0.006) and the participants with different exercise levels (p < 0.001) was statistically significant. Breast cancer survivors with arthritis reported significantly lower OKS scores than those without arthritis (p = 0.040).

Conclusions
The OKS Mandarin Chinese version showed excellent acceptability and psychometric properties in breast cancer survivors in measuring knee pain and function.
Original languageEnglish
Pages (from-to)S9
JournalSupportive Care in Cancer
Volume30
Issue numberSupplement 1
DOIs
Publication statusPublished - 1 Jun 2022

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