title: Psychometric properties of the Breast Cancer and Lymphedema Symptom Experience Index: The Chinese version.
abstract: OBJECTIVE
  To translate the Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) into Chinese language and evaluate its psychometric properties among breast cancer survivors with and without lymphedema in China.
  
  
  METHODS
  The BCLE-SEI was translated from English to Chinese language using an integrative translation method. The Chinese version was then evaluated for its psychometric properties using a comparison-group and test-retest method. Purposive sampling was used to recruit 219 breast cancer survivors with and without lymphedema in Beijing, China. Cronbach's alpha and test-retest reliability were conducted to assess the reliability; discriminant validity, criterion-related validity and exploratory factor analysis were examined to assess the validity of the instrument.
  
  
  RESULTS
  No semantic modifications to items were needed in terms of comparability of language and similarity of interpretability. Feedback on the pretest of the Chinese version by 15 Chinese breast cancer patients resulted in one item modification. The Chinese version of the instrument demonstrated excellent reliability (Cronbach's alpha = 0.930-0.967) and test-retest reliability (r = 0.572-0.705, p < 0.001, n = 34). A significant difference was observed between the lymphedema group and non-lymphedema group (z = -7.127, p < 0.001). The criterion-related validity was supported by negative correlation with the Short-Form Health Survey (physical component summary, r = -0.612; mental component summary, r = -0.540). Factor analysis for symptom occurrence revealed 5 factors, which explained 66.1% of the total sample variance; 5 factors were also identified in symptom distress, which explained 70.6% of the total sample variance.
  
  
  CONCLUSIONS
  The Chinese BCLE-SEI is a reliable and valid instrument to evaluate breast cancer-related lymphedema symptom experience for Chinese breast cancer survivors.
authors.affiliation: Department of Medical & Surgical Nursing, Peking University School of Nursing, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China. Electronic address: shuang_sunshine@163.com.
authors.forename: Shuang
authors.initials: S
authors.lastname: Shi
authors.affiliation: Department of Medical & Surgical Nursing, Peking University School of Nursing, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China. Electronic address: luqian@bjmu.edu.cn.
authors.forename: Qian
authors.initials: Q
authors.lastname: Lu
authors.affiliation: College of Nursing, New York University, 433 First Avenue, 4th Floor, Room 426, New York 10010, USA. Electronic address: mf67@nyu.edu.
authors.forename: Mei R
authors.initials: MR
authors.lastname: Fu
authors.affiliation: Department of Medical & Surgical Nursing, Peking University School of Nursing, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China. Electronic address: 289424430@qq.com.
authors.forename: Qian
authors.initials: Q
authors.lastname: Ouyang
authors.affiliation: Department of Lymphatic Surgery, Beijing Shijitan Hospital, No. 10 Tieyi Road, Haidian District, Beijing 100038, China. Electronic address: 22088324@qq.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Lymphatic Surgery, Beijing Shijitan Hospital, No. 10 Tieyi Road, Haidian District, Beijing 100038, China. Electronic address: lvjinglinba@sina.cn.
authors.forename: Jing
authors.initials: J
authors.lastname: Lv
authors.affiliation: Department of Surgery, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing 100034, China. Electronic address: wang_ying_xin@yeah.net.
authors.forename: Yingxin
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000150:complications*; D002681:China; D005163:Factor Analysis, Statistical; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008209:Lymphedema / Q000150:complications*; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data; D014177:Translations
keywords: Breast cancer; Breast cancer survivor; Breast neoplasms; Lymphedema; Reliability; Symptom distress; Symptoms; Validity