Objective:To evaluate the reliability and validity of the simplified Chinese version of Lymphedema function, disability and health questionnaire for lower limb lymphedema (Lymph-ICF-LL).Methods:The original English version was translated into mandarin and modified to accommodate Chinese customs. According to the inclusion and exclusion criteria, 61 patients with lower extremity lymphedema who were treated in the Department of Burn and Plastic Surgery of Xi’an Central Hospital from June 2019 to June 2021 were recruited in this study. The questionnaires filled by the included patients were classified as sample 1 to sample 4 by the screening process. The valid simplified Chinese version of Lymph-ICF-LL was collected as sample 1 ( n=55), including 1 male and 54 females, aged (51.0±9.4) years (24-70 years). Among the 55 patients, 28 patients underwent lymphaticovenular anastomosis (LVA). The simplified Chinese version of Lymph-ICF-LL completed before and follow-up of 6 months after surgery were selected as sample 2 and sample 3( n=28), respectively. The simplified Chinese version of lymphoedema quality of life questionnaire (LYMQOL) filled out by the patients in sample 1 was used as sample 4 ( n=55). The reliability was analyzed by internal consistency test reliability and split-half reliability, Cronbach’s α coefficient ≥0.80 indicated good internal consistency reliability and the Spearman-Brown split-half reliability coefficient ≥0.70 indicated good split-half reliability. The content validity of the Lymph-ICF-LL was determined by three plastic surgery experts who judged the consistency of the questionnaire with the original English content. Exploratory factor analysis and criterion validity were used to analyze construct validity. For criterion validity assessment, Pearson correlation analysis was used to test the correlation between the Lymph-ICF-LL scores in sample 1 and the LYMQOL scores in sample 4. The scores of Lymph-ICF-LL before and half a year after lymphadenectomy were compared by paired t-test. Results:(1) Cronbach’s alpha was 0.937, indicating good internal consistency. The Spearman-Brown split-half reliability coefficient of the total scale was 0.700, indicating good split-half reliability. (2) The content validity of the simplified Chinese version of Lymph-ICF-LL was good. Five factors (physical function, mental function, general tasks/household, mobility and life/social life) were identified by factor analysis. The total score of the simplified Chinese version of Lymph-ICF-LL was positively correlated with the score of the simplified Chinese version of LYMQOL ( r=0.73, P<0.001), and the criterion correlation validity was good. (3) The scores of Lymph-ICF-LL for half a year after LVA was significantly lower than its preoperative counterparts (40.70±15.13 vs. 54.40±15.70, t=5.96, P<0.001). The quality of life of patients after LVA was significantly improved. Conclusion:The simplified Chinese version of Lymph-ICF-LL shows good reliability and validity and can be used to evaluate the quality of daily life regarding patients with lower limb lymphedema.

Objective:To evaluate the reliability and validity of the simplified Chinese version of Lymphedema function, disability and health questionnaire for lower limb lymphedema (Lymph-ICF-LL).Methods:The original English version was translated into mandarin and modified to accommodate Chinese customs. According to the inclusion and exclusion criteria, 61 patients with lower extremity lymphedema who were treated in the Department of Burn and Plastic Surgery of Xi’an Central Hospital from June 2019 to June 2021 were recruited in this study. The questionnaires filled by the included patients were classified as sample 1 to sample 4 by the screening process. The valid simplified Chinese version of Lymph-ICF-LL was collected as sample 1 ( n=55), including 1 male and 54 females, aged (51.0±9.4) years (24-70 years). Among the 55 patients, 28 patients underwent lymphaticovenular anastomosis (LVA). The simplified Chinese version of Lymph-ICF-LL completed before and follow-up of 6 months after surgery were selected as sample 2 and sample 3( n=28), respectively. The simplified Chinese version of lymphoedema quality of life questionnaire (LYMQOL) filled out by the patients in sample 1 was used as sample 4 ( n=55). The reliability was analyzed by internal consistency test reliability and split-half reliability, Cronbach’s α coefficient ≥0.80 indicated good internal consistency reliability and the Spearman-Brown split-half reliability coefficient ≥0.70 indicated good split-half reliability. The content validity of the Lymph-ICF-LL was determined by three plastic surgery experts who judged the consistency of the questionnaire with the original English content. Exploratory factor analysis and criterion validity were used to analyze construct validity. For criterion validity assessment, Pearson correlation analysis was used to test the correlation between the Lymph-ICF-LL scores in sample 1 and the LYMQOL scores in sample 4. The scores of Lymph-ICF-LL before and half a year after lymphadenectomy were compared by paired t-test. Results:(1) Cronbach’s alpha was 0.937, indicating good internal consistency. The Spearman-Brown split-half reliability coefficient of the total scale was 0.700, indicating good split-half reliability. (2) The content validity of the simplified Chinese version of Lymph-ICF-LL was good. Five factors (physical function, mental function, general tasks/household, mobility and life/social life) were identified by factor analysis. The total score of the simplified Chinese version of Lymph-ICF-LL was positively correlated with the score of the simplified Chinese version of LYMQOL ( r=0.73, P<0.001), and the criterion correlation validity was good. (3) The scores of Lymph-ICF-LL for half a year after LVA was significantly lower than its preoperative counterparts (40.70±15.13 vs. 54.40±15.70, t=5.96, P<0.001). The quality of life of patients after LVA was significantly improved. Conclusion:The simplified Chinese version of Lymph-ICF-LL shows good reliability and validity and can be used to evaluate the quality of daily life regarding patients with lower limb lymphedema.