Translation, Linguistic Validation, and Cultural Adaptation of the Bladder Cancer Index (BCI) Questionnaire Into the Persian (Farsi) Language and Comparing it With WHO Quality of Life Questionnaire: An Observational Study

Whether ileal conduit diversion (ICD) or orthotopic neobladder (ONB) urinary diversion provides better quality of life (QoL) is still under debate. The Bladder Cancer Index (BCI) is a specific tool for bladder cancer (BCa) patients, providing reliable results in previous studies. A validated Farsi version of the BCI concerning cultural aspects could help Farsi-speaking clinicians gain more reliable feedback on QoL following urinary diversion.

Based on WHO suggestions, we translated the BCI questionnaire into the Persian language. Then, we performed a cross-sectional study on BCa patients who underwent ICD or ONB urinary diversion. We compared their QoL via BCI and WHO questionnaires. Chi-square and independent t-tests were used where appropriate.

The content validity ratio and the content validity indexes were 1 and 0.8-1.0, respectively. Of 57 participants, six patients (10.5%) were women. The ICD was performed for 38 (66.7%) and ONB diversion for 19 (33.3) participants. The mean age of ICD and ONB was 68.71 ± 7.40 and 64.28 ± 8.34 years, respectively (p-value: 0.055). In all sub-domains of BCI, except bowel habits, the mean scores were higher in the ICD group. A significant difference between ICD and ONB groups was found regarding urinary function (p-value<0.001). There was no significant difference between ICD and ONB groups in none of the domains of the WHO questionnaire.

The QoL of ICD and ONB patients did not differ significantly. Even ICD may be superior in ritual purification, while the psychological status of ONB patients was better.