The Cross-cultural Adaptation And Application Of Death And Dying Distress Scale For Advanced Cancer Patients

Objectives To translate the Death and Dying Distress Scale into Chinese and evaluate the reliability and validity of Chinese version of DADDS for advanced cancer patients.Methods Agreed by the scale author Lo C,according to the guide of intercultural adaptation process,we carried out positive translation on the scale,comprehensive,back translation,expert evaluation,preliminary investigation to develop the Chinese version of DADDS.First phase,we carried out a preliminary test using the convenience sampling method in one hospital for tumor specialized subject in anhui province.The preliminary test sample was 30 advanced cancer patients and we formed the Chinese clinical testing version of DADDS.From June 2016 to November 2016,134 advanced cancer patients were recruited and completed the Chinese version DADDS clinical testing version.Project-analysis were conducted for the evaluation of items,experts evaluation to assess content validity and construct validity was assessed by principal component factor analysis and parallel analysis.Second phase,,108 patients with advanced cancer were recruited for preliminary application of Chinese version of DADDS.Results(1)The CVI value of Chinese version of DADDS is between 0.875-1.000,S-CVI/Ave is0.983;(2)The difference between high and low score groups were statistically significant(P < 0.05),indicating good identification;(3)construct validity was assessed by exploratory factor analysis,and the results showed that the number of factor is 2,which eigenvalue is greater than 1,and cumulative variance contribution rate is 72.331%.After the largest orthogonal rotation factor loading matrix,we found a phenomenon that factor across of items 4,6,7,8,9 and 11.The parallel analysis results show that the number of factors is 1,so the best scale construct is single factor.We carried out fixed single factor extraction.When the original number of scale factor is one,eigenvalue value is 9.704,the variance contribution rate is 64.694% and the loading factor is 0.731 to 0.857.(4)Internal consistency reliability is 0.960,and a half reliability is 0.898 and retest reliability is 0.810.(5)The total score of death anxiety level of advanced cancer patients was 40.68±16.74(0-69).The top 2 items of the Chinese Version of DADDS is8 and 9.(6)According to the results of single factor analysis,different gender,marital status,and presence of religious beliefs of patients with adanced cancer,death anxiety difference was statistically significant,Conclusions The reliability and validity of Chinese version of DADDS is good,and it is suitable for the assessment of death anxiety for advanced cancer patients in China.