Shunmugasundaram Chindhu, Dhillon Haryana M, Butow Phyllis N, Sundaresan Puma, Chittem Mahati, Akula Niveditha, Veeraiah Surendran, Rutherford Claudia
Faculty of Science, School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making, The University of Sydney, Sydney, New South Wales, Australia.
Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, New South Wales, Australia.
J Patient Rep Outcomes. 2021 Jun 7;5(1):44. doi: 10.1186/s41687-021-00316-y.
Head and neck cancers (HNC) are one of the most traumatic forms of cancer because they affect essential aspects of life such as speech, swallowing, eating and disfigurement. HNCs are common in India, with over 100,000 cases being registered each year. HNC and treatment are both associated with considerable anxiety and depression. With increasing multinational research, no suitable measures in Indian languages are available to assess anxiety and depression in Indian HNC patients. This study evaluated the psychometric properties of cross-culturally adapted versions of Zung's self-rating Anxiety Scale (SAS) and the Patient health questionnaire - 9 (PHQ-9) in Tamil, Telugu and Hindi speaking Indian HNC populations.
HNC patients were recruited from three tertiary cancer centres in India. Patients completed the cross-culturally adapted versions of SAS and PHQ-9. We assessed targeting, scaling assumptions, construct validity (exploratory and confirmatory factor analyses), convergent validity, and internal consistency reliability.
The study sample included 205 Tamil, 216 Telugu and 200 Hindi speaking HNC patients. Exploratory and confirmatory factor analyses indicated a two-factor solution for PHQ-9 and four-factor solution for SAS in all three languages. Cronbach's alpha coefficients ranged between 0.717 and 0.890 for PHQ-9 and between 0.803 and 0.868 for SAS, indicating good reliability. Correlations between hypothesized scales were as expected providing evidence towards convergent validity.
This first psychometric evaluation of the measurement properties of Tamil, Telugu and Hindi versions of the SAS and PHQ-9 in large, Indian HNC populations supported their use as severity and outcome measures across the disease and treatment continuum.
头颈癌（HNC）是最具创伤性的癌症形式之一，因为它们会影响生活的重要方面，如言语、吞咽、进食和容貌损毁。头颈癌在印度很常见，每年登记的病例超过10万例。头颈癌及其治疗都与相当程度的焦虑和抑郁相关。随着跨国研究的增加，没有适合印度语言的措施可用于评估印度头颈癌患者的焦虑和抑郁。本研究评估了在说泰米尔语、泰卢固语和印地语的印度头颈癌人群中，经过跨文化改编的zung自评焦虑量表（SAS）和患者健康问卷-9（PHQ-9）的心理测量特性。
从印度的三个三级癌症中心招募头颈癌患者。患者完成了经过跨文化改编的SAS和PHQ-9版本。我们评估了针对性、量表假设、结构效度（探索性和验证性因素分析）、收敛效度和内部一致性信度。
研究样本包括205名说泰米尔语、216名说泰卢固语和200名说印地语的头颈癌患者。探索性和验证性因素分析表明，在所有三种语言中，PHQ-9为两因素解决方案，SAS为四因素解决方案。PHQ-9的Cronbach's alpha系数在0.717至0.890之间，SAS的在0.803至0.868之间，表明信度良好。假设量表之间的相关性符合预期，为收敛效度提供了证据。
这项对SAS和PHQ-9的泰米尔语、泰卢固语和印地语版本在大量印度头颈癌人群中的测量特性进行的首次心理测量评估，支持将它们用作疾病和治疗连续过程中的严重程度和结果测量工具。
