Table 4: Cognitive interview results: instruments, items, number participants per instrument, and issues.

InstrumentItemsNumber of participantsIssues Identified

European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-C30 (EORTC-C30) [30] Spanish US Version 33021Difficulty responding to items pertaining to time or distance.
Patients had concerns with shortness of breath item, relating it to asthma.
Difficulty with responding to pain questions, associating the question with different kinds of pain.
Difficulty with understanding the question of physical condition or medical treatment interfering with family life.

1-item neuropathy screener developed by research team 13None reported or observed.

European Organization for Research and Treatment of Cancer Chemotherapy-Induced Peripheral Neuropathy 20
(CIPN20) [31]
2019Did not understand meaning of “adormecidos” (numbness) or “boligrafo” (pen).

Patient Reported Outcomes Measurement Information System (PROMIS) Pain Interference Short Form 6a [32, 33]
Spanish v1.0
612Did not understand meaning of “ocio” (leisure).

PROMIS Fatigue 7a Spanish v1.0 [34] 718Did not understand meaning of “extenuación” (exhaustion).

PROMIS Depression 8a Spanish v1.0 [35] 812None reported or observed.

Expanded Prostate Cancer Index Composite for Clinical Practice [36] (EPIC-CP)166Did not understand meaning of “almohadilla” (supposed to mean pad).
The word “pad” does not have to be repeated in the response options since it was already in the question.
Did not understand that men with prostate cancer could have these symptoms.
Thought that “flujo” meant infection, not flow.
Confused about the difference in response options (very small, small, moderate, or big problem).
Confused about whether “funcion sexual” included both functional aspect and sexual desire.

EPIC-CP (revised translation) 169Preferred the word “pañales” (diapers) rather than “protectores” (protectors).
Did not understand meaning of “defecar” (bowel movement); preferred the word “evacuar.”
Spanish slang terms for reaching orgasm (“venirse” or “acabar”), included in parentheses to assist low literacy readers, were offensive.
Found the new word for flow (“chorrito”) appropriate.

Symptom Distress Scale [37] (SDS) Southwest Oncology Group Spanish version1314Difficulty with similarity of the answer sets.
Difficulty formulating response for insomnia (some with aches and pains keeping them up; they took a sleep aid to fall asleep).
Not possible to be worried and not afraid.

Patient Health Questionnaire-Nine Symptom Checklist [38, 39] (PHQ-9) Spanish for USA918Difficulty understanding question and answers.
Difficulty understanding either/or questions (e.g., trouble falling or staying asleep or sleeping too much); thought they should be asked individually.

Religion/Spirituality Questionnaire412None reported or observed.

Skin Problems Questionnaire15None reported or observed.