J Natl Compr Canc Netw. 2018 Aug;16(8):959-966. doi: 10.6004/jnccn.2018.7027.
The objective of this study was to validate the NCCN Distress Thermometer (DT), including the accompanying Problem List (PL), in a Swedish population of patients diagnosed with colorectal cancer (CRC). A total of 488 patients diagnosed with CRC completed the DT/PL and EORTC core quality-of-life questionnaire (QLQ-C30) before surgery. Construct validity of the PL was analyzed using a confirmatory factor analysis. Internal consistency reliability (ICR) was tested using Cronbach's alpha coefficient. Correlations between the reported PL areas and QLQ-C30 function scales were used to explore convergent validity. Discriminant validity was examined by evaluating associations between the DT and QLQ-C30 measures of overall health-related quality of life (HRQoL). Findings showed that the Swedish translation of the DT/PL is consistent with the original English version. The DT has good ICR, with the total number of reported problems significantly correlating with DT scores (=0.67; <.001). Analysis of convergent validity indicated that the PL areas significantly correlated with QLQ-C30 function scales, with emotional problems showing the highest correlation (=0.76; <.001), and item-level correlation analyses showed significant correlations between symptoms. There was also good discriminant validity between the DT and the QLQ-C30 in terms of HRQoL, including overall health status (=-0.49; <.001) and overall quality of life (=-0.57; <.001). Furthermore, there was good discriminant validity between the DT and QLQ-C30 regarding poor, moderate, and excellent HRQoL. These findings provide validity evidence regarding the DT, including the PL. Findings also show that the DT has good potential for screening distress-related practical, family, emotional, and physical problems during the cancer trajectory in Swedish-speaking patients. Additionally, the DT seems to be an effective screening tool to detect patients with poor, moderate, and excellent HRQoL.
本研究旨在验证 NCCN 苦恼温度计（DT），包括随附的问题清单（PL），在瑞典结直肠癌（CRC）患者人群中的有效性。共有 488 名被诊断为 CRC 的患者在手术前完成了 DT/PL 和 EORTC 核心生活质量问卷（QLQ-C30）。使用验证性因素分析分析了 PL 的结构有效性。使用 Cronbach's alpha 系数测试内部一致性可靠性（ICR）。使用报告的 PL 区域与 QLQ-C30 功能量表之间的相关性来探索收敛有效性。通过评估 DT 和 QLQ-C30 对整体健康相关生活质量（HRQoL）的测量之间的关联来检验判别有效性。研究结果表明，DT/PL 的瑞典语翻译与原始英文版一致。DT 具有良好的 ICR，报告的问题总数与 DT 分数显著相关（=0.67；<.001）。收敛有效性分析表明，PL 区域与 QLQ-C30 功能量表显著相关，其中情绪问题相关性最高（=0.76；<.001），症状的项目级相关性分析也显示出显著相关性。在 HRQoL 方面，DT 和 QLQ-C30 之间也具有良好的判别有效性，包括总体健康状况（=-0.49；<.001）和总体生活质量（=-0.57；<.001）。此外，DT 和 QLQ-C30 之间在较差、中等和较好的 HRQoL 方面也具有良好的判别有效性。这些发现为 DT 提供了有效性证据，包括 PL。研究结果还表明，DT 具有在瑞典语患者的癌症轨迹中筛查与苦恼相关的实际、家庭、情感和身体问题的良好潜力。此外，DT 似乎是一种有效的筛查工具，可用于检测 HRQoL 较差、中等和较好的患者。
