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Chinese version, Control Attitudes Scale-Revised, perception of control, psychometric validation



  1. Chen, Shixiang MD
  2. Zheng, Shinan MD
  3. Wang, Xiaobing MD
  4. Zhang, Xiaonan MD
  5. Fa, Tiane BD
  6. Fu, Li BD
  7. Zang, Xiaoying PhD
  8. Zhao, Yue PhD


Background: The concept of perceived control reflects the belief that one has resources needed to cope with negative events and the ability to positively influence consequences of those negative events. In patients with heart failure, perceived control is associated with a variety of health outcomes. Perceived control is commonly measured using the Control Attitudes Scale-Revised (CASR). There is no Chinese version of the CAS-R (CCAS-R).


Objective: The purpose of this article was to perform linguistic validation and psychometric evaluation of the CCAS-R.


Methods: The CAS-R was translated into Chinese according to Brislin's model. Then, a multicenter observational study was performed. Floor and ceiling effects, internal consistency, structural validity, and hypothesis testing were all assessed for psychometric validation of the CCAS-R.


Results: A total of 227 patients with chronic heart failure were included. There were no ceiling or floor effects detected. Cronbach [alpha] was 0.94, indicating a high reliability. The results of the confirmatory factor analysis showed that the 1-factor structure as proposed by the original CAS-R fits the data well. The results of the principal component analysis suggested that the 1-factor structure was optimal as well, accounting for 71.6% of the total variance. The a priori hypothesis was supported by a statistically significant correlation between the CCAS-R and 3 theoretically related variables.


Conclusion: We developed a semantically equivalent version of the CAS-R in Chinese. The evaluation of the instruments' psychometric properties demonstrated that the CCAS-R has good reliability and validity for use in Chinese patients with chronic heart failure.