Grupo Área de Investigaciones, Instituto Nacional de Cancerología - E.S.E., Bogotá, D.C., Colombia; Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
Grupo de Salud Mental, Instituto Nacional de Cancerología - E.S.E., Bogotá, D.C., Colombia.
Biomedica. 2021 Dec 15;41(4):721-733. doi: 10.7705/biomedica.6131.
Introduction: Cancer patients have significant levels of emotional distress. The National Comprehensive Cancer Network (NCCN) developed the distress management tool to quickly assess significant distress in oncological patients who require intervention. For its use in Colombia, we made its cross-cultural adaptation and validation. Objective: To determine the operative characteristics of the distress management tool, version 2.2018, in patients seen at the Instituto Nacional de Cancerología (INC) in Colombia. Materials and methods: Counting with the authorization from the NCCN, we translated, made the cross-cultural adaptation, and evaluated the operational characteristics of the tool. We included 343 cancer patients seen at the INC, who filled out the cross-culturally adapted instrument. A diagnostic test study was carried out with a semi-structured interview as a reference. Results: The patients had an average age of 49.7 years (SD=15) and the majority were women (67%). The instrument had an area under the ROC curve of 0.81 (95% CI: 0.77 -0.86); its optimal cut-off point was 3.5 approached to 4 when using integers on the scale; its sensitivity was 0.81 (95% CI: 0.76 - 0.85), and its specificity, 0.69 (95% CI: 0.64 - 0.74). The agreement percentage between the result of the interview and the instrument was 73% (kappa = 0.64; p< 0.001). Conclusions: The distress management tool allowed for the detection of moderate to severe distress requiring intervention and management. This instrument was adapted and validated in cancer patients in Colombia keeping the cutoff point at ≥ 4 as in the original version.
癌症患者存在明显的情绪困扰。美国国家综合癌症网络(NCCN)开发了这种痛苦管理工具,以便快速评估需要干预的肿瘤患者的显著痛苦。为了在哥伦比亚使用,我们对其进行了跨文化适应性和验证。目的:确定 NCCN 授权的 2.2018 版痛苦管理工具在哥伦比亚国家癌症研究所(INC)就诊的患者中的操作特性。材料和方法:在获得 NCCN 授权的情况下,我们对该工具进行了翻译、跨文化适应性调整,并评估了其操作特性。我们纳入了在 INC 就诊的 343 例癌症患者,他们填写了跨文化适应性工具。采用半结构化访谈作为参考进行诊断测试研究。结果:患者的平均年龄为 49.7 岁(标准差=15),大多数为女性(67%)。该工具的 ROC 曲线下面积为 0.81(95%置信区间:0.77-0.86);其最佳截断点为 3.5,接近整数尺度上的 4 时,接近 4;其灵敏度为 0.81(95%置信区间:0.76-0.85),特异性为 0.69(95%置信区间:0.64-0.74)。访谈结果与工具结果之间的一致性百分比为 73%(kappa=0.64;p<0.001)。结论:痛苦管理工具可检测需要干预和管理的中重度痛苦。该工具在哥伦比亚的癌症患者中进行了适应性和验证,保留了与原始版本相同的≥4 的截断点。