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Translation and psychometric validation of the symptom catastrophizing scale in cardiac surgery patients: a
Duo Zhang1,2,3,4, Haoyang Zheng5, Wencan Cheng6
1Department of Nursing, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Background:
Symptom catastrophizing reflects maladaptive cognitive and emotional responses to physical symptoms and may worsen symptom burden, distress, and recovery. However, no validated Chinese instrument is available for cardiac surgery patients, limiting patient-centered assessment and early risk identification.
Objective:
To translate and culturally adapt a symptom-neutral catastrophizing measure derived from the original Post-concussion Symptom Catastrophizing Scale and evaluate its psychometric properties in Chinese cardiac surgery patients.
Methods:
Following Brislin's translation model, the scale was translated into Chinese. A convenience sample of 676 cardiac surgery patients was recruited from June to October 2025. Item analysis included critical ratio testing, item-total correlations, and internal consistency evaluation. Reliability was assessed using internal consistency, split-half, and test-retest methods. Content validity was evaluated through expert consultation. Exploratory and confirmatory factor analyses were conducted to examine construct validity. Data were analyzed using SPSS 29.0 and Mplus 8.0.
Results:
The adapted Chinese Symptom Catastrophizing Scale demonstrated strong content validity in cardiac surgery patients (S-CVI/Ave = 0.975; CVR = 0.800-1.000). Exploratory factor analysis extracted a three-factor model explaining 79.774% of the variance. Confirmatory factor analysis indicated acceptable model fit (χ2/df = 2.175, CFI = 0.970, TLI = 0.962, RMSEA = 0.059). Reliability coefficients included Cronbach's α = 0.936, split-half reliability = 0.894, test-retest reliability = 0.958, and McDonald's ω = 0.934.
Conclusion:
The Chinese Symptom Catastrophizing Scale demonstrated satisfactory initial reliability and validity evidence in cardiac surgery patients. It provides a brief, standardized, patient-centered measure for identifying maladaptive symptom responses and may facilitate early psychological risk screening, targeted symptom management, and future patient-reported outcome research.