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Cancer, heart failure, instrument validation, symptom assessment



  1. Chair, Sek Ying PhD, RN


Purpose: The purpose of the study was to translate the M.D. Anderson Symptom Inventory-Heart Failure (MDASI-HF), a specific instrument to assess symptoms in cancer patients with concurrent heart failure (HF), into Mandarin Chinese and to examine its psychometric properties in Chinese cancer patients.


Design: A translation and psychometric evaluation design was used.


Methods: The translation of the MDASI-HF into Mandarin Chinese followed Brislin's model with the four steps: translation, monolingual assessment, backward translation, and comparison. The Chinese version MDASI-HF was tested among 135 cancer patients with concurrent HF from a cancer hospital in Tianjin, China. Psychometric properties of content validity, internal consistency, test- retest reliability, concurrent validity, and sensitivity of the instrument were evaluated.


Findings: The Cronbach's [alpha] was .913 for the core items, .835 for the HF items, and .897 for the interference items. The test-retest reliability was satisfactory with intraclass coefficients > .9 and content validity index was .94. The Chinese version MDASI-HF was significantly correlated with the Eastern Cooperative Oncology Group performance grade (correlation coefficients .456-.600) and the New York Heart Association classification (correlation coefficients .477-.631), indicating the established concurrent validity of the translated instrument.


Conclusions: The Chinese version MDASI-HF is a valid and reliable instrument to assess the symptoms of Chinese cancer patients with concurrent HF.


Clinical Relevance: Symptom assessment and management play important roles in cancer rehabilitation. The Chinese version MDASI-HF can assist appropriate and timely symptom assessment in cancer patients with concurrent HF and can promote communication between healthcare professionals and patients. On the basis of the assessment, the rehabilitation team could provide effective symptom management, evaluate the effectiveness of interventions, and improve patients' quality of life.