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J Occup Rehabil. 2015 Dec;25(4):685-95. doi: 10.1007/s10926-015-9576-3.

Validation of the Chinese Version of the Cognitive Symptom Checklist-Work-21 in Breast Cancer Survivors.

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Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, No. 63 DouBao Road, Liwan District, Guangzhou, 510150, China.
Departments of Medical and Clinical Psychology and Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.



The purpose of this study was to translate the Cognitive Symptom Checklist-Work-21 (CSC-W21), into Chinese, and culturally adapt and validate the Chinese version, a measure of work-related cognitive limitations in occupationally active breast cancer survivors (BCS).


The translation of the English version of the CSC-W21 followed a systematic procedure. Exploratory factor analysis was used to identify factor structures. The internal consistency of the factors was assessed by calculating the Cronbach's alpha reliability coefficients. Item- and scale-level content validity was determined. The intra-class correlation coefficient (ICC) was used to analyze test-retest reliability. A total of two hundred and twenty BCS participated in the psychometric testing of the CSC-W21-C. The construct validity of the total score of the CSC-W21-C was determined through convergent validity and an analysis of its relationship with the four subscales of the Work Limitations Questionnaire (WLQ), a measure of four types of job task difficulties.


The CSC-W21-C demonstrated item- and scale-level content validity (>.80). The factor structure of the CSC-W21-C was similar to the original English version. The internal consistency of the subscales of the CSC-W21-C ranged from .84 to .95. The ICC was between .80 and .96 indicating good test-retest reliability. The CSC-W21-C was significantly correlated with the WLQ, particularly the mental-interpersonal subscale, where it accounted for 27.3 % of the total variance.


The findings indicate that the CSC-W21-C has sound measurement properties that strongly suggest it can be used in future assessment and intervention research to identify cognitive limitations related to specific work tasks in BCS.


Breast cancer survivor; Chinese translation; Self-report measure; Validation; Work-related cognitive limitations

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