Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan.
Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Palliat Support Care. 2023 Aug;21(4):677-687. doi: 10.1017/S147895152200092X.
This study aims to (i) develop a screening tool for determining distress and supportive care needs of adolescent and young adult cancer patients (AYAs) based on the NCCN's Distress Thermometer and Problem List (DTPL), (ii) evaluate its feasibility, discriminant validity, and test-retest reliability in clinical settings, and (iii) report prevalence of distress and unmet needs.
In the development phase, after translation of the Japanese version of the DTPL (DTPL-J) from English into Japanese and back translation, cognitive debriefing was performed. Items in the problem list were modified to better reflect AYAs' concerns after interviews. The modified items were reviewed and accepted unanimously by healthcare professionals. In the feasibility phase, the DTPL-J for AYAs was used in a clinical setting for 3 months. Descriptive statistics of participants' demographics, selected items, and DT scores were calculated to report prevalence of distress and unmet needs. Response and referral rates to experts were assessed to evaluate feasibility. Some items were compared with patient demographics to assess discriminant validity. Among the patients who responded at least twice, correlations between two consecutive screenings were assessed to evaluate test-retest reliability.
The DTPL-J consisted of 49 items in five categories. Of 251 patients, 232 (92.4%) were provided the DTPL-J and 230 (91.6%) responded. Based on the DT cutoff of ≥4, 69 of 230 patients (30%) had high distress. Anxiety ( = 85, 36.6%) was the most commonly selected item. Primary nurses referred 45 (21.7%) patients to an attending physician or another expert. Referral rates after DTPL-J use were higher than rates before use, but the difference was not statistically significant ( = 0.06). The items compared were consistent with their social background. A positive correlation was observed between two responses for some items.
The feasibility, discriminant validity, and test-retest reliability of the tool were suggested.
本研究旨在(i) 基于 NCCN 的痛苦温度计和问题清单（DTPL），为青少年和年轻成年癌症患者（AYA）开发一种用于确定其痛苦和支持性护理需求的筛查工具；(ii) 在临床环境中评估其可行性、判别有效性和重测信度；以及(iii) 报告痛苦和未满足需求的普遍性。
在开发阶段，对 DTPL 的日语版本（DTPL-J）进行了从英语到日语的翻译和回译后，进行了认知审查。对问题清单中的项目进行了修改，以更好地反映 AYA 的关注点。经访谈修改后的项目由医疗保健专业人员审查并一致通过。在可行性阶段，使用 DTPL-J 对 AYA 进行了 3 个月的临床评估。对参与者的人口统计学、选定项目和 DT 评分的描述性统计数据进行了计算，以报告痛苦和未满足需求的普遍性。评估了对专家的回应和转介率，以评估可行性。将某些项目与患者的人口统计学数据进行了比较，以评估判别有效性。在至少两次回应的患者中，评估了两次连续筛查之间的相关性，以评估重测信度。
DTPL-J 由五个类别中的 49 个项目组成。在 251 名患者中，232 名（92.4%）提供了 DTPL-J，230 名（91.6%）作出了回应。根据 DT 临界值≥4，230 名患者中有 69 名（30%）存在高痛苦。焦虑（ = 85，36.6%）是最常被选择的项目。初级护士将 45 名（21.7%）患者转介给主治医生或其他专家。使用 DTPL-J 后的转介率高于使用前，但差异无统计学意义（ = 0.06）。比较的项目与其社会背景一致。一些项目的两次回应之间存在正相关。
该工具的可行性、判别有效性和重测信度得到了提示。
