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Background <p>Patients with chronic diseases often experience learned helplessness (LH), which affects their psychological state and triggers physical symptoms, seriously affecting their quality of life. The Chronic Disease Helplessness Survey (CDHS) was developed to measure LH in patients with chronic diseases, but it has not been validated in the Chinese population. The aim of this study was to translate the CDHS into Chinese and validate its reliability and validity in Chinese patients with chronic diseases, thus providing an appropriate assessment tool for the Chinese population.</p> Methods <p>A forward-backward English-Chinese-English translation of the CDHS was performed according to standard practice. This study recruited 106 chronic disease patients from March to May 2024, and 100 cases in September 2025. The Chinese CDHS has 12 items in three dimensions: cognitive, motor, and emotional. The criterion-related tools used included the Learned Helplessness Scale-18 (LHS-18), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEMCD). Criterion-related validity was assessed by examining the correlations between CDHS scores and the scores of these tools. The internal consistency was tested via Cronbach’s α, the test-retest reliability was tested via the intraclass correlation coefficient (ICC), and the construct validity was tested via Exploratory Factor Analysis and Confirmatory Factor Analysis.</p> Results <p>The Chinese CDHS had a Cronbach’s α of 0.896, indicating good internal consistency, and an ICC of 0.929, indicating high stability. EFA and CFA showed a good fit for the three-factor model (χ<sup>2</sup>/df = 1.623, CFI = 0.961, TLI = 0.949, NFI = 0.905, RMSEA = 0.078). CDHS scores were positively correlated with LHS-18 (<i>r</i> = 0.659, <i>P</i> &lt; 0.001), GAD-7 (<i>r</i> = 0.659, <i>P</i> &lt; 0.001), and PHQ-9 (<i>r</i> = 0.714, <i>P</i> &lt; 0.001) scores and negatively correlated with SEMCD scores (<i>r</i> = -0.614, <i>P</i> &lt; 0.001), demonstrating good criterion-related validity.</p> Conclusion <p>The Chinese CDHS has good reliability and validity for assessing learned helplessness in Chinese chronic disease patients and is a valuable tool for early psychological intervention, it could be used in screening, clinical decision-making, or monitoring psychological states over time.</p>

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Adaptation and validation of the chronic disease helplessness survey for Chinese patients with chronic conditions

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Bingying Huang,
  • Jiaying Tang,
  • Zhiting Guo,
  • Ying Chen,
  • Lili Zhou,
  • Fengying Zhang,
  • Qiaomei Zhao,
  • Hua Zhao

摘要

Background

Patients with chronic diseases often experience learned helplessness (LH), which affects their psychological state and triggers physical symptoms, seriously affecting their quality of life. The Chronic Disease Helplessness Survey (CDHS) was developed to measure LH in patients with chronic diseases, but it has not been validated in the Chinese population. The aim of this study was to translate the CDHS into Chinese and validate its reliability and validity in Chinese patients with chronic diseases, thus providing an appropriate assessment tool for the Chinese population.

Methods

A forward-backward English-Chinese-English translation of the CDHS was performed according to standard practice. This study recruited 106 chronic disease patients from March to May 2024, and 100 cases in September 2025. The Chinese CDHS has 12 items in three dimensions: cognitive, motor, and emotional. The criterion-related tools used included the Learned Helplessness Scale-18 (LHS-18), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEMCD). Criterion-related validity was assessed by examining the correlations between CDHS scores and the scores of these tools. The internal consistency was tested via Cronbach’s α, the test-retest reliability was tested via the intraclass correlation coefficient (ICC), and the construct validity was tested via Exploratory Factor Analysis and Confirmatory Factor Analysis.

Results

The Chinese CDHS had a Cronbach’s α of 0.896, indicating good internal consistency, and an ICC of 0.929, indicating high stability. EFA and CFA showed a good fit for the three-factor model (χ2/df = 1.623, CFI = 0.961, TLI = 0.949, NFI = 0.905, RMSEA = 0.078). CDHS scores were positively correlated with LHS-18 (r = 0.659, P < 0.001), GAD-7 (r = 0.659, P < 0.001), and PHQ-9 (r = 0.714, P < 0.001) scores and negatively correlated with SEMCD scores (r = -0.614, P < 0.001), demonstrating good criterion-related validity.

Conclusion

The Chinese CDHS has good reliability and validity for assessing learned helplessness in Chinese chronic disease patients and is a valuable tool for early psychological intervention, it could be used in screening, clinical decision-making, or monitoring psychological states over time.