Cross-cultural Adaptation of the Chinese Version of QoLAF-Q (Quality of Life in Patients With Anal Fistula Questionnaire) ：A Multi-center Study

Reliability analysis was used to study the reliability and precision of the responses to quantitative data (especially the attitude scale questions).The Cronbach's α coefficient is a commonly used reliability index, which measures the correlation between various items in the scale and determines whether each item in the scale is measuring the same concept or trait. If the Cronbach's alpha coefficient is high, it indicates that the correlation among the items is strong, and the internal consistency of the scale is good, meaning that these items can relatively consistently reflect the psychological trait or concept being measured.In the reliability analysis of this study, if the Cronbach's α coefficient reaches above 0.8, it indicates that each item can effectively revolve around the core concept of "the quality of life of patients with anal fistula", and there is a high degree of consistency among these items.

Validity analysis is used to study the rationality of the design of quantitative data (especially items in attitude scales). For the validity analysis of this scale, it is required to use the KMO value to determine whether the data obtained after converting the subjective choices of patients into Likert scale scores are reasonable and whether they can be used for factor analysis, so as to judge the appropriateness of information extraction and verify the validity level of the data.

The factor analysis of the Quality of Life in Anal Fistula Questionnaire (QoLAF-Q) is used to verify the applicability of QoLAF-Q in China through cross-cultural research, which includes two parts: exploratory factor analysis(EFA) and confirmatory factor analysis(CFA). EFA extracts the latent factors in the scale through methods such as principal component analysis to determine the structural dimensions of the scale.Based on EFA, CFA uses structural equation modeling to verify the structure of the scale and further evaluate the construct validity of the scale. By comparing the model fit indices, such as the chi-square to degrees of freedom ratio (χ²/df), goodness-of-fit index (GFI), etc, the degree of fit between the model and the data is judged.When the various indicators in the factor analysis of QoLAF-Q are basically higher than the predicted values, it indicates that the QoLAF has good applicability for the assessment of Chinese patients.