Abstract: Background: Children undergoing cancer treatment experience varying levels of symptom distress. It is crucial for clinical intervention that a scientific, rapid and accurate assessment is conducted to accurately identify the true symptoms in these children. Objective: To introduce the Symptom Screening in Pediatrics Tool（SSPedi）and to test the reliability and validity of its Chinese version in children with cancer and their parents. Design: Cross-sectional study. Methods: The Brislin translation model was employed to covert the scale into Chinese. Six experts were enlisted to conduct cultural adjustments, and a pre-survey was executed to formulate the Chinese versions of SSPedi for children and parents（SSPedi-C and SSPedi-P）.The formal survey targeted children aged 8-18 undergoing cancer treatment and their parents, who were hospitalized in the Department of Pediatrics at Nanfang Hospital of Southern Medical University and the Department of Pediatric Hematology at Zhujiang Hospital of Southern Medical University from December 1, 2022, to May 26, 2023. After obtaining consent from the hospital and relevant departments, a uniformly trained investigator from each hospital entered the ward on the day of admission or the following day to distribute SSPedi-C and SSPedi-P in Chinese to the children and their parents. After the questionnaire data were entered and verified by the investigators on the same day, item analysis, reliability analysis, and validity analysis were conducted. Main outcome measures: The reliability and validity of the Chinese versions of SSPedi-C and SSPedi-P. Results: A total of 220 (95.65%) valid questionnaires were included in the analysis. The age of the 220 children with cancer ranged from 8 to 17 years old （11.26±2.28）, with 130 males (59.1%) and 90 females. The parents' ages ranged from 28 to 59 years （40.15±5.23）, comprising 50 fathers (22.7%) and 170 mothers. Item analysis revealed that the critical ratio for all 15 items in the Chinese versions of SSPedi-C and SSPedi-P were between 3.987-8.824 (all P<0.001) and 4.817-3.829 (all P<0.001), respectively. The correlation coefficients between each item and the total score of the Chinese versions of SSPedi-C and SSPedi-P were between 0.431-0.701 (all P<0.001) and 4.817-3.829 (all P<0.001), respectively. The correlation coefficients between each item and the total score were 0.431-0.701 (P<0.001) for the Chinese SSPedi-C and 0.482-0.787 (P<0.001) for Chinese SSPedi-P. Reliability analysis showed that the total Cronbach's α coefficients of Chinese SSPedi-C and SSPedi-P were 0.877 and 0.893, respectively, and the split-half reliability coefficients were 0.843 and 0.806, respectively. Content validity analysis showed that the item-level content validity index and averaging scale-level content validity index of Chinese SSPedi-C and SSPedi-P were both 1.000. For both two Chinese scales, confirmatory factor analysis showed that the chi-square degree of freedom ratio (χ2/df was <3.000, RMSEA was <0.080, and fitting index was >0.900. Conclusion: The Chinese version of SSPedi demonstrates good reliability and validity among children with cancer and their parents. Its simplicity and ease of operation make it a valuable tool for evaluating the level of symptom distress in children aged 8-17 undergoing cancer treatment.

Key words: Cancer, Self-report, Symptom disturbance, Symptom Screening in Pediatrics Tool, Scale translation