Localization,Revision And Application Of The Chemotherapy-induced Alopecia Distress Scale In Patients With Breast Cancer

BackgroundAlopecia is a common side effect of chemotherapy in patients with breast cancer,which will bring physical discomfort and serious emotional trauma to patients.At present,a single tool for measuring the degree of alopecia is often used to evaluate chemotherapy-induced alopecia,which can not fully reflect the psychological distress caused by chemotherapy-induced alopecia.After a systematic literature review,we found that the Chemotherapy-induced Alopecia Distress Scale(CADS)is the only existing tool specifically targeted at chemotherapy-induced alopecia.The CADS scale was originally developed by Cho and other scholars in 2014.It can be used to evaluate the degree of distress caused by chemotherapy-induced alopecia in breast cancer patients with good reliability and validity.Purpose1.To translate the CADS into Chinese and evaluate the psychometric properties of the Chinese version of CADS(CADS-C)in breast cancer patients.2.To investigate the the current situation and influencing factors of chemotherapy alopecia distress in breast cancer patients undergoing chemotherapy with the revised scale.3.To understand the current situation of body image and quality of life in patients with breast cancer.4.To explore the relationship and mechanism among chemotherapy-induced alopecia distress,body image and quality of life in patients with breast cancer.Methods1.After obtaining the permission and authorization of the original author,the reliability and validity of the scale were tested to form a revised Chinese version of CADS.2.295 breast cancer patients undergoing chemotherapy from the breast department of a tertiary comprehensive hospital in Guangzhou were surveyed by convenient sampling method using demographic questionnaire,Chemotherapy-induced Alopecia Distress Scale,Body Image Scale(BIS)and Quality of Life Scale of Breast Cancer(QLQ-BR23).Results1.There are 15 items in the revised Chinese version of CADS,and the content validity index(S-CVI)of the scale is 0.94.Exploratory factor analysis extracted three common factors,which explained 65.4%of the variation,and verified by confirmatory factor analysis,the comparative fit index of the model was 0.84.The Cronbach's a coefficient of the total scale was 0.90.the Cronbach's a coefficient of each dimension was 0.81-0.89,and the test-retest reliability was 0.89.2.The score of chemotherapy-induced alopecia distress in patients with breast cancer was(25.45±7.45).The results of multiple linear regression analysis showed that religious belief and different degree of hair loss were the related factors of chemotherapy-induced alopecia distress in patients with breast cancer.3.The score of chemotherapy-induced alopecia distress was positively correlated with the score of quality of life(?=0.479,P<0.001)and body image(?=0.773,P<0.001),and the score of body image was positively correlated with the score of quality of life(?=0.527,P<0.001).Body image played a partial intermediary role between chemotherapy-induced alopecia distress and quality of life,and the intermediary effect accounted for 45.94%of the total effect.Conclusions1.The reliability and validity of the Chinese version of the CADS were acceptable to the analysis of psychological characteristics.This brief and useful tool can be applied to measure the distress caused by chemotherapy-induced alopecia,it also provides the basis for medical staff to understand the psychological status of patients and provide tailor-made supportive help to patients.2.The degree of chemotherapy-induced alopecia distress of breast cancer patients in China is relatively high.Religious belief and different degrees of hair loss are the main factors affecting the degree of chemotherapy-induced alopecia distress of breast cancer patients.Therefore,medical staff should comprehensively grasp the factors affecting chemotherapy-induced alopecia distress of breast cancer patients,and take targeted measures to reduce the chemotherapy-induced alopecia distress of breast cancer patients.3.The status of body image and quality of life of breast cancer patients undergoing chemotherapy in China still need to be improved.chemotherapy-induced alopecia distress can directly affect the quality of life of patients with breast cancer,and it can also indirectly affect the quality of life of breast cancer patients through body image.Therefore,targeted nursing measures can be taken to reduce the chemotherapy-induced alopecia distress and improve the level of body image of patients to improve the quality of life of patients with breast cancer.