Miller Melissa F, Mullins C Daniel, Onukwugha Eberechukwu, Golant Mitch, Buzaglo Joanne S
Cancer Support Community (CSC) Research and Training Institute, 4100 Chamounix Drive, Philadelphia, PA, 19131, USA,
Qual Life Res. 2014 Dec;23(10):2855-63. doi: 10.1007/s11136-014-0742-4. Epub 2014 Jun 26.
The objective was to test the discriminatory power of a 25-item distress screening tool for use among cancer survivors. We used a measure of item discrimination to determine which items perform better than others at identifying those at greatest risk of distress.
A total of 251 members (90 % female, median age 57 years) of a community-based cancer support organization completed a web-based distress screening tool. Participants were asked to rate each of 25 items according to the question "Today, how concerned are you about…?" using a five-point Likert scale (0 not at all to 4 very seriously concerned). An overall distress score was calculated as the sum of items rated at or above two for somewhat concerned. Participants were categorized as high scorers (≥13, n = 59) and low scorers (≤4, n = 60). The item discrimination index (IDI) was calculated for each item as the percentage difference in concerned (somewhat or greater) responses between high and low scorers.
Items with the greatest discriminatory power (IDI ≥0.8) were as follows: changes or disruptions in work, school or home life; feeling sad or depressed; feeling too tired to do the things you need or want to do; worrying about the future and what lies ahead; and feeling nervous or afraid. Conversely, items with the lowest IDI included considering taking your own life; eating and nutrition; tobacco or substance use; and transportation to treatment and appointments.
The results highlight, among 25 items of a community-based distress screening tool, items with the greatest discriminatory power to identify cancer survivors with psychosocial distress. Results suggest targeted screening items to identify those most at risk for distress and priority areas for support services.
本研究旨在测试一种包含25个条目的困扰筛查工具在癌症幸存者中的鉴别能力。我们采用条目鉴别度测量方法来确定哪些条目在识别困扰风险最高的人群方面比其他条目表现更好。
一个社区癌症支持组织的251名成员（90%为女性，年龄中位数为57岁）完成了一项基于网络的困扰筛查工具。参与者被要求根据“今天，你对……有多担心？”这个问题，使用五点李克特量表（0表示一点也不担心，4表示非常担心）对25个条目中的每一个进行评分。总体困扰得分计算为评分在“有些担心”（即2分及以上）的条目的总和。参与者被分为高分者（≥13分，n = 59）和低分者（≤4分，n = 60）。每个条目的条目鉴别指数（IDI）计算为高分者和低分者在“有些担心”或更担心的回答上的百分比差异。
鉴别能力最强（IDI≥0.8）的条目如下：工作、学校或家庭生活的变化或干扰；感到悲伤或沮丧；感到太累而无法做自己需要或想做的事情；担心未来和即将发生的事情；以及感到紧张或害怕。相反，IDI最低的条目包括考虑自杀；饮食和营养；烟草或物质使用；以及前往治疗和预约的交通。
结果突出了在一个基于社区的困扰筛查工具的25个条目中，鉴别心理社会困扰的癌症幸存者能力最强的条目。结果表明了用于识别困扰风险最高人群的针对性筛查条目以及支持服务的优先领域。
