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Aim: The aim of this study was to identify unobserved subgroups of Chinese parents' caregiving ability for children with haematological malignancies and examine the associations of the latent class membership with individual characteristics. Design: A multicentre cross‐sectional survey study was conducted. Methods: A total of 392 parents of children with haematological malignancies in China were surveyed with the Hematologic Malignancies' Family Caregiver Skills Scale and a study‐specific demographic information questionnaire. Latent class analysis (LCA) and multinomial logistic regression model were applied in data analysis. Results: LCA results suggested that there existed three distinct a priori unknown classes of parents of children with haematological malignancies in regard to caregiving ability: Class 1—"high caregiving ability" class (n = 131, 33.4%), Class 2—"medium caregiving ability" class (n = 170, 43.4%) and Class 3—"low caregiving ability" class (n = 91, 23.2%). Socio‐demographics and clinical characteristics had significant associations with the latent class membership. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify unobserved distinct latent classes/subgroups of breast cancer (BC) patients in China with respect to various sexual health measures and examine the association of the latent membership with individual characteristics.Methods: In a cross-sectional study, 123 BC patients were analyzed. Their sexual health was measured using the Female Sexual Functioning Index (FSFI). Latent class analysis (LCA) was used to examine the patterns of sexual health in patients. Associations of the latent class membership with individual characteristics were examined using multinomial logistic regression.Results: Three a priori unknown distinct latent classes of patients were identified with respect to the 19 FSFI sexual health measures: 50 patients (41.6%) were classified in class 1 "No Impairment Group," 49 patients (39.4%) in class 2 "Organic Sexual Dysfunction Group," and 24 patients (19.1%) in class 3 "Poor Sexual Health Group." Income and anxiety were positively, whereas disease duration was negatively associated with the likelihood of being in class 2 than in class 1, patients with recurrence of cancer were likely to be in classes 2 and 3. Patients classified in class 3 were more likely to have better prior body image and have more severe menopausal symptoms, whereas less likely to have better post body image and have better partner relationships.Conclusion: The findings revealed the heterogeneity of sexual health among BC patients in China and may guide to identify the high-risk patients and enable early intervention. [ABSTRACT FROM AUTHOR]

Purpose: Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric forms measure symptoms and function of pediatric patients experiencing chronic disease by using the same measures. Comparability is one of the most important purposes of the PROMIS initiative. This study aimed to test the factorial structures of four symptom measures (i.e., Anxiety, Depression, Fatigue, and Pain Interference) in the original English and the Chinese versions and examine the measurement invariance of the measures across two cultures.Methods: Four PROMIS Pediatric measures were used to assess symptoms, respectively, in Chinese (n = 232) and American (n = 200) children and adolescents (8-17 years old) in treatment for cancer or in survivorship. The categorical confirmatory factor analysis (CCFA) model was used to examine factorial structures, and multigroup CCFA was applied to test measurement invariance of these measures between the Chinese and American samples.Results: The CCFA models of the four PROMIS Pediatric symptom measures fit the data well for both the Chinese and American children and adolescents. Minor partial measurement invariance was identified. Factor means and factor variances of the four PROMIS measures were not significantly different between the two populations.Conclusions: Our results provide evidence that the four PROMIS Pediatric symptom measures have valid factorial structures and a statistical property of measurement invariance across American and Chinese children and adolescents with cancer. This means that the items of these measures were interpreted in a conceptually similar manner by two groups. They could be readily used for meaningful cross-cultural comparisons involving pediatric oncology patients in these two countries. [ABSTRACT FROM AUTHOR]

Purpose: The pediatric patient-reported outcomes measurement information system (PROMIS) was developed to provide self-reported item banks and short forms for children and adolescents (aged 8-17 years) experiencing a chronic illness to assess their quality of life and symptoms. The pediatric PROMIS short forms have been translated into Chinese and applied in children with cancer in China. This study aimed to describe psychometric properties of the Anxiety and Depression measures. Methods: A total of 232 children and adolescents with cancer were recruited in hospital-based inpatient and outpatient clinics. Eight Chinese versions of pediatric PROMIS (C-Ped-PROMIS) measures were administered. Categorical confirmatory factor analysis (CCFA) were conducted to evaluate scale dimensionality and item local dependence of the C-Ped-PROMIS Anxiety and Depression items. Multiple indicator multiple cause models were used to analyze differential item functioning (DIF), item response theory parameters were calculated, and test information against T scores was reported for each measure. Results: The results of the CCFA confirmed that both C-Ped-PROMIS Anxiety and Depression scales appropriately measure the theoretical constructs as designed. No significant DIF was found for the items of the two scales according to age and gender. Both scales have high test reliability as long as their T scores are not on the low or high extremes. Conclusions: The pediatric PROMIS Anxiety and Depression measures were developed to provide efficient and flexible assessment of emotional distress domains. Our results provide evidence that the two C-Ped-PROMIS measures can be readily applied to measure anxious and depressive symptoms in Chinese children with cancer. [ABSTRACT FROM AUTHOR]

Abstract: Background: Although the Brief Symptom Inventory-18 (BSI-18) has been widely used for mental health screenings in both clinical and non-clinical populations, the validation of its application to Chinese populations has been very limited. The objective of this research is to assess the factorial structure of the BSI-18 within a Chinese drug using population. Methods and results: A total sample of 303 drug users recruited via Respondent Driven Sampling (RDS) from Changsha, China was used for the study. Our results show: (1) The BSI-18 item scores are highly skewed; (2) With dichotomous items measures (1 – problem at least moderately caused respondent discomfort during the past week; 0 – otherwise), our findings support the designed 3 – factor solution of the BSI-18 (somatization, depression, and anxiety); (3) The BSI-18 has a hierarchical factorial structure with 3 first-order factors and an underlying second-order factor (general psychological distress); (4) Tentative support should also be given to a single dimension of general psychological distress in Chinese drug using populations. Our study recommends a useful alternative approach for evaluating the factorial structure of the BSI-18 – i.e. CFA with dichotomous item measures. Both the total BSI-18 score and the three subscales (SOM, DEP, and ANX) can be used in applications of the BSI-18. Conclusion: Overall, our findings suggest the BSI-18 is useful with Chinese drug users, and shows potential for use with non-Western and substance using populations more generally. [Copyright &y& Elsevier]

The article discusses a study that described the changes in eating attitudes and eating disorders from 2006 to 2008 in a medical student sample in Changsha, China. Self-reported questionnaires were employed to assess the changes. It is said that male students kept lower distorted eating attitudes and behaviours compared to female students. The study showed that females had higher eating disorders and distorted eating attitudes compared to males in 2006 and 2008.

Background Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target. Methods A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC). Results Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (−0.19, p = 0.038) and PC (−0.31, p < 0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p < 0.001) and NSS (0.25, p = 0.010). Drug treatment experiences related to AP (0.20, p = 0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status. Conclusions Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment. [ABSTRACT FROM AUTHOR]

Abstract: Drug treatment services of varying types have been scaled up in China over the past decade. Yet, barriers to treatment remain among the population of drug users in China. In this paper, we use a person-centered approach to examine external barriers to drug treatment among a sample of Chinese drug users. Specifically, we used a latent class analysis to determine a typology of external barriers to treatment among a sample of 262 drug users. The results of the analyses suggest three-classes of drug users with respect to their perceptions of external barriers to treatment – Major Barriers, Low Barriers, and Systems-level Barriers – indicating that drug users are a heterogeneous population on this matter. Age and types of drugs used were predictors of class membership. In this regard, different tactics must be utilized in order to successfully reach this wide ranging group of individuals. [Copyright &y& Elsevier]

Aims: To identify unobserved body composition patterns among Chinese women with breast diseases using latent class analysis (LCA) and to examine the relationship between body composition patterns and breast cancer (BC) risk., Design: A descriptive, cross-sectional study., Methods: Female patients (N = 1816) with breast diseases were included in the study from April 2016 - March 2017. Body composition measures were done by the bioelectrical impedance analysis. The LCA models were estimated using Mplus 8.1., Results: Four latent classes were identified based on water, protein, minerals and body fat mass: Class 1 - Low Muscle Mass class; Class 2 - High Body Composition class; Class 3 - High Fat class; and Class 4 - Normal Body Composition Class. Classes 2 and 3 are higher risk classes for developing BC compared with the other two classes (p < 0.05). Overall, age is positively associated with the odds of BC development (p < 0.001). However, age effect depends on the body composition patterns. Age effect on the odds of BC was statistically significant only for women who had least body fat mass (Class 1, OR = 1.110, 95% C.I.: 1.084-1.136) or had normal body composition (Class 4, OR = 1.090, 95% C.I.: 1.036-1.147). The effect of age was not statistically significant if women had higher risk body composition (e.g., in Classes 2 or 3)., Conclusion: Latent Class Analysis is a useful person-centred analytical approach for identification of unobserved patterns of body composition and it could be used to predict the risk of BC and develop personalized interventions for body composition studies., (© 2019 John Wiley & Sons Ltd.)

Background: The Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to measure symptoms and functions of children with a variety of chronic diseases. As the Chinese version of pediatric PROMIS (C-Ped-PROMIS) measures was developed, the measurement properties of C-Ped-PROMIS have not been demonstrated., Objective: The aim of this study was to examine the reliability, validity, and factorial structure of the C-Ped-PROMIS measures in children with cancer in China., Methods: A total of 272 children and adolescents were recruited from 3 hospitals in China. The 8 C-Ped-PROMIS measures and Pediatric Quality of Life Inventory General Core Module and Cancer Module were administered in a cross-sectional design. Known-group validity, concurrent validity, and item and scale reliability of these 8 measures were examined by using SPSS 21.0, and factorial structures were tested by using confirmatory factor analysis with Mplus 7.1., Results: All 8 C-Ped-PROMIS measures showed good known-group validity as hypothesized (P < .05) and good concurrent validity measured by significant correlations with the Pediatric Quality of Life Inventory General Core Module and Cancer Module; the correlation coefficients ranged from r = 0.519 to r = 0.655, except for peer relationship with r = 0.255 and r = 0.136, respectively. The Cronbach's α of C-Ped-PROMIS ranged from .758 to .910, and model-estimated scale reliabilities ranged from 0.740 to 0.905. The confirmatory factor analysis models of each measure fit data very well., Conclusions: All 8 C-Ped-PROMIS measures have a valid factorial structure as theoretically defined with good reliability and validity., Implications for Practice: The C-Ped-PROMIS can be readily used to measure symptoms and functions of children and adolescents with cancer in China.

Background: The Strategies Used by People to Promote Health (SUPPH) is an instrument used to measure self-reported self-efficacy in patient populations. Self-efficacy has a major impact on quality of life and psychological well-being. Previous findings of dimensionality of the SUPPH vary, and cultural differences exist suggesting the need for further investigation and psychometric testing to establish construct validity of the SUPPH in different cultures., Objective: The purpose of this study was to examine the factorial structure of the Chinese version of the SUPPH (C-SUPPH)., Methods: Using reports from 764 oncology patients in China, the factorial structure of the C-SUPPH was assessed via 2 analytical strategies. First-order confirmatory factor analysis (CFA) models were used to examine the dimensionality of the C-SUPPH; a second-order CFA was used to determine the existence of a factorial structure hierarchy of the C-SUPPH., Results: Compared with the 2- and 4-factor solutions, the 3-factor CFA of the C-SUPPH had a better fit with the data (comparative fit index = 0.94, Tucker-Lewis index = 0.94, root-mean-square error of approximation = 0.05, the close-fit test P = .565, and standardized root-mean-square residual = 0.04). Our findings confirmed the 3-scale structure: Positive Attitude, Stress Reduction, and Making Decisions; together, the 3 factors represent an underlying higher-order factor, that of general self-care self-efficacy., Conclusions: The C-SUPPH has a valid factorial structure and can be readily applied to studying self-efficacy in Chinese patients who are diagnosed with cancers., Implications for Practice: Our findings provide support for a culturally sensitive, reliable, and valid self-efficacy measure (the C-SUPPH) of Chinese adult cancer patients' self-care self-efficacy.

Background: Methamphetamine use has grown considerably in China in recent years. Information about perceptions of risk on methamphetamine is important to facilitate health promotion efforts., Methods: Using both survey data and qualitative interview data, the authors evaluate the perceived risk of methamphetamine use among Chinese users using a mixed-methods approach. Through Respondent Driven Sampling, the authors recruited a sample of 303 methamphetamine users in Changsha, China., Results: A majority (59.1%) perceive that infrequent methamphetamine use poses no risk to the user, while 11.2% perceive at least moderate risk for light use. A majority (56.7%) perceived at least moderate risk associated with regular methamphetamine use. Most (82.2%) also perceive methamphetamine to be easily obtainable. A path model indicates that perceived risk shapes intentions to use and expectations of future use, as does perceived availability. Qualitatively, while addiction was the most common risk discussed by users, they differed on whether they perceived the drug addictive. Other concerns raised by interviewees included impaired cognition, mental health problems, physical harm, and social dysfunction., Conclusion: While some users identify significant risks with methamphetamine, others do not perceive its use to be problematic. Collectively, these findings indicate that intervening upon perceptions of risk among Chinese methamphetamine users may be a means to influence intentions to use., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Introduction: Although the relationship between partial socioeconomic status (SES) and self-efficacy has been studied in previous studies, few research have examined self-efficacy difference among patients with cancer with different SES., Methods: A cross-sectional survey involving 764 patients with cancer was completed. Latent class analysis (LCA) was applied to identify distinct groups of patients with cancer using four SES indicators (education, income, employment status and health insurance status). Standardization and decomposition analysis (SDA) was then used to examine differences in patients' self-efficacy among SES groups and the components of the differences attributed to confounding factors, such as gender, age, anxiety, depression and social support., Results: Participants were classified into four distinctive SES groups via using LCA method, and the observed self-efficacy level significantly varied by SES groups; as theorized, higher self-efficacy was associated with higher SES. The self-efficacy differences by SES groups were decomposed into "real" group differences and factor component effects that are attributed to group differences in confounding factor compositions., Conclusion: Self-efficacy significantly varies by SES. Social support significantly confounded the observed differences in self-efficacy between different SES groups among Chinese patients with cancer., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background and Purpose: The Chinese version of the Strategies Used by Patients to Promote Health (C-SUPPH) is a self-report instrument used to measure self-efficacy among patients with cancer. The purpose of this article is to examine measurement invariance of C-SUPPH using data of 764 cancer patients recruited in China., Methods: Multigroup confirmatory factor analysis (CFA) models were applied across the selected sociodemographic groups of gender, age, education, and monthly income levels., Results: The factorial structure and factor loadings (relationships between items and their underlying factors) of C-SUPPH were invariant across all sociodemographic groups., Conclusions: The findings showed that the C-SUPPH measures the same latent constructs/factors in the same way when administered to different sociodemographic groups and thus can be readily applied to studying self-efficacy of cancer patients in China.

Background: The Pediatric Patient-Reported Outcomes Measurement Information System (PROMIS) measures were developed using modern measurement theory and tested in a variety of settings to assess the quality of life, function, and symptoms of children and adolescents experiencing a chronic illness and its treatment. Developed in English, this set of measures had not been translated into Chinese., Objective: The objective of this study was to develop the Chinese version of the Pediatric PROMIS measures (C-Ped-PROMIS), specifically 8 short forms, and to pretest the translated measures in children and adolescents through cognitive interviewing methodology., Methods: The C-Ped-PROMIS was developed following the standard Functional Assessment of Chronic Illness Therapy Translation Methodology. Bilingual teams from the United States and China reviewed the translation to develop a provisional version, which was then pretested with cognitive interview by probing 10 native Chinese-speaking children aged 8 to 17 years in China., Results: The translation was finalized by the bilingual teams. Most items, response options, and instructions were well understood by the children, and some revisions were made to address patient's comments during the cognitive interview., Conclusions: The results indicated that the C-Ped-PROMIS items were semantically and conceptually equivalent to the original. Children aged 8 to 17 years in China were able to comprehend these measures and express their experience and feelings about illness or their life., Implications for Practice: The C-Ped-PROMIS is available for psychometric validation. Future work will be directed at translating the rest of the item banks, calibrating them and creating a Chinese final version of the short forms.

Background: Methamphetamine use has emerged in China over the past decade. With the growth in methamphetamine use, it remains uncertain how users in China perceive its association with the HIV epidemic., Methods: The authors utilize qualitative and survey data from a mixed-methods study on methamphetamine use and HIV risk in China to assess the extent to which users perceive a risk for HIV transmission as well as how they conceive of the drug's links to HIV., Results: Data indicate that a considerable majority (82.2%) perceived themselves to have zero risk for HIV infection. Qualitative interviews highlight the lack of information about HIV possessed by methamphetamine users given the confusion and disbelief often expressed. Others acknowledged that while there was an intertwining of risk, they were not personally at risk., Conclusion: Given the known association between methamphetamine use and HIV risk, health promotion initiatives in China should target methamphetamine users to build HIV-related knowledge and inhibit self-exempting beliefs. In particular, educational efforts regarding the association of methamphetamine use with HIV may inhibit risk behaviors.

Background: The City of Hope Quality of Life-Ostomy Questionnaire is a widely accepted scale to assess quality of life in ostomy patients. However, the validity and reliability of the Chinese version (C-COH) have not been studied., Objective: The objective of the study was to assess the validity and reliability of the C-COH among ostomy patients sampled from Shanghai from August 2010 to June 2011., Methods: Content validity was examined based on the reviews of a panel of 10 experts; test-retest was conducted to assess the item reliabilities of the scale; a pilot sample (n = 274) was selected to explore the factorial structure of the C-COH using exploratory factor analysis; a validation sample (n = 370) was selected to confirm the findings from the exploratory study using confirmatory factor analysis (CFA). Statistical package SPSS version 16.0 was used for the exploratory factor analysis, and Amos 17.0 was used for the CFA., Results: The C-COH was developed by modifying 1 item and excluding 11 items from the original scale. Four factors/subscales (physical well-being, psychological well-being, social well-being, and spiritual well-being) were identified and confirmed in the C-COH The scale reliabilities estimated from the CFA results for the 4 subscales were 0.860, 0.885, 0.864, and 0.686, respectively., Conclusions: Findings support the reliability and validity of the C-COH., Implications for Practice: The C-COH could be a useful measure of the level of quality of life among Chinese patients with a stoma and may provide important intervention implications for healthcare providers to help improve the life quality of patients with a stoma.