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Cited by 29Cancer survivorship and careHealth Education and ValidationAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Validation of the Distress Thermometer in a Swedish population of oncology patients; accuracy of changes during six months

Thalén-Lindström, Annika, Larsson, Gunnel, Hellbom, Maria, Glimelius, Bengt, Johansson, Birgitta·2013·European Journal of Oncology Nursing
DOI 10.1016/j.ejon.2012.12.005
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Abstract

Purpose To validate the Swedish version of the Distress Thermometer (DT) against the Hospital Anxiety and Depression Scale (HADS) for screening of distress and to explore how well DT measures changes of distress during six months in a population of heterogeneous oncology patients.Methods The DT was translated into Swedish according to the forward- and back-translation procedure. HADS total score ≥15 was used as gold standard. Consecutive patients were invited to participate at their first visit to the Oncology department. The HADS and the DT were completed at baseline and after 1, 3 and 6 months.Results 462 baseline and 321 six-month assessments were completed. The patients had a variety of cancer diagnoses (n = 42). Most patients (95%) received active treatment. The DT compared favourably with the HADS. The area under the curve was 0.86 (95% CI, 0.82-0.90). DT ≥ 4 showed a sensitivity of 87%, a specificity of 73%, a positive predictive value (PPV) of 52% and a negative predictive value (NPV) of 95% at baseline. The results from the 1, 3 and 6 months assessments were equivalent baseline results. The DT means changed in the same direction as HADS at all points of assessment. Patients with distress reported statistically significantly more problems in all categories on the associated 'Problem List' compared to non-distressed patients.Conclusion The Swedish version of the DT with a score ≥4 is valid for screening of distress in heterogeneous oncology patients. Its ability to measure changes in distress over time is comparable to HADS.

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Authors
Thalén-Lindström, A., Larsson, G., Hellbom, M., Glimelius, B., & Johansson, B.
Affiliations
  • Uppsala University (SE)
  • Skåne University Hospital (SE)
Corresponding author
  • Thalén-Lindström, Annika
  • Larsson, Gunnel
  • Hellbom, Maria
  • Glimelius, Bengt
  • Johansson, Birgitta
ORCID
Johansson, Birgitta
Venue
European Journal of Oncology Nursing
Publisher
Elsevier BV
Published
2013-10
Volume
17
Issue
5
Pages
625-631
ISSN
1462-3889 (ISSN-L)
DOI
10.1016/j.ejon.2012.12.005
OpenAlex
W2060349013
Cited by
29
References
29
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 4 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 1
FWCI
1.78
Type
journal article
Language
en
Open access
closed
Locations
  • European Journal of Oncology Nursing (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Education › Health Education and Validation
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
Distress Thermometer, psychological distress screening, cancer patients, Swedish translation, cross-cultural validation, Hospital Anxiety and Depression Scale, anxiety and depression, sensitivity and specificity, problem list
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Analysis of Variance, Anxiety, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms, Psychometrics, Surveys and Questionnaires, ROC Curve, Severity of Illness Index, Stress, Psychological, Sweden, Time Factors, Cohort Studies, Incidence, Age Distribution, Sex Distribution, Young Adult

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