Validation of the simplified Chinese version of PROMIS Parent Proxy-25 Profile in parents of children with cancer.

PURPOSE: To determine the psychometric properties of the Patient-reported Outcomes Measurement Information System Parent Proxy-25 Profile (PROMIS-25) in a sample of Chinese parents of children with cancer. DESIGN AND METHODS: A cross-sectional sample (N = 148) of parents with children aged 5-17 years living with cancer was recruited. Each participant completed sociodemographic and clinical questionnaires and PROMIS-25. The flooring and ceiling effects were calculated. Reliability was determined by the Cronbach's alpha and split-half coefficient. Factor structure was examined by factor analysis. Model fit and graphical plots were assessed to test the assumptions of Rasch model-based item response theory (IRT). Differential item functioning (DIF) was assessed in terms of gender, age, and treatment stage. RESULTS: PROMIS-25 demonstrated some flooring and ceiling effect, excellent reliability (Cronbach's α > 0.7 for all six domains), and the six-domain factor structure was supported. The IRT assumptions were met in terms of unidimensionality, local independence, monotonicity, and measurement equivalence with acceptable DIF in terms of gender, age, diagnosis, and treatment stage. CONCLUSION: PROMIS-25 is a highly reliable and valid instrument for evaluating children with cancer that assesses important health-related quality of life domains of child cancer. PRACTICE IMPLICATION: Chinese parents of children with cancer and healthcare providers could use PROMIS-25 to assess the symptoms of children.

Risk factors for self-reported high symptom cluster burdens in patients with breast cancer undergoing chemotherapy in China: A cross-sectional study.

Background and Aims: Further exploration is needed to recognize symptom clusters and categorize subgroups with distinct cluster patterns and associated risks, focusing on symptoms that are highly self-reported by patients with breast cancer undergoing chemotherapy. This study aimed to identify subgroups and risk factors for self-reported high symptom cluster burden among patients with breast cancer undergoing chemotherapy. Methods: A total of 647 participants who met the inclusion criteria were included in the study, with data collected on demographics, disease information, self-reported symptoms, and psychosocial factors. Latent class analysis was utilized to identify the subgroup, while logistic regression was used to pinpoint predictive risk factors. Results: Latent class analysis revealed three subgroups: the "high burden of all symptoms group" (n = 107, 16.54%), the "high burden of psychological symptoms group" (n = 103, 15.92%), and the "low burden of all symptoms group" (n = 437, 67.54%). Patients in the high burden of all symptom group and high burden of psychological symptom group exhibited significantly worse function outcomes (p < 0.001). Predictive risk factors for the "high burden of all symptom group" included older age, lower self-efficacy, worse body image, and a higher financial burden. Similarly, patients with high burden of psychological symptom were more likely to have low self-efficacy, poor body image, and a high financial burden. Conclusion: The study demonstrated the importance of giving more attention to patients with breast cancer who are at risk of developing into membership of high symptom cluster burden group.