Validation of "Cancer Dyspnea Scale" in Patients With Advanced Cancer in a Palliative Care Setting in India

J Pain Symptom Manage. 2017 Nov;54(5):715-720.e1. doi: 10.1016/j.jpainsymman.2017.06.004. Epub 2017 Aug 8.

Abstract

Context: Assessment of dyspnea in patients with advanced cancer is challenging. Cancer Dyspnea Scale (CDS) is a multidimensional scale developed for the measurement of dyspnea. It is available only in Japanese, English, and Swedish and has not been validated before in the Indian languages.

Objective: The objective was to describe the process of validation and reliability testing of CDS in Indian advanced cancer patients.

Methods: This is a prospective observational study conducted in the palliative care clinic of a tertiary cancer center in Mumbai. The English version of CDS was translated into Indian languages-Hindi (CDS-H) and Marathi (CDS-M). One hundred twenty newly registered eligible patients (60 for CDS-H and 60 for CDS-M) were enrolled into the study consecutively. They were asked to fill CDS (translated version) and Visual Analogue Scale for dyspnea. Only baseline measures were used.

Results: Validity was separately analyzed for CDS-H and CDS-M. The results showed good construct validity between CDS-H and CDS-M. Intersubscale correlation was done by calculating the Pearson's correlation coefficient (mean r = 0.64 and 0.764 for CDS-H and CDS-M, respectively). Convergent validity was calculated by computing the correlation of each factor with VAS-D scores and was found statistically significant (P < 0.001; average r ranging from 0.706 to 0.714). Reliability of the scale was determined by its internal consistency (Cronbach's alpha coefficient ranging from 0.716 to 0.879).

Conclusion: This study demonstrates that CDS-H and CDS-M are valid and reliable multidimensional scales, which can be used to assess dyspnea in patients with advanced cancer.

Keywords: Advanced cancer; Cancer Dyspnea Scale; dyspnea; palliative care.

Publication types

  • Observational Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dyspnea / diagnosis*
  • Dyspnea / etiology*
  • Dyspnea / physiopathology
  • Feasibility Studies
  • Female
  • Humans
  • India
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / diagnosis
  • Neoplasms / physiopathology
  • Palliative Care* / methods
  • Prospective Studies
  • Reproducibility of Results
  • Severity of Illness Index*
  • Tertiary Care Centers
  • Translating
  • Young Adult