Localization and validation of Chemotherapy-induced Alopecia Distress Scale for breast cancer

Abstract

Objective To localize the Chemotherapy-induced Alopecia Distress Scale (CADS) for breast cancer and to validate its reliability and validity. Methods Blyth Lin's cross-cultural translation principle was used for localizing and adjusting CADS in Chinese. A total of 190 breast cancer inpatients receiving chemotherapy in He'nan Cancer Hospital between January 2016 and December 2017 were selected by convenient sampling and investigated with CADS and Self-Anxiety Scale (SAS) . The reliability and validity of the Chinese version of CADS was analyzed. A total of 171 valid questionnaires were collected. Results Totally 17 items were reserved for the Chinese version of CADS. The reliability and validity of each item (I-CVI) ranged 0.833-1.000, and that of the Chinese scale (S-CVI) was 0.956. By exploratory factor analysis (EFA) , totally 4 common factors whose characteristic root value was >1 could be extracted from the Chinese version of CADS, whose cumulative variance proportion was 73.4%. The coefficient of correlation of each factor ranged 0.386-0.548, while the coefficient of correlation with the total score ranged 0.713-0.803 (P<0.05) . The area under receiver operating curves (AUC-ROC) was 0.830 (95%CI=0.776-0.883, P<0.01) . When the score of CADS was ≥38.5, the Youden index was the largest, 0.691, whose sensitivity was 0.776 and whose specificity was 0.915. The total Cronbach's α coefficient was 0.963, and the retest coefficient of correlation was 0.768. Conclusions The Chinese version of CADS has sound reliability and validity and applies to the evaluation and screening of alopecia distress for breast cancer patients in China. Key words: Breast neoplasms; Chemotherapy; Alopecia; Distress; Reliability; Validity