The Chinese version of hospital anxiety and depression scale: Psychometric properties in Chinese cancer patients and their family caregivers

•The C-HADS has satisfactory psychometric properties for use among Chinese cancer patients and their family caregivers.•The findings support the basic assumption of two-factor construct of C-HADS.•Attention be paid to exploring the predictors of anxiety and depression in cancer patients and family caregivers.

PurposeThe 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.MethodsThis 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.ResultsBoth 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.ConclusionsThe 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.