Journal
QUALITY OF LIFE RESEARCH
Volume 21, Issue 4, Pages 555-562Publisher
SPRINGER
DOI: 10.1007/s11136-011-9972-x
Keywords
Screening; Distress thermometer; Cancer; Culture
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Funding
- Maccabi Institute for Health Services Research
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Background The adaptability of the distress thermometer (DT) to multicultural groups has rarely been assessed. Aims To assess DT adaptability to the Israeli population as a multicultural society. Methods Participants were 496 cancer patients. They were recruited for 3 days a week in 2009-2010 (97% response rate). Participants completed the DT, a problem list, Hospital Anxiety and Depression Scale (HADS), and the Brief Symptom Inventory (BSI-18). Results Receiver-operating characteristic (ROC) curve analyses of DT scores yielded area under the curve (AUC) of 0.63 as against HADS and of 0.78 as against BSI-18. ROC analysis revealed that the optimal cutoff score was <= 3. It yielded sensitivity and specificity of 0.74 and 0.65, as against the HADS, and 0.64 and 0.64, as against the BSI-18. The Jewish participants reported higher distress than the Arab participants, and the ROC properties were markedly higher for the Jewish subgroup alone. Conclusions The adapted DT was moderately efficient for detecting emotional distress in cancer patients in Israel. Cultural aspects related to distress should be taken into account for administration of the DT in multicultural societies.
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