Psychometric Evaluation of the Chinese Version of the Vulvovaginal Symptom Questionnaire in Women With Breast Cancer.

Single-centre hospital outpatient sample, so generalisability to other settings, Chinese-speaking populations or treatment centres is limited. Only women who had completed breast cancer treatment for more than one month were included, so the results do not cover women receiving active treatment. The study was cross-sectional, so it can show associations but not cause and effect. Content validity was not examined; the authors relied on the original English VSQ having adequate properties. The life-impact subscale was less stable, with test-retest ICC values of 0.57 and 0.53. Several items had factor loadings below 0.5, and average variance extracted values were below 0.50 for the symptoms, emotions and sexual-impact subscales. The sexually active subgroup was only 103 women, and 99 participants did not respond to the sexual-impact subscale, which limits confidence in the four-factor model. Self-reported symptoms may have been affected by recall bias, tiredness and discomfort discussing private topics. Data collection was prolonged by COVID-19 restrictions, which may have affected participation. Possible influences such as social support, partner relationships and emotional status were not measured.

The authors declared no conflicts of interest. The study was funded by the Ministry of Science and Technology, Taiwan.

Do not read the questionnaire's correlations with quality of life and sexual function as evidence that any vulvovaginal treatment works, or as proof that the C-VSQ is valid for all women. It was tested only in 202 Chinese-speaking women with breast cancer who had completed treatment, and several subscale properties were weaker than the total score.