Measurement Examination Of Chinese Version Of Pediatric Promis Measures Among Children And Adolescents With Cancer

Patient-reported outcomes（PROs） has been expected more accurate to measuresubjective event like symptoms and it is meaningful for clinical decisions，which has beena hot point in cancer research, especially the PROs of the children and adolescents havebeen focused. Pediatric Patient-Reported Outcomes Measurement InformationSystem（Pediatric PROMIS） as part of PROMIS that funded by National Institute ofHealth（NIH）, were designed to measure symptoms, quality of life and function acrossdiverse pediatric groups. With the grant fund by Oncology Nursing Society Foundationand authorization from PROMIS Statistical Center to translate the pediatric PROMIS shortforms items into Simpliifed Chinese，we cooperated with American Children’s NationalMedical Center to develop the Pediatric PROMIS related to pediatric cancer, so that wecould provide the comparable, reliable and valid instruments system for improvement ofpediatric cancer care, provide evidence for the children to participate the clinical decisionand evaluation of the treatment effect.Objective:（1）Toifnish the translation and cognitive interview with children and adolescents ofPediatric Depressive Symptoms, Anger, Anxiety, Fatigue and Pain Impact, PeerRelationships, Physical Function-Mobility, Physical Function-Upper Extremity ofPediatric PROMIS.（2）To ifnish the measurement examination of Pediatric PROMIS measures amongchildren and adolescents with cancer in China.Methods:（1）TheChinese version of pediatric PROMIS（C-Ped-PROMIS） measures wereestablished by following the standard Functional Assessment of Chronic Illness Therapy（FACIT） translation methodology which included forward translation，reconciliaiton, backtranslation, expert review, proofreading and cognitive interviewing, with the cognitiveinterviewing method，we interviewed10children and adolescents to examine the linguisticvalidity of the pediatric PROMIS measures in children and adolescents in China.（2）Theinvestigation method and instruments were determined Through methods oftheory study and literature review, The instruments were the general informationquestionnaire, C-Ped-PROMIS measures which included the Depressive Symptoms, Anger，Anxiety,Fatigue and Pain Impact，Peer Relationships, Physical Function-Mobility,Physical Function-Upper Extremity eight short forms, the Chinese PedsQL^TM4.0andPedsQL^TM3.0were administered in a cross-sectional design，232children and adolescentswho were aged8-17years in treatment for childhood cancer or in survivorship wereincluded to investigate their symptoms and quality of life. We recruited pediatriconcology patients at four hospitals from Shanghai and Chengdu. The reliabilities andvalidities of the C-Ped-PROMIS measures were examined by using the methods oftwo-sample t-test or nonparametric test, correlation and conifrmatory factor analysis andso on.Results:（1）All the translation procedures were completed by the bilingual team members whohad been taught to strictly follow the FACIT Translation Methodology. Most items had aconsistent translation in the translation process with only minor inconsistencies, withanalyzed the result of cognitive interview,7items were revised for diiffcult understandingor vague words, All the translation procedures and results have been approved by thePROMIS Statistical Center.（2）The analysis of measurement of C-Ped-PROMIS measures showed that there were232children and adolescents with cancer in China were investigated,140boy and92girls,the average age was11.58士3.24; the valid response rate was93.93%，and all the itemswere correlated with their short forms; except Pediatric Anxiety Short Form, the otherseven short forms could distinguish the exist different symptoms and quality of lifebetween children in treatment and in survivorship; Except Peer Relationships, the otherseven short forms had signiifcant correlation with Pediatric Quality of Life Inventory?General Core Module(PedsQL^TM4.0) and Pediatric Quality of Life Inventory? CancerModule (PedsQL^TM3.0); The model ift indices of eight short forms have reached thereference standard which indicated that all of them had good construct validity. Cronbach’sa and Guttman split-half coeiffcients of the scale were between0.744?0.906and0.687⁰.885which implied their good reliabilities, they have achieved the requirements ofpsychometric standard. Conclusion（1） The C-Ped-PROMIS measures were semantically and conceptually equivalent tothe original English version. Children aged8-17years in China were able to comprehendthese measures and express their experience and feelings about illness or their life. Weshould focus on the self-reported health outcomes of children and adolescents, listen totheir voice, then make directive interventions to reduce their suffering and improve theirquality of life.（2） After strict and standard scale metrological test, the C-Ped-PROMIS measures hadgood reliabilities and validities, which as comparable, reliable and valid instrumentssystem can be applied in measurement of symptom and quality of life of children andadolescents with cancer in china and then improve pediatric cancer care.