Understanding differential outcome trajectories and associated change in coping resources has implications for developing ongoing psychological services for cancer patients during the diagnosis and treatment process.

There are very few symptom assessment instruments in Chinese. We present the validity and reliability of the Memorial Symptom Assessment Scale Short Form (MSAS-SF) and the Condensed Form MSAS (CMSAS) in Chinese cancer patients. The Chinese version of the 32-item MSAS-SF, a self-report measure for assessing symptom distress and frequency in cancer patients, was administered to 256 Chinese patients with colorectal cancer at a clinical oncology outpatient unit. Highly prevalent symptoms included worrying (59%), dry mouth (54%), lack of energy (54%), feeling sad (48%), feeling irritable (48%), and pain (41%). Both the MSAS-SF and CMSAS demonstrated good validity and reliability. For the MSAS-SF subscales, Cronbach alphas ranged from 0.84 to 0.91, and for CMSAS subscales, from 0.79 to 0.87. Moderate-to-high correlations of MSAS-SF and CMSAS subscales with appropriate European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 subscales (0.42-0.71, Ps<0.001) indicated acceptable convergent validity. Low correlations with the Rosenberg Self-Esteem and Optimism Scale (0.22, P<0.001) indicated divergent validity. MSAS subscales varied as expected with other Chinese scales--the Chinese Health Questionnaire (CHQ) and the Life Orientation Scale. Construct validity of both MSAS versions was demonstrated by effective differentiation between clinically distinct patient groups (Karnofsky scores <80% vs. > or =80% [P<0.001]; no active treatment vs. active treatment [P<0.002-0.034]; CHQ-12 scores < or =4 vs. CHQ-12 scores >4 [P<0.001]). The Number of Symptoms subscale correlated appropriately with the EORTC QLQ-C30 function (-0.46 to -0.60, P<0.001) and symptom scales (0.31-0.64, P<0.001). The average time to complete the MSAS-SF was six minutes. The Chinese versions of the MSAS-SF and CMSAS are valid and practical measures. Further validation is needed for Chinese patients with other cancer types and with other symptom instruments.

Physical symptom distress is one of the commonest correlates of psychological adjustment in cancer patients. Positive affect (PA) can be a dynamic resource for patients to cope with the cancer-related physical demands. The present study examined whether differential patterns of change in PA were associated with anxiety and depressed mood, and whether PA modified the association between change in symptom distress and psychological distress in 215 Chinese people newly diagnosed with colorectal cancer (CRC). Participants completed measures of physical symptoms, PA, and anxiety and depression at diagnosis and again at 3-month follow-up. Multivariate analyses of covariance revealed that at follow-up, people reporting higher anxiety and depressed mood demonstrated loss in PA, whereas those reporting lower depressed mood demonstrated a gain in PA. Structural equation modelling revealed that change in PA significantly mediated and moderated the associations between increased symptom distress and anxiety and depressed mood. We conclude that in line with Hobfoll's conservation of resources theory, continuous physical symptom distress depletes PA of newly diagnosed cancer patients, resulting in higher levels of anxiety and depressed mood. Effectiveness of symptom management intervention could be enhanced by preserving or enhancing PA in patients.

2016-11-03T14:11:40

The Social Relational Quality Scale is a psychometrically sound self-report measure of social relational quality among Chinese CRC patients and needs further validation among other Asian groups.