Nejmi Mati, Wang Xin Shelley, Mendoza Tito R, Gning Ibrahima, Cleeland Charles S
Départment d'Anesthésiologie et de Traitment de la Douleur, Institut National d'Oncologie, Rabat, Morocco.
J Pain Symptom Manage. 2010 Jul;40(1):75-86. doi: 10.1016/j.jpainsymman.2009.12.007.
Little is known about symptom burden-a concept encompassing both symptom severity and the degree of symptom interference with daily living-in patients with cancer in Morocco or other countries with Arabic-speaking populations.
The goal of this study was to psychometrically validate the Arabic version of the M. D. Anderson Symptom Inventory (MDASI-A), a tool for measuring multiple symptoms in patients with cancer, and to test its utility in a sample of patients with late-stage cancer in Morocco.
The MDASI-A was developed by standard forward-backward translation of the English MDASI. We used nonidiomatic Arabic in the MDASI-A to enhance its possible usefulness for all Arabic-speaking patients with cancer. One hundred sixty-five Arabic-speaking patients with various cancer types were recruited from a city hospital in Rabat, Morocco. The MDASI-A was administered by interview, as only 5% of the patients had a high school education.
Psychometric analysis demonstrated acceptable internal consistency, with Cronbach alpha values of 0.85 for all 19 items, 0.78 for symptom severity items, and 0.79 for interference items; known-group validity was demonstrated by significant differences in mean symptom severity and interference between patients with good vs. poor performance status. All patients had moderate to severe pain and were taking pain medications. Additional severe symptoms included fatigue, lack of appetite, and disturbed sleep. Patients with gastrointestinal or gynecological cancer reported relatively more symptom severity than patients with breast or lung cancer. Poor performance status, male gender, and current infection were significant predictors of high symptom interference (R(2)=0.48, P<0.05).
The MDASI-A is a valid and reliable patient-reported outcome instrument that can be used to assess Moroccan Arabic-speaking cancer patients' multiple symptoms. Its utility for use in other Arab countries needs to be tested.
在摩洛哥或其他讲阿拉伯语的国家，对于癌症患者的症状负担（一个涵盖症状严重程度和症状对日常生活干扰程度的概念）知之甚少。
本研究的目的是对MD安德森症状量表阿拉伯语版（MDASI-A）进行心理测量学验证，MDASI-A是一种用于测量癌症患者多种症状的工具，并在摩洛哥的晚期癌症患者样本中测试其效用。
MDASI-A通过对英文MDASI进行标准的前后向翻译而开发。我们在MDASI-A中使用了非惯用阿拉伯语，以增强其对所有讲阿拉伯语的癌症患者的潜在实用性。从摩洛哥拉巴特的一家城市医院招募了165名讲阿拉伯语的患有各种癌症类型的患者。由于只有5%的患者接受过高中教育，因此通过访谈方式实施MDASI-A。
心理测量学分析显示内部一致性可接受，所有19个项目的克朗巴赫α值为0.85，症状严重程度项目为0.78，干扰项目为0.79；已知组效度通过功能状态良好与较差的患者在平均症状严重程度和干扰方面的显著差异得到证明。所有患者都有中度至重度疼痛，并正在服用止痛药物。其他严重症状包括疲劳、食欲不振和睡眠障碍。胃肠道或妇科癌症患者报告的症状严重程度相对高于乳腺癌或肺癌患者。功能状态差、男性和当前感染是高症状干扰的显著预测因素（R² = 0.48，P < 0.05）。
MDASI-A是一种有效且可靠的患者报告结局工具，可用于评估讲摩洛哥阿拉伯语的癌症患者的多种症状。其在其他阿拉伯国家的效用需要进行测试。
