Content and Linguistic Validity of the Patient-Generated Subjective Global Assessment Tool among Adults Living with Cancer in Ethiopia

Abstract

<title>Abstract</title> Background Prior studies in Ethiopia have not validated the Patient-Generated Subjective Global Assessment (PG-SGA) for assessing the nutritional status of adult cancer patients. This study aimed to evaluate the content and linguistic validity of both the full-length and short-form versions of the PG-SGA in Ethiopia. Methods A panel of nine experts assessed the difficulty, clarity, and relevance of each item. The experts evaluated the content validity of the full PG-SGA. The linguistic validity of the translated patient component (PG-SGA Short Form) was evaluated using a purposively selected sample of 20 patients. Item and scale content validity indices (I-CVI and S-CVI) were calculated to determine the content validity of the tool. Cohen's kappa and Fleiss' kappa statistics were used to assess inter-rater reliability. Results This study evaluated four domains and 67 items for content validation. The item content validity index for the full PG-SGA ranged from 0.78 to 1. The scale content validity index for the patient and professional components based on average was 0.98 and 0.96, respectively. The scale content validity index of the full-form PG-SGA was 0.97. The modified kappa values for all items ranged from 0.87 to 1. Unfamiliarity and illiteracy among some participants were identified as challenges during the linguistic validation. Conclusion The contextualized version of the PG-SGA is valid for assessing malnutrition in Ethiopian adults with cancer. The Amharic-translated short form, along with the adapted English version of the Physical Examination section, can be used to assess malnutrition in the oncological and research contexts in Ethiopia.