Translation and Validation of the Chinese Version of the BCPT Eight Symptom Scale (BESS) in Patients with Breast Cancer

Overview

Journal Asia Pac J Oncol Nurs

Publisher Elsevier

Date 2024 May 23

PMID 38779179

Authors

Yi Kuang

Feng Jing

Lichen Tang

Jiajia Qiu

Weijie Xing

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to translate the Breast Cancer Prevention Trial Eight Symptom Scale (BESS) into Chinese and subsequently examine the latent constructs and psychometric properties of the Chinese BESS (C-BESS) among patients with breast cancer.

Methods: In Phase 1, the BESS was translated from English into Chinese using the FACIT translation method. An expert panel was convened to assess the content validity, and pilot testing was performed with 20 patients with breast cancer. In Phase 2, a total of 427 patients with breast cancer from four Grade-A public hospitals in China were recruited to examine psychometric properties of the C-BESS. The internal consistency was evaluated based on the Cronbach's α, and the construct validity was tested using confirmatory factor analysis, convergent validity, and discriminant validity.

Results: The C-BESS demonstrated satisfactory content validity index (item-level content validity index [I-CVI]: 0.8-1.0; scale-level content validity index [S-CVI]: 0.97). The Cronbach's α value for the entire C-BESS scale was 0.92. Confirmatory factor analysis indicated that eight-factor structure of the C-BESS was a good fit to the data (CFI = 0.959, AGFI = 0.904, RMSEA = 0.05, RMR = 0.029). The scale exhibited good convergent validity and discriminant validity.

Conclusions: This study translated and validated the C-BESS for use in the Chinese population. The results demonstrate that the C-BESS exhibits good reliability and validity, with ideal psychometric properties for assessing the symptom burden in Chinese patients with breast cancer. This tool can be effectively integrated into the routine symptom monitoring of patients with breast cancer in China, helping Chinese clinical professionals in conducting comprehensive assessments of symptom burden.

References

Eremenco S, Cella D, Arnold B . A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Eval Health Prof. 2005; 28(2):212-32. DOI: 10.1177/0163278705275342. View

Cleeland C, Mendoza T, Wang X, Chou C, Harle M, Morrissey M . Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer. 2000; 89(7):1634-46. DOI: 10.1002/1097-0142(20001001)89:7<1634::aid-cncr29>3.0.co;2-v. View

Cheng A, Liu X, Kwok C, Chung R, Zeng Y, Feuerstein M . Chinese translation of a measure of symptom burden, functional limitations, lifestyle, and health care-seeking skills in breast cancer survivors: the Cancer Survivor Profile. J Cancer Surviv. 2019; 13(1):130-147. DOI: 10.1007/s11764-019-0733-0. View

Brady M, Cella D, Mo F, Bonomi A, Tulsky D, Lloyd S . Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol. 1997; 15(3):974-86. DOI: 10.1200/JCO.1997.15.3.974. View

Tsai C, Tsai P, Liu C, Lin Y, Ling Y, Tseng I . Psychometric Evaluation of the Chinese Breast Cancer Prevention Trial Symptom Scale. Cancer Nurs. 2017; 41(4):E18-E30. DOI: 10.1097/NCC.0000000000000499. View

Chen R, Yang S, Xu Z, Peng M, Chen M, Wang Q . Validation and Application of the Chinese Version of the M. D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI-C). J Pain Symptom Manage. 2019; 57(4):820-827. DOI: 10.1016/j.jpainsymman.2019.01.007. View

Williams P, Ducey K, Sears A, Williams A, Bunde P . Treatment type and symptom severity among oncology patients by self-report. Int J Nurs Stud. 2001; 38(3):359-67. DOI: 10.1016/s0020-7489(00)00067-5. View

de Haes J, van Knippenberg F, Neijt J . Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist. Br J Cancer. 1990; 62(6):1034-8. PMC: 1971567. DOI: 10.1038/bjc.1990.434. View

Yan T, Zheng W, Wang D, Zhang W . Cultural adaptation and validation of the Survivor Unmet Needs Survey Short-Form among cancer patients in China. Nurs Open. 2021; 8(3):1098-1107. PMC: 8046061. DOI: 10.1002/nop2.720. View

10.

Fu M, McDaniel R, Rhodes V . Measuring symptom occurrence and symptom distress: development of the symptom experience index. J Adv Nurs. 2007; 59(6):623-34. DOI: 10.1111/j.1365-2648.2007.04335.x. View

11.

Montazeri A . Health-related quality of life in breast cancer patients: a bibliographic review of the literature from 1974 to 2007. J Exp Clin Cancer Res. 2008; 27:32. PMC: 2543010. DOI: 10.1186/1756-9966-27-32. View

12.

Hamer J, McDonald R, Zhang L, Verma S, Leahey A, Ecclestone C . Quality of life (QOL) and symptom burden (SB) in patients with breast cancer. Support Care Cancer. 2016; 25(2):409-419. DOI: 10.1007/s00520-016-3417-6. View

13.

Alfano C, McGregor B, Kuniyuki A, Reeve B, Bowen D, Baumgartner K . Psychometric properties of a tool for measuring hormone-related symptoms in breast cancer survivors. Psychooncology. 2006; 15(11):985-1000. PMC: 2996243. DOI: 10.1002/pon.1033. View

14.

Bentler P . Comparative fit indexes in structural models. Psychol Bull. 1990; 107(2):238-46. DOI: 10.1037/0033-2909.107.2.238. View

15.

Portenoy R, Thaler H, Kornblith A, Lepore J, Kiyasu E, Sobel K . The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer. 1994; 30A(9):1326-36. DOI: 10.1016/0959-8049(94)90182-1. View

16.

Whisenant M, Williams L, Mendoza T, Cleeland C, Chen T, Fisch M . Identification of Breast Cancer Survivors With High Symptom Burden. Cancer Nurs. 2021; 45(4):253-261. PMC: 8964827. DOI: 10.1097/NCC.0000000000001019. View

17.

Ganz P, Day R, Ware Jr J, Redmond C, Fisher B . Base-line quality-of-life assessment in the National Surgical Adjuvant Breast and Bowel Project Breast Cancer Prevention Trial. J Natl Cancer Inst. 1995; 87(18):1372-82. DOI: 10.1093/jnci/87.18.1372. View

18.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

19.

Stanton A, Bernaards C, Ganz P . The BCPT symptom scales: a measure of physical symptoms for women diagnosed with or at risk for breast cancer. J Natl Cancer Inst. 2005; 97(6):448-56. DOI: 10.1093/jnci/dji069. View

20.

Erdemsoy Karahan B, Izgu N . Impact of symptom burden and self-efficacy on functional status in advanced breast cancer patients: A path analysis. Nurs Health Sci. 2023; 25(3):354-364. DOI: 10.1111/nhs.13033. View