Psychometric Evaluation of the Romanian Quality of Life in Adult Cancer Survivors (QLACS) in Women with Breast Cancer: A Cross-Sectional Study.

The increase in the number of people living after an oncological diagnosis requires the use of instruments capable of assessing both general dimensions and specific aspects of quality of life. The study aimed to evaluate the psychometric properties of the Romanian version of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire, analyze the relationships between its scores, age, and residence environment, and identify distinct quality of life profiles. Methods: A cross-sectional study was conducted in 224 adult women with a confirmed diagnosis of breast cancer. The internal consistency of the 12 QLACS domains was assessed by Cronbach's alpha coefficient. The structure of the instrument was explored by principal component analysis with Oblimin rotation. Differences according to residence were analyzed by the Mann-Whitney test, and the relationships with age by the Spearman coefficient. Multivariable regression models including age and residential environment were fitted for all 12 QLACS domains. Quality of life profiles were identified by hierarchical classification and k-means analysis. Results: Cronbach's alpha coefficients ranged from 0.832 to 0.925, indicating good internal consistency across the 12 QLACS domains. Principal component analysis retained 11 components, explaining 73.738% of the total variance, providing preliminary exploratory support for the multidimensional structure of the instrument. Most domains were clearly delineated, whereas Cognitive problems partially overlapped with Recurrence distress. Urban residence was associated with higher Cognitive problems scores (r = 0.17), whereas rural residence was associated with higher Family distress scores (r = 0.29). Age was negatively correlated with Negative feelings (rho =-0.200, p = 0.003). A weak exploratory association was also observed with Recurrence distress (rho = 0.135, p = 0.043), although the corresponding multivariable model was not statistically significant. Cluster analysis identified three exploratory quality-of-life profiles, and residential environment was associated with cluster membership, although the association was small (Cramer's V = 0.188). Conclusions: The Romanian QLACS showed good internal consistency and preliminary exploratory structural evidence in women with breast cancer. Further studies are needed to confirm its psychometric properties.