Translation, cultural adaptation, and psychometric validation of the simplified Chinese EORTC QLQ-SH22 among cancer patients

Abstract Background Sexual health is a critical aspect of quality of life in cancer patients. The EORTC QLQ-SH22 (SH22) assesses sexual health–related quality of life (SH-QoL), but no Simplified Chinese version has been validated. This study aimed to translate and culturally adapt the SH22 into Simplified Chinese (SH22-C) and to evaluate its psychometric properties in mainland Chinese cancer patients. Methods This study comprised two phases. Phase I involved translation and cultural adaptation of the SH22, following the standardized EORTC translation procedure to ensure clarity and cultural relevance. Phase II was a cross-sectional survey in outpatient oncology clinics of a tertiary hospital in mainland China, with 270 adults completing the SH22-C and 30 participants completing a retest after 2 weeks. Psychometric properties assessed included internal consistency, test–retest reliability, structural validity, and convergent/discriminant validity. Results Cognitive interviews led to revisions of ambiguous sexual activity terms, with no further changes in the second round. Phase II demonstrated excellent internal consistency ( Sexual Satisfaction α = 0.93; Sexual Pain α = 0.81) and good test–retest reliability (intraclass correlation coefficients = 0.86 and 0.84, respectively; single-item r = 0.73–0.88). Confirmatory factor analysis confirmed a two-factor structure with acceptable fit and factor loadings of 0.62–0.92. Strong convergent validity and low inter-factor correlation ( r = − 0.26) supported discriminant validity. Conclusions The SH22-C showed good cultural equivalence, reliability, and validity in mainland Chinese cancer patients and provides a valid and practical tool for assessing SH-QoL.