忧伤温度计在中国肿瘤患者的适用性研究

Validation of the Distress Thermometer in Chinese cancer patients

目的探讨忧伤温度计在我国肿瘤患者应用的可行性,为临床医务人员提供简单、快速筛选肿瘤患者忧伤状况的量表。方法通过翻译、回译美国国家综合肿瘤网推荐的忧伤温度计,构建中文版忧伤温度计。对189例恶性肿瘤患者运用医院焦虑抑郁量表、中文版忧伤温度计进行调查,运用ROC曲线分析中文版忧伤温度计灵敏度、特异度和临界值,运用χ2检验和Kappa系数判断两者的一致性。结果肿瘤患者忧伤温度计得分3.51±2.56;HAD总分10.14±6.18;以HAD总分≥15分为临界值时,26.98%肿瘤患者有严重的心理疾患;忧伤≥4分时,30.69%患者有心理疾患。ROC曲线显示忧伤为4分时,灵敏度为0.902,特异度为0.863,约登指数=0.827,Kappa=0.806,秩相关系数0.832。结论中文版忧伤温度计是一种简单、有效、快速筛查肿瘤患者忧伤情况的量表。

Objective To examine the feasibility of the Distress Thermometer （DT） applied to Chinese cancer patients, and to provide medical staff with a simple and fast screening instrument to measure cancer patients＇ distress. Methods DT which was recommended by the National Comprehensive Cancer Network was translated into Chinese version and back-translation was performed. A total of 189 patients with malignant tumors were investigated by using the Hospital Anxiety and Depression Scale （HAD） and the Chinese DT. ROC curve was used to test sensitivity, specificity, and critical value, and consistency between HAD and DT was tested by 2 test and Kappa coefficient. Results Patients＇ distress measured by the DT scored 3.51±2.56, the total HAD score was 10.14± 6.18. When the HAD cutoff score was set at 15 or higher, 26.98% of the patients experienced severe mental disorders; when the DT cutoff score was set at 4 or higher, 30.69 % of them had mental disorders. ROC curve indicated the optimal cut-point was 4, with the sensitivity of 0. 902 and specificity of 0. 863. The Youden index, Kappa coefficient, and Spearman rank correlation coefficient between HAD score and DT score were 0. 827, 0. 806, and 0. 832 respectively. Conclusion The Chinese DT is a simple, effective and fast screening instrument for measuring distress of cancer patients.