title: Symptom burden of cancer patients: validation of the German M. D. Anderson Symptom Inventory: a cross-sectional multicenter study.
abstract: BACKGROUND
  Cancer patients frequently suffer from various symptoms often impairing functional status and quality of life. To enable timely supportive care, these symptoms must be assessed adequately with reliable tools.
  
  
  OBJECTIVE
  This study aimed to validate the German version of the M. D. Anderson Symptom Inventory (MDASI).
  
  
  METHODS
  This was a multicenter, cross-sectional, observational study. At five German university hospitals, 697 cancer patients aged from 18 to 80 years undergoing active anticancer treatment were recruited to participate in the study. For the validation, reliability (Cronbach's alpha), construct validity (factor analysis), known group validity (Eastern Cooperative Oncology Group Performance Status), and convergent divergent analyses were calculated.
  
  
  RESULTS
  Of the 980 patients who were eligible, 697 patients were included and agreed to participate in the study (71%). Reliability analysis showed good internal consistencies for the MDASI set of symptoms (Cronbach's alpha coefficient = 0.82; 95% CI = 0.78, 0.84) and for the set of interference items (Cronbach's alpha coefficient = 0.857; 95% CI = 0.484, 0.87). Factor analysis resulted in a one-factor solution (general symptoms; eigenvalue = 4.26) with a psychological (distress and sadness) and a gastrointestinal subscale (nausea and vomiting). Convergent and divergent analyses showed significant correlations between symptom burden and distress and global health-related quality of life (subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 Version 3.0.).
  
  
  CONCLUSIONS
  The MDASI-German version is a valid tool for measuring patient-reported symptom severity and symptom interference in German cancer patients. It is easily applicable and can be used by German clinicians and researchers for screening and monitoring purposes and the comparison of international data.
authors.affiliation: Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Nursing Research Unit, University Hospital Halle (Saale), Halle, Germany. Electronic address: heike.schmidt@medizin.uni-halle.de.
authors.forename: Heike
authors.initials: H
authors.lastname: Schmidt
authors.affiliation: Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Nursing Research Unit, University Hospital Halle (Saale), Halle, Germany.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cleeland
authors.affiliation: Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Nursing Research Unit, University Hospital Halle (Saale), Halle, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Bauer
authors.affiliation: Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Nursing Research Unit, University Hospital Halle (Saale), Halle, Germany.
authors.forename: Margarete
authors.initials: M
authors.lastname: Landenberger
authors.affiliation: Institute for Health and Nursing Science, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany; The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA; Nursing Research Unit, University Hospital Halle (Saale), Halle, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Jahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D005858:Germany; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Cancer; M. D. Anderson Symptom Inventory; Validation; symptom burden