Chinese version of the M. D. Anderson Symptom Inventory: Validation and application of symptom measurement in cancer patients

Division of Internal Medicine, Department of Symptom Research, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer (Impact Factor: 4.89). 11/2004; 101(8):1890-901. DOI: 10.1002/cncr.20448
Source: PubMed


Symptom management is an essential component of cancer treatment for patients of every culture and nationality. Symptom assessment depends on subjective reporting, mandating linguistically equivalent versions of symptom assessment scales. Because disease-related and treatment-related symptoms most often occur in clusters, there is a global need for a standardized multiple-symptom assessment tool.
The authors sought to validate the Chinese version of the M. D. Anderson Symptom Inventory (MDASI-C) by enrolling patients who had received various diagnoses of and different types of treatment for cancer (n = 249) in a cross-sectional symptom study conducted at an urban cancer center in China.
Factor analysis identified 2 underlying constructs, general symptoms and gastrointestinal symptoms, which had Cronbach alpha coefficients of 0.86 and 0.84, respectively. These results were consistent with English- and Japanese-language MDASI validation studies. Known-group validity was supported by the MDASI-C's ability to detect significant differences in symptom and interference levels according to Eastern Cooperative Oncology Group performance status (ECOG PS; P < 0.001) and chemotherapy status (P < 0.05). Fifty-five percent of the study cohort had > or = 1 symptom that was considered severe (score > or = 7 on a 0-10 scale). ECOG PS was strongly associated with symptom burden (total interference score: R(2) = 0.26; P < 0.001). Fatigue, sadness, drowsiness, and lack of appetite accounted for most of the variability in the total interference score (R(2) = 0.49; P < 0.05).
The authors demonstrated that the MDASI-C is a valid, reliable, and concise tool for measuring symptom severity and interference with functioning in Chinese cancer patients.

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    • "This instrument consists of an 18-item symptom scale and a 6-item interference scale. The reliability and validity of both the original version and the Chinese version have been demonstrated previously (Ye and Xu, 1993; Wang et al., 2004). The symptom scale scores the severity of each symptom in the previous 24 h, from 0 ( " Not at all " ) to 10 ( " I can't imagine it being any worse " ). "
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    ABSTRACT: Purpose To explore the influence of self-efficacy and demographic, disease-related, and psychological factors on symptom distress among Chinese colorectal cancer patients receiving postoperative adjuvant chemotherapy. Methods Two-hundred and fifty-two colorectal cancer patients who had undergone postoperative adjuvant chemotherapy completed Chinese versions of M. D. Anderson Symptom Inventory (MDASI-GI), Stanford Inventory of Cancer Patient Adjustment (SICPA), and Hospital Anxiety and Depression Scale (HADS). Associations between patients' self-efficacy and demographic, disease-related, psychological factors and symptom distress were examined. Results Patients' overall symptom distress level was mild; MDASI median subscale scores showed mild symptom severity and symptom interference. Anxiety and depression were positively associated with symptom distress. Multivariable analysis showed that more severe symptoms were associated with age ≥60 years, female gender, suburban residence, body mass index <18.5, and stage III cancer. Age ≥60 years, female gender, marital status of single or divorced, and suburban residence were associated with greater symptom interference with daily activities. Greater self-efficacy was associated with milder symptoms severity and less symptom interference with daily life. After adjusting for confounders, patients with higher SICPA scores had less symptom distress. Conclusions Self-efficacy is strongly associated with reduced symptom severity and symptom interference with daily life in CRC patients. Symptom severity is associated with age >60 years, female gender, body mass index <18.5, suburban residence and stage III disease. Nurse-administered self-efficacy interventions may help to improve self-efficacy and reduce symptom distress.
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    • "Evaluation of QOL was performed using the MD Anderson Symptom Inventory (MDASI; Cleeland et al, 2000; Wang et al, 2004) and Functional Assessment of Cancer Therapy (FACT; Cella et al, 1993; Yu et al, 2000) pretreatment and then after every 8 weeks thereafter while on study. A TCM diagnosis was made at the study entry as part of the clinical trial but was not used to determine treatment randomisation. "
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    ABSTRACT: Symptoms other than their primary disease can interfere in the lives of terminal cancer patients. We sought to identify which of these symptoms is most important. We administered a questionnaire, including the M.D. Anderson Symptom Inventory (MDASI), to 142 terminal cancer patients at the National Cancer Center, Korea. The validity of the MDASI was tested by principal-axis factor analysis and Cronbach's alpha coefficient. Stepwise multiple regression analysis was used to determine the symptoms that interfered most in terminal cancer patients' lives. Factor analysis showed that it was composed of two factors (symptom and interference scales). Cronbach's alpha coefficients of symptom and interference scales were each >0.70. The patients had an average of 11 of 13 symptoms of the MDASI. Pain was the most common and severe, followed by feelings of distress and fatigue. Fatigue was the most highly correlated with interference sum. In stepwise multiple regression analysis, the most interfering symptom was fatigue. Although pain was the most common and severe symptom, fatigue was the most important symptom interfering in the lives of terminal cancer patients. In treating terminal cancer patients, healthcare providers should actively intervene to reduce both fatigue and pain.
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