Assessing cancer-specific anxiety in Chinese men with prostate cancer: psychometric evaluation of the Chinese version of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC)
- 246 Downloads
The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) was developed to identify and assess cancer-specific anxiety among men with prostate cancer (PCa); however, there is no Chinese version. The aim of our study was to translate the English version of MAX-PC into Chinese and evaluate the psychometric properties of it.
The study cohort comprised 254 participants. Internal consistency including the Cronbach’s alpha coefficient and item–total correlations were used to measure the reliability of the scale. Factor structure was analyzed by exploratory factor analysis and concurrent validity by comparing MAX-PC scores with anxiety subscale scores of the Hospital Anxiety and Depression Scale (HADS). Divergent validity was assessed by correlating MAX-PC with HADS depression subscale, while discriminant ability by comparing differences in MAX-PC scores between different patient groups.
The Chinese version of MAX-PC demonstrated good reliability; the Cronbach’s alpha coefficient for the total and three subscales (prostate cancer anxiety, PSA anxiety, and fear of recurrence) being 0.94, 0.93, 0.82, and 0.85, respectively. Exploratory factor analysis supported the three-factor structure of the scale established in the original version. Despite the somewhat underperformed divergent validity, the scale demonstrated good concurrent validity with a strong correlation with the HADS anxiety subscale (r = 0.71, p < 0.01). Moreover, discriminant ability was demonstrated by ability to differentiate between disease stages.
The MAX-PC Chinese version was confirmed to be a valid, reliable instrument and is thus appropriate for identifying and quantifying cancer-specific anxiety in Chinese PCa patients.
KeywordsProstate cancer Cancer-specific anxiety Chinese men Psychometric evaluation
We would like to thank Qiqi Mao, Xiangyi Zheng, Chenjuan Ma, Yuxiang Zhu, Ben Liu, Shaohua Hu for their contributions to translation and culture-adaptation of the scale. We also want to thank all the men with prostate cancer who participated in this study. The work was supported by Medical and Health Research project of Zhejiang province (2014ZDA009).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests.
Human and animal rights
The study was approved by the Ethics Committee of the First Affiliated Hospital, College of Medicine, Zhejiang University
Informed consent was obtained from all individual participants included in the study, and written informed consents were obtained from all the participants.
- 5.Darwish-Yassine M, Berenji M, Wing D, Copeland G, Demers RY, Garlinghouse C, Fagerlin A, Newth GE, Northouse L, Holmes-Rovner M, Rovner D, Sims J, Wei JT (2014) Evaluating long-term patient-centered outcomes following prostate cancer treatment: findings from the Michigan Prostate Cancer Survivor study. J Cancer Surviv 8(1):121–130. doi: 10.1007/s11764-013-0312-8 CrossRefPubMedGoogle Scholar
- 12.Watson E, Shinkins B, Frith E, Neal D, Hamdy F, Walter F, Weller D, Wilkinson C, Faithfull S, Wolstenholme J, Sooriakumaran P, Kastner C, Campbell C, Neal R, Butcher H, Matthews M, Perera R, Rose P (2016) Symptoms, unmet needs, psychological well-being and health status in survivors of prostate cancer: implications for redesigning follow-up. BJU Int 117(6B):E10–E19. doi: 10.1111/bju.13122 CrossRefPubMedGoogle Scholar
- 14.Resnick MJ, Lacchetti C, Bergman J, Hauke RJ, Hoffman KE, Kungel TM, Morgans AK, Penson DF (2015) Prostate Cancer Survivorship Care Guideline: American Society of Clinical Oncology Clinical Practice Guideline Endorsement. J Clin Oncol 33(9):1078–1085. doi: 10.1200/JCO.2014.60.2557 CrossRefPubMedGoogle Scholar
- 15.Choi EP, Wong CK, Tsu JH, Chin WY, Kung K, Wong CK, Yiu MK (2016) Health-related quality of life of Chinese patients with prostate cancer in comparison to general population and other cancer populations. Support Care Cancer 24(4):1849–1856. doi: 10.1007/s00520-015-2980-6 CrossRefPubMedGoogle Scholar
- 16.Saini A, Berruti A, Cracco C, Sguazzotti E, Porpiglia F, Russo L, Bertaglia V, Picci RL, Negro M, Tosco A, Campagna S, Scarpa RM, Dogliotti L, Furlan PM, Ostacoli L (2013) Psychological distress in men with prostate cancer receiving adjuvant androgen-deprivation therapy. Urol Oncol 31(3):352–358. doi: 10.1016/j.urolonc.2011.02.005 CrossRefPubMedGoogle Scholar
- 18.Roth A, Passik S (1996) Anxiety in men with prostate cancer may interfere with effective management of the disease. Prim Care Cancer 16:30–37Google Scholar
- 19.Roth AJ, Rosenfeld B, Kornblith AB, Gibson C, Scher HI, Curley-Smart T, Holland JC, Breitbart W (2003) The memorial anxiety scale for prostate cancer: validation of a new scale to measure anxiety in men with prostate cancer. Cancer 97(11):2910–2918. doi: 10.1002/cncr.11386 CrossRefPubMedGoogle Scholar
- 20.Roth A, Nelson CJ, Rosenfeld B, Warshowski A, O'Shea N, Scher H, Holland JC, Slovin S, Curley-Smart T, Reynolds T, Breitbart W (2006) Assessing anxiety in men with prostate cancer: further data on the reliability and validity of the memorial anxiety scale for prostate cancer (MAX–PC). Psychosomatics 47(4):340–347. doi: 10.1176/appi.psy.47.4.340 CrossRefPubMedGoogle Scholar
- 21.Nelson CJ, Starr TD, Macchia RJ, Hyacinthe L, Friedman S, Roth AJ (2016) Assessing anxiety in black men with prostate cancer: further data on the reliability and validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Support Care Cancer 24(7):2905–2911. doi: 10.1007/s00520-016-3092-7 PubMedPubMedCentralGoogle Scholar
- 23.van den Bergh RC, Korfage IJ, Borsboom GJ, Steyerberg EW, Essink-Bot ML (2009) Prostate cancer-specific anxiety in Dutch patients on active surveillance: validation of the memorial anxiety scale for prostate cancer. Qual Life Res 18(8):1061–1066. doi: 10.1007/s11136-009-9516-9 CrossRefPubMedPubMedCentralGoogle Scholar
- 31.(2012) Ending violence against doctors in China. Lancet 379(9828): 1764. doi: 10.1016/S0140-6736(12)60729-6.
- 33.Tucker JD, Cheng Y, Wong B, Gong N, Nie JB, Zhu W, McLaughlin MM, Xie R, Deng Y, Huang M, Wong WC, Lan P, Liu H, Miao W, Kleinman A, Patient-Physician Trust Project Team (2015) Patient–physician mistrust and violence against physicians in Guangdong Province, China: a qualitative study. BMJ Open 5(10):e008221. doi: 10.1136/bmjopen-2015-008221 CrossRefPubMedPubMedCentralGoogle Scholar