Validity of the Psycho-Oncology Screening Tool (POST)

Abstract

Identifying cancer patients who are experiencing psychosocial challenges during the early phase of oncology treatment can prevent escalating patient distress. Standardized screening methods allow the medical team to identify those at high risk for poor adjustment. The purpose of this study was to provide preliminary psychometric evidence for a brief, self-administered screening instrument, the Psycho-Oncology Screening Tool (POST), designed to evaluate emotional and physical distress, depressive symptoms, and social concerns. Participants included 944 radiation oncology patients who completed the POST prior to their treatment appointment and a subgroup of 516 patients who completed the POST and one of six concurrent validity measures. Psychometric analysis included construct validity evidence provided through confirmatory factor analysis (CFA), internal reliability estimates, and concurrent validity estimates assessed with bivariate correlations between POST subscales scores and conceptually similar established measures. A three-factor CFA model was found to produce acceptable model fit, supporting the three domain structure of the POST. Furthermore, the three subscales--emotional and physical distress, depressive symptoms and social concerns--were found to produce acceptable internal reliability estimates (α = .73-.88). Concurrent validity evidence was observed with significant, moderate to large correlations between the POST subscales and all relevant measures (i.e., Profile of Mood States, Hospital Anxiety and Depression Scale, Functional Assessment of Cancer Therapy Fatigue, Beck Depression Inventory, Pain Disability Index, and the Interpersonal Support Evaluation List) with correlations ranged from 0.42 to 0.83, p < 0.01. Patients and clinic staff reported no problems administering or completing the POST. Results of this study support the psychometric soundness as well as the feasibility and acceptability of the POST as a brief screening tool for oncology patients receiving outpatient services.

Experiences with a psychosocial screening instrument (S‐FIRST) to identify the psychosocial support needs of parents of children suffering from cancer

“…This method requires that, in addition to the values of the screening instrument, an independent measurement is available that divides the population of interest into two groups. Usually, this allocation is achieved through the use of another diagnostic test . We used two reliable instruments—the Impact on Family Scale (IFS) and the Munich List of Quality of Life Dimensions (MLDL)—as they assess for comparable dimensions.…”

“…The systematic assessment of burden and needs is essential to identify clients with a high psychosocial burden and to allow for accurate decisions to be made regarding indications for treatment. Screening instruments, such as the Distress Thermometer, the (revised) Psychosocial Assessment Tool (PAT) or others, allow for the screening of psychosocial risks (and competencies) . The PAT is a parent–report screener that classifies families into a low‐risk, medium‐risk, or high‐risk group .…”

A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting

“…The traditional paper-based PROs instruments are limited by its lack of flexibility, language and literacy requirement, [5,6] possible inappropriateness towards minority groups, [7,8] lack of timeliness (in generating instantaneous clinical meaningful interpretations) [9] and inability to adopt state-of-the-art measurement science such as Item Response Theory (IRT) and Computer Adapted Test (CAT) technique [10]. To overcome the difficulty of integrating the administration and analysis of PRO instruments into clinical practice, researchers are developing and validating alternatives to traditional paper-based instruments such as office-based touch-screen computers, [11-13] telephone-based interactive voice-response (IVR) systems, [14-16] hand-held computers, [17,18] mobile phones, [19-21] and more recently, the Internet [22-24]. Some rationales [25-28] put forward for measuring PROs in a cancer setting include, but not limited to: 1) better communication and shared decision making by patients and providers; 2) assessing the health status of patients entering therapy and identifying treatable problems; 3) determining the degree and sources of the patient’s decreased ability to function; 4) distinguishing between types of problems, including physical, emotional, and social; 5) detecting adverse effects of therapy; 6) monitoring the effects of disease progression and response to therapy; 7) informing decisions about changing treatment plans, and 8) predicting the course of disease and outcomes of care.…”

Now What? Toward an Integrated Research and Practice Agenda in Distress Screening

“…In addition, longer tools are capable of assessing multiple domains of distress (Vodermaier et al, 2009). Commonly used instruments include the 14-item Hospital Anxiety and Depression Scale (HADS), the 13-item Psychological Distress Inventory (PDI), the 18-item Brief Symptom Inventory (BSI), and the recently developed 33-item Psycho-Oncology Screening Tool (POST) (Bjellan, Alv, Haug, & Neckelman, 2007;Kilbourn et al, 2011;Morasso, Constantini, Baracc, Borreani, & Capelli, 1996;Zabora, BrintzenhofeSzoc, Jacobsen, et al, 2001;Zigmond & Snaith, 1983). By nature of their brevity, ultrashort measures generally focus on only one psychological domain.…”