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Children with cancer, Chinese parents, Psychological distress, Reliability, Validity



  1. Bu, Xiu-qing MSN, RN
  2. You, Li-ming PhD, RN
  3. Li, Yong PhD
  4. Liu, Ke PhD, RN
  5. Zheng, Jing PhD, RN
  6. Yan, Tie-bin PhD
  7. Chen, Shao-xian PhD
  8. Zhang, Li-feng PhD, RN


Background: The Kessler Psychological Distress Scale (K10) has been widely used in rating psychological distress in general and clinical populations. However, whether it can be used in parents of children with cancer is unknown. Still lacking is the evidence on its reliability and validity in culturally diverse groups.


Objective: The aim of this study was to translate the K10 into Mandarin Chinese and test its psychometric properties (especially the factor structure) of the Chinese version (C-K10) in parents of children with cancer.


Methods: By convenience sampling, 2 samples of parents of children with cancer (sample I, n = 206, and sample II, n = 103) were surveyed in Guangzhou, China. Sample I completed the C-K10, and the internal consistency reliability and exploratory factor analysis of the C-K10 were estimated. Sample II completed the C-K10, the State Subscale of State-Trait Anxiety Inventory, and the Zung Self-rating Depression Scale; confirmatory factor analysis and concurrent validity estimates were completed.


Results: The C-K10 demonstrated strong internal consistency reliability (Cronbach's [alpha] = .93). Both exploratory and confirmatory factor analyses supported a 2-factor structure (ie, anxiety and depression). The concurrent validity was moderate with Pearson correlations greater than 0.50 (P < .001).


Conclusion: The C-K10 demonstrated very acceptable reliability and validity in screening psychological distress in Chinese parents of children with cancer.


Implications for Practice: This study provides evidence that the C-K10 is a valid tool that can be used in clinical settings to screen for psychological distress in Chinese parents of children with cancer.