Development of a Multilingual Quality of Life Questionnaire Aligned with the Cultural Sensitivities of Indian Breast Cancer Patients

A bstract Context: Breast cancer (BC) is the leading cancer amongst Indian women, yet outcome assessment tools remain Western-centric. The BREAST-Q and similar instruments overlook cultural, linguistic, financial and spiritual dimensions critical to Indian survivorship. Aim: We aimed to develop and validate a questionnaire, a patient-reported outcome measure (PROM) for Indian patients, tailored to these unique contexts. Settings and Design: This was a multiphased mixed-method study conducted between 2022 and 2025, integrating qualitative and quantitative methods. Materials and Methods: A total of 200 BC survivors were recruited, 100 for pilot and 100 for validation, with equal arms of breast-conserving surgery and mastectomy. Statistical Analysis: Domains were generated from literature review, expert input and patient narratives, then refined through feedback. Psychometric evaluation included data quality, internal consistency, exploratory factor analysis (EFA) and known-group validity. Results: Internal consistency was excellent across domains (Cronbach’s α = 0.87–0.96). EFA confirmed construct validity Kaiser-Meyer-Olkin = 0.802; Bartlett’s P < 0.001, revealing a stable 5-factor model explaining 58% variance. Patients and healthcare workers consistently rated the tool as culturally relevant, clear and practical, with translations validated in 15 Indian and 1 foreign language. Conclusions: The Amrita Sneham Questionnaire is a reliable, valid and culturally resonant PROM for Indian patients. It fills the gaps left by Western instruments and enables holistic survivorship assessment in oncology practice.