Assessing reliability and validity of the Chinese version of Crown–Crisp experience index and its application in coal miners

In China, coal miners are the primary workforce in coal mining, and among all patients with occupational diseases, 90% suffer from pneumoconiosis. Therefore, the psychological problems resulting from the dual pressures of occupational stress and the high risk of occupational diseases among coal miners are significant factors that affect the development of physical and mental health and even production safety. The Crown–Crisp Experience Index (CCEI) is a multidimensional questionnaire that assesses the psychological state of patients. This study aims to test reliability and validity of Chinese version of the CCEI questionnaire using factor analysis, and apply it to coal miners. We recruited a total of 900 participants from different occupational stages in coal mining, including active miners, Coal Workers’ Pneumoconiosis (CWP) patients, and retired miners, to evaluate the reliability and validity of the Chinese version of the CCEI questionnaire. A questionnaire survey was conducted on three groups of 1000 individuals each, including active coal miners, retired coal miners, and pneumoconiosis patients, to determine the detection rate of psychological problems in each group. An analysis was performed for each group to explore the primary factors influencing anxiety. The exploratory factor analysis yielded six principal components that accounted for a total of 79.389% of variances. The confirmatory factor analysis showed that the Chi-square freedom ratio (χ²/df) was 1.843, the root mean square error approximation was less than 0.044, and the comparative fit index was 0.938 and Tucker–Lewis index (TLI) was 0.934. The Cronbach's alpha coefficient was 0.948, and the scale-level content validity index (S-CVI) was 0.88. Effective questionnaires were obtained from 98.5%, 96.9%, to 91.0% of pneumoconiosis patients, active miners, and retired miners, respectively, with the incidence rates of psychological problems being 21%, 35.8%, and 13.6%, respectively. Compared with retired miners, active miners showed higher levels of psychological problems in the dimensions of depressive symptoms, free-floating anxiety and somatic symptoms, whereas pneumoconiosis patients had higher levels of psychological problems in the dimensions of phobic anxiety and somatic symptoms. This study demonstrates that the Chinese version of the CCEI is highly reliable and valid and can be used as a screening tool to measure patients' anxiety and fear levels in coal minders. Miners face distinct psychological challenges at different stages and require targeted screening and interventions.