Development And Application Of The Chinese Version Of The Cancer Distress Scales For Adolescent And Young Adults

[Objective]1.Introduced and revised the Cancer Distress Scales for Adolescent and Young Adults(CDS-AYA)developed by McMaster University of Canada,and conducted cross-cultural debugging to construct the Chinese version of the Cancer Distress Scales for Adolescent and Young Adults.2.The psychometric indicators of the Chinese version of Cancer Distress Scales for Adolescent and Young Adults(CDS-AYA)were analyzed to preliminarily verify the applicability of the scale in young cancer patients in China.3.The Cancer Distress Scales for Adolescent and Young Adults(CDS-AYA)was used to investigate the status of psychological pain of young cancer patients,analyze related influencing factors,and explore its correlation with social support and quality of life.[Methods]1.In the stage of the introduction of the scale,a research group was established for the localization of the scale.Members of the group strictly followed the FACIT translation model to construct the Chinese version of the Cancer Distress Scales for Adolescent and Young Adults.Then,young cancer patients from April 2020 to September 2020 were selected from two level-A hospitals and one community hospital in Jiangsu Province.Adolescent and young patients were selected to fill in questionnaires including a general data questionnaire,Distress Thermometer(DT),the Cancer Distress Scales for Adolescent and Young Adults(CDS-AYA),and the Hospital Anxiety and Depression Scale(HADS)to assess the reliability and validity of the scale.The Chinese version of CDS-AYA was screened by item analysis method.The validity of the Chinese version of CDS-AYA was evaluated by exploratory factor analysis,confirmatory factor analysis,content validity and convergence validity.The reliability of the Chinese version of CDS-AYA was evaluated by internal consistency reliability and retest-reliability.2.In the application stage of the Chinese version of the Cancer Distress Scales for Adolescent and Young Adults.Young cancer patients were selected from two level-A hospitals and one community hospital in Jiangsu province from September 2020 to February 2021 by convenience sampling method.The general data questionnaire,the revised Chinese version of the Psychological Pain Scale for Young Cancer Patients,the Social Support Rating Scale(SSRS)and the European Organization for Research and Treatment of Cancer QLQ-C30(EORTC QLQ-C30)were used to investigate the patients and analyze the results.[Results]1.The revised Chinese version of CDS-AYA contains 6 dimensions and a total of 50 items.The CR value of each item in the scale ranges from 5.992～28.453,and the correlation coefficient between each item ranges from 0.428～0.778(except the two items that have been deleted).I-CVI was 0.83～1.00,S-CVI/AVE was 0.988;Six common factors were extracted by exploratory factor analysis that could explain 70.079%of the total difference quantity.And the results of confirmatory factor analysis showed that χ2/df was 2.886,RMSEA was 0.082,and AGFI was 0.624,which reached the model adaptation standard.The total Cronbach’s α of the scale was 0.971,the Cronbach’s a of each dimension was 0.892-0.962,and the retest reliability was 0.963.2.The psychological distress score of young cancer patients was(43.26±22.91).Multiple linear regression analysis showed that the average monthly income of family,pathological stage,treatment method and VAS pain score were the influencing factors of psychological pain degree.The scores of psychological distress and quality of life in young cancer patients(β=-0.479,P<0.001)and social support scores(β=0.773,P<0.001)was negatively correlated,quality of life scores was positively correlated with social support scores(β=0.527,P<0.001).[Conclusion]1.In this study,through the introduction and Chinese revision of CDS-AYA,a revised Chinese version of CDS-AYA with good reliability and validity was initially formed.All the indicators of CDS-AYA met the psychometrics requirements of the scale,which could be applied to the assessment of psychological distress of young cancer patients.The introduction and revision of the scale can assist medical personnel to quickly screen the psychological status of young patients,and provide a basis for timely and accurate targeted intervention measures.2.Young cancer patients have a higher degree of psychological pain.Family financial situation,pathological stage of tumor,treatment methods and VAS pain score are important factors affecting the degree of psychological pain of patients.It is suggested that medical personnel should provide personalized support and psychological intervention for young patients with different pathological stages and treatment methods,so as to improve the quality of life of young cancer patients.