• Nanfang Xu, Zhehuang Li, Feng Wei, Xiaoguang Liu, Liang Jiang, Na Meng, Ping Jiang, Miao Yu, Fengliang Wu, Lei Dang, Hua Zhou, Yan Li, and Zhongjun Liu.
• Department of Orthopedics, Peking University Third Hospital, Beijing, China.
• J Pain Symptom Manage. 2017 Mar 1; 53 (3): 605-613.

ContextTumors involving the spine are associated with unique symptoms affecting both patient survival and health-related quality of life. Currently, there is no disease-specific instrument in Chinese to assess the symptom burden of these patients.ObjectivesThe objective of this study was to translate and validate a Chinese version of the M.D. Anderson Symptom Inventory-Spine Tumor Module (MDASI-SP-C) to assess the symptom burden of Chinese-speaking patients with spinal tumors.MethodsMDASI-SP-C was forward-and-backward translated according to standard protocols and administered to patients fulfilling study criteria at a major referral center of spine tumor between November 2014 and September 2015. The generic instruments of Short Form 36 Quality of Life Questionnaire (SF-36), Functional Assessment of Cancer Therapy-General Version (FACT-G), and Karnofsky Performance Scale were used along with MDASI-SP-C. Prevalence and severity distribution of each item were analyzed. Psychometric assessment and hierarchical cluster analysis were performed for the translated instrument.ResultsOne hundred forty-two patients were enrolled. High interdependency and relatively low intra-cluster distances were identified. Cronbach's alpha of the entire instrument, the symptom severity subscale, and the interference subscale was 0.93, 0.91, and 0.92, respectively. Principal axis factoring resulted in a four-factor solution, which was reduced to a three-factor (general symptoms, spine-specific symptoms, and gastrointestinal symptoms) solution on account of clinical interpretation. Correlation coefficients between MDASI-SP-C items and their corresponding domains in SF-36 and/or FACT-G were all greater than 0.3. MDASI-SP-C was able to distinguish patients with different Karnofsky Performance Scale levels.ConclusionMDASI-SP-C demonstrated satisfactory psychometric properties and could be used to better assess the symptom burden of Chinese-speaking patients with spine tumors for improved management of their medical needs.Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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