Revision Of Chinese Version Of Psychological Distress Screening Tools For Cancer Patients And Study On The Optimal Cut-off Point Of The Distress Thermometer

Objectives To explore the main reasons for psychological distress among Chinesecancer patients by using qualitative study method; translate and revise the psychologicaldistress screening tools which recommended by the US National ComprehensiveCancer Network and determine the optimal cut-off point of the Distress Thermometer.Methods Phenomenological research method was adopted. Twelve cancer patients wereinterviewed by using purposive sampling method. The data was analyzed and themeswere abstracted for exploring the reasons of psychological distress among Chinesecancer patients, and thus to provide references for the revision of the problem listincluded in psychological distress screening tools. What’s more, in line with the strictprocedure of the translation, the problem list was translated into Chinese, then it wasadapted and revised with fully cross-cultural concerns.In addition, the assessment ofcontent validity by experts and pre-test for internal consistence were conducted. Finally,the Chinese version of problem list was established. The current status of psychologicaldistress among cancer patients were investigated through a cross-sectional descriptivestudy.On the basis of comprehensive consideration of various diagnostic or screeningindex, the Receiver Operating Characteristic curves approach was used to determine theoptimal cut-off point of the Distress Thermometer, with the Hospital Anxiety andDepression Scale as the reference.Results Three themes were extracted: discomfortable physiological symptoms, family and social impacted factors, and the unmet health care needs. Items in therevised problem list were comprehensive and easy to understand. The average of allitem-level content validity index was0.90and the Cronbach’s Alpha Coefficient frompre-test was0.913. For cross-sectional descriptive study,⑴The scores of HADS and itsdimensions all have significant correlations with the level of psychological distress(r=0.683～0.791, P<0.01).⑵The optimal cut-off point of the Distress Thermometer inour study was4with the area under ROC was0.885(P<0.01), with the sensitivity wasat85.5%and the specificity was78.3%.⑶W henusing four as cut-off point,217(52.7%) cancer patients suffered from psychological distress.⑷Logistic regressionanalysis suggested that age, residence and treatment were influencing factors ofpsychological distress.Conclusion Psychological distress has a broad meaning with multiple contributingfactors and the prevalence was relatively high among cancer patients.The revisedproblem list presented in the current study were comprehensive and easy to understand.More clinical studies need to be conducted for further testing its reliability and validityThe optimal cut-off point of the Distress Thermometer in present study was four.