| ObjectiveThis study aimed to perform the translation,cross-cultural adaptation,and initial validation of the Well-being Numerical Rating Scales(WB-NRSs),and explore the association between fear of progression(Fo P),perceived stress,psychological resilience and subjective well-being in patients with chronic diseases.Methods1.Using the Brislin’s back-translation model,the WB-NRSs was translated and back-translated from English to Chinese and finally underwent cross-cultural adaptation.2.From December 2021 to June 2022,a total of 639 patients with chronic diseases and542 community participants were recruited using a convenience sampling method.Participants completed the WB-NRSs-CV,the Single-item Self-report Subjective Well-being Scale(SISRSWBS),the World Health Organization Five-item Well-Being Index(WHO-5),the 10-item Perceived Stress Scale(PSS-10)and the Kessler Psychological Distress Scale(K10).The psychometric properties of the WB-NRSs-CV were evaluated using Classical Test Theory(CTT)and Item Response Theory(IRT).Finally,a multi-group confirmatory factor analysis(MG-CFA)was conducted to examine measurement invariance across gender and age groups.3.From December 2021 to June 2022,639 patients with chronic diseases were conveniently recruited from two tertiary hospitals in Guangzhou.Face-to-face and paper-and-pencil interviewing(PAPI)with structured questionnaires was conducted to collect the data.Participants completed the WB-NRSs-CV,Fear of Progression Questionnaire-Short Form,10-item Perceived Stress Scale and Connor-Davidson Resilience Scale-10 item.Results1.The WB-NRSs-CV was undeleted any item during the process of cross-cultural adaptation,and was composed of 1 dimension and 5 items.2.In CTT analysis,high internal consistency was obtained for both the clinical(Cronbach’s α=0.921)and community(Cronbach’s α=0.939)samples.Test-retest reliability for a four-week interval was also significant(r=0.878,0.885,respectively).WB-NRSs-CV was significantly and positively associated with SISRSWBS and WHO-5,negatively associated with PSS-10 and K10 in both patients sample and community sample,indicating good internal consistency and effectiveness.3.In IRT analysis,the fit for IRT model was adequate,with the discrimination parameters ranging from 2.73 to 3.56 indicating that items have strong discriminatory ability.The difficulty parameters ranged from-3.40 to 1.71 and were evenly spaced along the trait,attesting to the appropriateness of the response categories.4.The results of invariance tests demonstrated that the WB-NRSs-CV did not differ across groups by gender and age,thus,it may be efficiently applied for Chinese subjects of different gender and age group for comparable scores.5.The study revealed a moderately high level of subjective well-being among patients with chronic diseases,which requires prompt attention for improvement.The multiple linear regression analysis revealed that subjective well-being of patients was influenced by several factors,including marital status,level of education,number of chronic diseases,number of medications,level of disability,fear of progression,perceived stress,and psychological resilience(P<0.05).Conclusions1.The WB-NRSs-CV has good reliability and validity in both clinical and nonclinical samples,and it is a useful and practical tool for assessing well-being in Chinese populations.2.Education level,marital status,number of chronic diseases,number of medications,degree of disability,fear of disease progression,perceived stress,and psychological resilience were identified as the key determinants of subjective well-being.Therefore,we should closely monitor patients who have low educational qualifications,are divorced or widowed,suffer from multiple chronic diseases,consume multiple medications,and exhibit mild to moderate dependence.To enhance subjective well-being,personalized intervention approaches considering physical,psychological,social,and spiritual factors is recommended,which may aid in improving psychological resilience and reducing levels of fear of disease progression and perceived stress,thereby increasing subjective well-being. |
