*Cross-sectional method, *Communicative competence, *Medical quality control, *Research funding, *Palliative treatment, *Death, *Cronbach's alpha, *Research methodology evaluation, *Questionnaires, *Translations, *Hospitals, *Descriptive statistics, *Communication, *Psychometrics, *Research methodology, *Factor analysis, *Clinics, *Health outcome assessment, *Comparative studies, *Discriminant analysis, Research evaluation

Background: Effective clinician-patient communication is essential for delivering quality end-of-life care. However, there are no validated measures to assess the quality of end-of-life communication for Chinese patients. Methods: This study aims to cross-culturally adapt and validate the patient-reported Quality of Communication Questionnaire (QOC) for Chinese speaking patients. The QOC was translated and adapted using a standardized methodology consisting of forward translations, backward translations, expert panel review, and testing with patients. We conducted a cross-sectional study to perform principal component, content validity, internal consistency, convergent and discriminant validity analyses of the 16-item Chinese QOC (C-QOC). Subjects were Chinese-speaking advanced cancer (n = 82) and advanced chronic kidney disease (n = 68) patients attending outpatient clinics in five hospitals or receiving home-based palliative care in Hong Kong. Results: The content validity of the C-QOC was established by an expert panel. The C-QOC has a 3-component structure (general communication skills, communication about illness trajectory, and end-of-life care planning subscales) and demonstrated good internal consistency (Cronbach's α = 0.88; subscales 0.84–0.90). Convergent validity was supported by positive association between C-QOC score and overall clinician communication quality (r = 0.47, p < 0.001) and clinician comfort in discussing dying (r = 0.63, p < 0.001). Discriminant validity was demonstrated by the stronger association between overall clinician communication quality and general communication skills, compared to the other two subscales. Conclusions: The C-QOC is a valid, reliable, and culturally relevant instrument for evaluating the quality of clinician end-of-life care communication by Chinese patients with advanced cancer and chronic kidney disease. [ABSTRACT FROM AUTHOR]

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