Cultural adaptation and psychometric validation of the Gastrointestinal Unhelpful Thinking Scale

Background Gastrointestinal symptoms are often influenced by cognitive and emotional factors. The Gastrointestinal Unhelpful Thinking Scale (GUTs) was developed to assess such cognition in patients with functional gastrointestinal disorders. However, no validated Chinese version exists by now. Aim To conduct translation, cultural adaption and psychometric evaluation of the Chinese version of the GUTs amongst patients with irritable bowel syndrome (IBS). Methods Following the Brislin translation model for cross-cultural adaptation, we recruited 212 IBS patients from a tertiary hospital in Shanghai using convenience sampling. The validation process included assessment of content validity, construct validity and reliability. Results The Chinese GUTs demonstrated excellent content validity, with the content validity level and the average level of scale being 0.80 and 0.987, respectively. Exploratory factor analysis verified the original two-factor structure (pain catastrophizing and visceral sensitivity), accounting for 66.240% of the total variance. Confirmatory factor analysis indicated the model fit was acceptable (χ 2 /df = 2.991, CFI = 0.853, RMSEA = 0.038). The scale demonstrated good internal consistency (Cronbach’s α = 0.947) and test-retest reliability (ICC = 0.844). Spearman-Brown coefficient was 0.912, and considered as strong split-half reliability. Conclusion The translated GUTs shows robust psychometric properties and is a valid, reliable scale for assessing gastrointestinal-specific unhelpful thinking patterns in Chinese IBS patients, suitable for clinical applications.