Validity and feasibility of the Arabic version of distress thermometer for Saudi cancer patients

Abstract

BackgroundThe distress thermometer (DT) has been studied and validated as an effective screening instrument for identifying distress among cancer patients worldwide. This study aims to evaluate the validity of the Arabic version of the DT in Saudi cancer patients, to define the optimal cutoff point of the Arabic DT for detecting clinically significant distress and to determine whether there is any correlation between clinically significant distress and other demographic and Problem List variables.MethodsThe original form of the DT was translated to Arabic using a forward and backward translation method. Then, a group of 247 cancer patients who were followed up at the Outpatient Oncology Clinic at King Saud Medical City in Riyadh, Saudi Arabia, completed a socio-demographic and clinical status questionnaire, the DT and the Problem List scale, and the Hospital Anxiety and Depression Scale (HADS).ResultsReceiver operating characteristic (ROC) curve analyses picked out an area under the curve of 0.76 when compared with a HADS cutoff score of 15. The DT had the best sensitivity (0.70) and specificity (0.63) with cutoff score of 4. A DT score of 4 or more was found to have a statistically significant correlation with female gender, advanced cancer stages and most of the Problem List items, including child care, work or school, treatment decision, dealing with children and partners, depression, fears, nervousness, sadness, loss of interest in usual activity, religious concerns, appearance, bathing/dressing, breathing, diarrhea, fatigue, feeling swollen, fever, getting around, indigestion, memory and concentration, nausea, dry nose, pain, and sexual problems. In contrast, a multivariate regression analysis confirmed only advanced cancer stages, treatment decision, depression, fear, sadness, worry, breathing, feeling swollen, fever, indigestion, memory and concentration, dry nose and congestion, pain and sleep as independent factors associated with distress in cancer patients.ConclusionsWe found the Arabic version of the DT to be a valid instrument for screening distress in Saudi patients with cancer. Our study proposes using a cutoff score of 4 as an indicator of clinically significant distress in this population.

Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?

“…These encountered problems are similar to those found by Alosaimai and coworkers [18] and could be explained by the similatrities between the cultural, emotional, spiritual, and physical demographics in the two study Arabian populations. The relationship between experienced distress and dissatisfaction with the treatment decision is probably bidirectional [21]. To alleviate treatment decision-related distress, it might be helpful to provide with patients with prognostic information, elicit decisionmaking preferences, and appreciate their fears and goals [22].…”

Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?

“…A P-value < 0.05 was considered statistically signi cant. Binary logistic regression test was carried out to explore the association between the DT cut-off scores of 4 [18] and the demographic and clinical variables, while binary and multivariable logistic regression tests were used to analyse the association between the DT cut-off scores and individual items in the PL.…”

“…The recently validated Arabic version of DT [18] was used for screening patients of the current study for distress with a cut-off score of ≥4 for signi cant distress. The study objectives and procedure were fully explained to the eligible patients.…”

“…Screening was carried out for newly diagnosed patients with cancer at their rst out-patient visit or in-patient admission. Patients were asked to rate their distress in the past week on an 11-point visual analog scale ranging from 0 (no distress) to 10 (extreme distress) [18]. Patients were then asked to ll in the Problem List (PL) that accompanies the visual image of the DT to check whether or not (yes/no) they have any of the problems listed during the previous 7 days [2,18].…”

“…Review of the literature had shown that DT has been investigated and validated as an effective screening tool for detecting distress among patients with various types of cancer, such as prostate carcinoma [10], lung cancer [11], and breast cancer. Moreover, the original NCCN English version [13] has been successfully translated into several languages, including Dutch [14], Japanese [15], Turkish [16], Italian, Spanish and Portuguese [17], and recently its Arabic version has been validated in Saudi cancer patients [18].…”