Translation and validation of the EORTC QLQ-CX24 questionnaire into the indigenous African languages of isiXhosa and Afrikaans

  • George C Du Toit University of Stellenbosch
  • Daan G Nel University of Stellenbosch
Keywords: European Organisation for Research and Treatment of Cancer QLQ-CX24 questionnaire, translation, Afrikaans, Xhosa


Objectives: Quality of life (QOL) assessment plays an important role in oncological clinical practice and research settings when evaluating treatment outcome. Cervical cancer remains a prevalent disease in South African women. The current study translated the European Organisation for Research and Treatment of Cancer (EORTC) cervical cancer module, QLQ-CX24, into isiXhosa and Afrikaans and validated the questionnaires. Setting and subjects: The QLQ-CX24 was translated forwards into isiXhosa and Afrikaans and backwards into English, and then reconciled by four independent language practitioners. The translated version was completed by 15 isiXhosa- and 15 Afrikaans-speaking patients with cervical cancer. Cronbach’s alpha coefficient, a measure of internal consistency of response, was calculated. The conversion validity was evaluated by assessing the correlation between each item and its scale. Discriminant validity was examined by comparing the correlation values of each item with other scales using Pearson’s and Spearman’s correlation coefficients. Results: The translated isiXhosa and Afrikaans questionnaires demonstrated good conversion validity in the multi-item scales, with values of Cronbach’s alpha coefficient ≥ 7. Discriminant validity was demonstrated in the single-item questions. Patients completed the questionnaires in less than 20 minutes. Conclusion: The translated isiXhosa and Afrikaans versions of QLQ-CX24 were successfully translated and validated and is available for research and clinical use.

Author Biographies

George C Du Toit, University of Stellenbosch
MBChB(Stell) MMed (O&G)(Stell) FCOG/LKOG (SA) Unit of Gynaecological Oncology Tygerberg Hospital University of Stellenbosch
Daan G Nel, University of Stellenbosch
Centre for Statistical Consultation University of Stellenbosch
Original Research