Lam Wendy Wing Tak, Law Chi Ching, Fu Yiu Tung, Wong Kam Hung, Chang Victor T, Fielding Richard
Centre for Psycho-Oncological Research and Teaching, Department of Community Medicine & Unit for Behavioural Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong.
J Pain Symptom Manage. 2008 Dec;36(6):584-95. doi: 10.1016/j.jpainsymman.2007.12.008. Epub 2008 Apr 22.
There are very few symptom assessment instruments in Chinese. We present the validity and reliability of the Memorial Symptom Assessment Scale Short Form (MSAS-SF) and the Condensed Form MSAS (CMSAS) in Chinese cancer patients. The Chinese version of the 32-item MSAS-SF, a self-report measure for assessing symptom distress and frequency in cancer patients, was administered to 256 Chinese patients with colorectal cancer at a clinical oncology outpatient unit. Highly prevalent symptoms included worrying (59%), dry mouth (54%), lack of energy (54%), feeling sad (48%), feeling irritable (48%), and pain (41%). Both the MSAS-SF and CMSAS demonstrated good validity and reliability. For the MSAS-SF subscales, Cronbach alphas ranged from 0.84 to 0.91, and for CMSAS subscales, from 0.79 to 0.87. Moderate-to-high correlations of MSAS-SF and CMSAS subscales with appropriate European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 subscales (0.42-0.71, Ps<0.001) indicated acceptable convergent validity. Low correlations with the Rosenberg Self-Esteem and Optimism Scale (0.22, P<0.001) indicated divergent validity. MSAS subscales varied as expected with other Chinese scales--the Chinese Health Questionnaire (CHQ) and the Life Orientation Scale. Construct validity of both MSAS versions was demonstrated by effective differentiation between clinically distinct patient groups (Karnofsky scores <80% vs. > or =80% [P<0.001]; no active treatment vs. active treatment [P<0.002-0.034]; CHQ-12 scores < or =4 vs. CHQ-12 scores >4 [P<0.001]). The Number of Symptoms subscale correlated appropriately with the EORTC QLQ-C30 function (-0.46 to -0.60, P<0.001) and symptom scales (0.31-0.64, P<0.001). The average time to complete the MSAS-SF was six minutes. The Chinese versions of the MSAS-SF and CMSAS are valid and practical measures. Further validation is needed for Chinese patients with other cancer types and with other symptom instruments.
中文的症状评估工具非常少。我们展示了纪念症状评估量表简表（MSAS-SF）和精简版MSAS（CMSAS）在中国癌症患者中的有效性和可靠性。对一家临床肿瘤门诊的256名中国结直肠癌患者施测了中文版的32项MSAS-SF，这是一种用于评估癌症患者症状困扰和频率的自评工具。高度普遍的症状包括担忧（59%）、口干（54%）、精力不足（54%）、悲伤（48%）、易怒（48%）和疼痛（41%）。MSAS-SF和CMSAS都显示出良好的有效性和可靠性。对于MSAS-SF分量表，克朗巴哈系数在0.84至0.91之间，对于CMSAS分量表，在0.79至0.87之间。MSAS-SF和CMSAS分量表与适当的欧洲癌症研究与治疗组织（EORTC）QLQ-C30分量表有中度到高度的相关性（0.42 - 0.71，P < 0.001），表明具有可接受的收敛效度。与罗森伯格自尊和乐观量表的低相关性（0.22，P < 0.001）表明具有区分效度。MSAS分量表与其他中文量表——中国健康问卷（CHQ）和生活取向量表——的变化符合预期。两个MSAS版本的结构效度通过在临床上不同的患者组之间的有效区分得到证明（卡诺夫斯基评分<80%与≥80%[P < 0.001]；无积极治疗与积极治疗[P < 0.002 - 0.034]；CHQ - 12评分≤4与CHQ - 12评分>4[P < 0.001]）。症状数量分量表与EORTC QLQ-C30功能量表（-0.46至-0.60，P < 0.001）和症状量表（0.31 - 0.64，P < 0.001）有适当的相关性。完成MSAS-SF的平均时间为6分钟。MSAS-SF和CMSAS的中文版是有效且实用的测量工具。对于患有其他癌症类型的中国患者以及使用其他症状评估工具的情况，还需要进一步验证。
