Adaptation and validation of the Chinese version of palliative care difficulties scale

Objective: The Palliative Care Difficulties Scale (PCDS) is the most popular tool in developed countries for the assessment of difficulties perceived by clinical professionals in palliative care practice. This study aimed to culturally adapt the PCDS into a Chinese version and validate the psychometric properties of the adapted Chinese version of the PCDS. Methods: The study was carried out in two major phases: (1) translation and cultural adaption of the PCDS into a Chinese version according to the corresponding guidelines, and (2) evaluation of the psychometric properties of the adapted Chinese version of the PCDS by consulting experts and performing a cross-sectional survey among 284 nurses and physicians. Floor and ceiling effects were estimated by the percentage of participants obtaining the lowest or highest possible scores. Internal consistency reliability was assessed using the Cronbach's a coefficient. Test-retest reliability was evaluated by the intra-class correlation coefficient (ICC). Content validity was evaluated by the content validity index (CVI). Construct validity was calculated by applying the confirmatory factor analysis (CFA). Results: The PCDS was translated and culturally adapted into a Chinese version. Neither floor nor ceiling effects were observed. The scale-level Cronbach's a coefficient was 0.94 with each dimension ranging from 0.84 to 0.92. The scale-level ICC was 0.66 with each dimension ranging from 0.41 to 0.65. Both the item-level and scale-level CVIs were equal to 1. The CFA verified the five-factor structure of the original PCDS with factor loadings for each item ranging from 0.62 to 0.96. Conclusions: The Chinese version of the PCDS showed satisfactory psychometric properties. It is a valid and reliable tool for the assessment of difficulties perceived by clinical staff in palliative care practice.