Development and validation of the Pediatrics Functional Living Index—Emesis scale

Background and objectiveAssessing the impact of chemotherapy-induced nausea and vomiting (CINV) on the quality of life (QoL) of cancer patients is critical. However, there is a dearth of specialized assessment tools designed specifically for pediatric cancer patients. The aim of this study was to de...

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Main Authors: Lili Han, Jun Deng, Yuyun Yang, Wanqi Yu, Wenxia Zhang, Jieru Lin, Feifei Zuo, Jing Yu, Ruiqing Cai, Meiling Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1573996/full
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author Lili Han
Jun Deng
Yuyun Yang
Wanqi Yu
Wenxia Zhang
Jieru Lin
Feifei Zuo
Jing Yu
Ruiqing Cai
Meiling Liu
author_facet Lili Han
Jun Deng
Yuyun Yang
Wanqi Yu
Wenxia Zhang
Jieru Lin
Feifei Zuo
Jing Yu
Ruiqing Cai
Meiling Liu
author_sort Lili Han
collection DOAJ
description Background and objectiveAssessing the impact of chemotherapy-induced nausea and vomiting (CINV) on the quality of life (QoL) of cancer patients is critical. However, there is a dearth of specialized assessment tools designed specifically for pediatric cancer patients. The aim of this study was to develop and validate the Pediatrics Functional Living Index-Emesis (PFLIE) as a patient-reported outcome measure (PROM) to assess the impact of CINV on QoL in pediatric patients. This study was approved by the Institutional Review Board of Sun Yat-sen University Cancer Center (Approval No. B2021-113-01) and was conducted in accordance with the Declaration of Helsinki.​Materials and methodsThe reliability, content validity, structural validity, and concurrent validity of the PFLIE were assessed through two rounds of Delphi expert consultation and a questionnaire survey of 90 pediatric cancer patients receiving chemotherapy at a tertiary care hospital cancer center in China.ResultsThe PFLIE consists of two domains: nausea (10 items) and vomiting (10 items). The content validity index (CVI) for both the nausea and vomiting domains was 0.933. The Cronbach’s alpha coefficients for the total scale, nausea domain, and vomiting domain were 0.964, 0.928, and 0.943, respectively. Item-domain correlations were stronger for the PFLIE (r = 0.678-0.882) across domains compared to across-domain correlations (r = 0.493-0.780), suggesting that the PFLIE has acceptable construct validity. In addition, the PFLIE demonstrated acceptable concurrent validity.ConclusionsThe validity and reliability of the Chinese version of the PFLIE are reliable and valid. The tool can help healthcare providers effectively identify and manage CINV symptoms, thereby improving the QoL of pediatric cancer patients. In low- and middle-income countries (LMICs) with limited resources, PFLIE can be used to improve the management of CINV and to ensure that pediatric cancer patients receive adequate care despite inadequate healthcare infrastructures. The tool can be used to improve the management of CINV and to ensure that pediatric cancer patients receive adequate care despite inadequate healthcare infrastructures.​
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spelling doaj-art-a6aace5a6fe64585be03d095babce5a62025-08-20T02:21:29ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15739961573996Development and validation of the Pediatrics Functional Living Index—Emesis scaleLili Han0Jun Deng1Yuyun Yang2Wanqi Yu3Wenxia Zhang4Jieru Lin5Feifei Zuo6Jing Yu7Ruiqing Cai8Meiling Liu9Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaDepartment of Pediatric Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, ChinaBackground and objectiveAssessing the impact of chemotherapy-induced nausea and vomiting (CINV) on the quality of life (QoL) of cancer patients is critical. However, there is a dearth of specialized assessment tools designed specifically for pediatric cancer patients. The aim of this study was to develop and validate the Pediatrics Functional Living Index-Emesis (PFLIE) as a patient-reported outcome measure (PROM) to assess the impact of CINV on QoL in pediatric patients. This study was approved by the Institutional Review Board of Sun Yat-sen University Cancer Center (Approval No. B2021-113-01) and was conducted in accordance with the Declaration of Helsinki.​Materials and methodsThe reliability, content validity, structural validity, and concurrent validity of the PFLIE were assessed through two rounds of Delphi expert consultation and a questionnaire survey of 90 pediatric cancer patients receiving chemotherapy at a tertiary care hospital cancer center in China.ResultsThe PFLIE consists of two domains: nausea (10 items) and vomiting (10 items). The content validity index (CVI) for both the nausea and vomiting domains was 0.933. The Cronbach’s alpha coefficients for the total scale, nausea domain, and vomiting domain were 0.964, 0.928, and 0.943, respectively. Item-domain correlations were stronger for the PFLIE (r = 0.678-0.882) across domains compared to across-domain correlations (r = 0.493-0.780), suggesting that the PFLIE has acceptable construct validity. In addition, the PFLIE demonstrated acceptable concurrent validity.ConclusionsThe validity and reliability of the Chinese version of the PFLIE are reliable and valid. The tool can help healthcare providers effectively identify and manage CINV symptoms, thereby improving the QoL of pediatric cancer patients. In low- and middle-income countries (LMICs) with limited resources, PFLIE can be used to improve the management of CINV and to ensure that pediatric cancer patients receive adequate care despite inadequate healthcare infrastructures. The tool can be used to improve the management of CINV and to ensure that pediatric cancer patients receive adequate care despite inadequate healthcare infrastructures.​https://www.frontiersin.org/articles/10.3389/fonc.2025.1573996/fullpediatricscancernauseavomitingquality of life
spellingShingle Lili Han
Jun Deng
Yuyun Yang
Wanqi Yu
Wenxia Zhang
Jieru Lin
Feifei Zuo
Jing Yu
Ruiqing Cai
Meiling Liu
Development and validation of the Pediatrics Functional Living Index—Emesis scale
Frontiers in Oncology
pediatrics
cancer
nausea
vomiting
quality of life
title Development and validation of the Pediatrics Functional Living Index—Emesis scale
title_full Development and validation of the Pediatrics Functional Living Index—Emesis scale
title_fullStr Development and validation of the Pediatrics Functional Living Index—Emesis scale
title_full_unstemmed Development and validation of the Pediatrics Functional Living Index—Emesis scale
title_short Development and validation of the Pediatrics Functional Living Index—Emesis scale
title_sort development and validation of the pediatrics functional living index emesis scale
topic pediatrics
cancer
nausea
vomiting
quality of life
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1573996/full
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