Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Psychosomatics. 2017 Sep-Oct;58(5):496-505. doi: 10.1016/j.psym.2017.03.016. Epub 2017 Apr 6.
Patients with cancer often experience distress, and early detection and management of psychologic distress are vital for improving patients' outcomes.
This study investigates the validity and determines the optimal cutoff score-for clinically significant distress-for the Taiwanese Distress Thermometer (DT).
This study consisted of 768 inpatients diagnosed with cancer in a general hospital in southern Taiwan. The condition of psychologic distress was assessed in these patients using the DT and Chinese Health Questionnaire-12. We applied a receiver operating characteristic curve analysis to evaluate the discriminative validity of the DT, adopting the Chinese Health Questionnaire-12 score of ≥4 as having psychologic distress. We also used a logistic regression model to determine the associated factors of the concordant screening results of both the DT and the Chinese Health Questionnaire-12.
The DT demonstrated an acceptable validity of discriminating between patients with psychologic distress and those without (area under curve = 0.787). We found a DT score of 4 to be the best cutoff value, with a 72.2% of sensitivity, a specificity of 80.0%, and an accuracy of 79.2%. The concurrence between the DT and the Chinese Health Questionnaire-12 was related to patients' sex and chemotherapy treatment experience.
Our findings show that the DT has acceptable psychometric properties for identifying psychologic distress in patients with cancer. However, the optimal cutoff point of the DT may vary with patients' characteristics.
癌症患者常经历痛苦，早期发现和管理心理痛苦对改善患者预后至关重要。
本研究旨在调查台湾版心理痛苦温度计（DT）的效度，并确定其用于识别临床显著心理痛苦的最佳截断值。
本研究纳入了台湾南部一家综合医院的 768 名癌症住院患者。使用 DT 和中国健康问卷-12 评估这些患者的心理痛苦状况。我们采用受试者工作特征曲线分析评估 DT 的区分效度，以中国健康问卷-12 评分≥4 作为存在心理痛苦的标准。我们还采用逻辑回归模型确定 DT 和中国健康问卷-12 一致筛查结果的相关因素。
DT 区分有心理痛苦和无心理痛苦的患者具有可接受的有效性（曲线下面积=0.787）。我们发现 DT 得分为 4 是最佳截断值，其敏感性为 72.2%，特异性为 80.0%，准确性为 79.2%。DT 与中国健康问卷-12 的一致性与患者的性别和化疗治疗经历有关。
本研究结果表明，DT 具有可接受的心理测量学特性，可用于识别癌症患者的心理痛苦。然而，DT 的最佳截断值可能因患者特征而异。
