title: The Chinese version of hospital anxiety and depression scale: Psychometric properties in Chinese cancer patients and their family caregivers.
abstract: OBJECTIVE
  The Hospital Anxiety and Depression Scale (HADS) acts as one of the most frequently used self-reported measures in cancer practice. The evidence for construct validity of HADS, however, remains inconclusive. The objective of this study is to evaluate the psychometric properties of the Chinese version HADS (C-HADS) in terms of construct validity, internal consistency reliability, and concurrent validity in dyads of Chinese cancer patients and their family caregivers.
  
  
  METHODS
  This was a cross-sectional study, conducted in multiple centers: one hospital in each of the seven different administrative regions in China from October 2014 to May 2015. A total of 641 dyads, consisting of cancer patients and family caregivers, completed a survey assessing their demographic and background information, anxiety and depression using C-HADS, and quality of life (QOL) using Chinese version SF-12. Data analysis methods included descriptive statistics, confirmatory factor analysis (CFA), and Pearson correlations.
  
  
  RESULTS
  Both the two-factor and one-factor models offered the best and adequate fit to the data in cancer patients and family caregivers respectively. The comparison of the two-factor and single-factor models supports the basic assumption of two-factor construct of C-HADS. The overall and two subscales of C-HADS in both cancer patients and family caregivers had good internal consistency and acceptable concurrent validity.
  
  
  CONCLUSIONS
  The Chinese version of the HADS may be a reliable and valid screening tool, as indicated by its original two-factor structure. The finding supports the basic assumption of two-factor construct of HADS.
authors.affiliation: Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China.
authors.forename: Qiuping
authors.initials: Q
authors.lastname: Li
authors.affiliation: Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Shanxi Provincial Tomor Hospital, Taiyuan, Shanxi Province, China.
authors.forename: Caiping
authors.initials: C
authors.lastname: Hu
authors.affiliation: Wuxi People's Hospital, Wuxi, Jiangsu Province, China. Electronic address: 540923082@qq.com.
authors.forename: Yinghua
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Wuxi People's Hospital, Wuxi, Jiangsu Province, China.
authors.forename: Huiya
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Xijing Hospital, Xi'an, Shaanxi Province, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Health Statistics, Fourth Military Medical University, Xi'an, Shaanxi Province, China. Electronic address: xuyongy66@163.com.
authors.forename: Yongyong
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D044466:Asian People / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D002681:China; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D005163:Factor Analysis, Statistical; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014177:Translations; D055815:Young Adult
keywords: Anxiety; Cancer; Caregiver-patient dyads; Chinese; Depression; Family caregivers; Hospital anxiety and depression scale; Psychometric properties