PSYCHOMETRIC PROPERTIES OF THE CANCER AND TREATMENT DISTRESS (CTXD) MEASURE IN HEMATOPOIETIC CELL TRANSPLANTATION PATIENTS

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PSYCHOMETRIC PROPERTIES OF THE CANCER AND TREATMENT DISTRESS (CTXD) MEASURE IN HEMATOPOIETIC CELL TRANSPLANTATION PATIENTS

Abstract

Objective

This study examines the psychometric properties of a measure of distress specific to cancer and its treatment, as tested in patients receiving hematopoietic cell transplantation (HCT).

Methods

With multicenter enrollment, the Cancer and Treatment Distress (CTXD) measure was administered to adults beginning HCT as part of an assessment that included the Center for Epidemiologic Studies Depression (CESD), Profile of Mood States (POMS) and Medical Outcomes Study Short Form 36 (SF-36).

Results

From eight transplant centers, 176 of 219 eligible patients completed the assessment. Average age was 46.7 (SD=11.9), 59% were male, the majority identified as Caucasian (93%). Principal components analysis with the CTXD identified 22 items that loaded onto six factors explaining 69% of the variance: uncertainty, health burden, identity, medical demands, finances, and family strain. Internal consistency reliability for the 22 items was 0.91. The receiver operating characteristic (ROC) area under the curve was 0.85 (95% confidence interval: 0.79, 0.91), with a cut point of 1.1 resulting in sensitivity of 0.91 and specificity of 0.58. Convergent and divergent validity were confirmed with large correlations of the CTXD total score with the CESD, POMS and SF-36 mental health, and a smaller correlation with the SF-36 physical function (r = −0.30).

Conclusion

The CTXD is a reliable and valid measure of distress for HCT recipients and captures nearly all cases of depression on the CESD in addition to detecting distress in those who are not depressed. It has potential value as both a research and clinical screening measure for distress.

Keywords: distress, cancer, oncology, psychometric, depression, hematopoietic cell transplantation

TABLE OF CONTENT

Title page- – – – – – – – – i
Approval page – – – – – – – -ii
Dedication – – – – – – – – -iii
Acknowledgement – – – – – – – -iv
Abstract – – – – – – – – – -v
Table of content – – – – – – – -vi

CHAPTER ONE
INTRODUCTION – – – – – – – -1
1.0 Background of the study – – – – -1
1.1 Statement of the problem – – – – -5
1.2 Purpose of the study – – – – – -6
1.3 Significance of the study – – – – -8
1.4 Research questions – – – – – -9
1.5 Scope of the study – – – – – – -10

CHAPTER TWO

LITERATURE REVIEW – – – – – – -11

CHAPTER THREE

Research methodology – – – – – – -39
Design of study – – – – – – – -40

CHAPTER FOUR

Presentation, analysis and interpretation of data – -48

CHAPTER FIVE

Summary of findings – – – – – – -60
Conclusion – – – – – – – – -61
Recommendations – – – – – – – -62
Suggestions for further research – – – – -64
References – – – – – – – – -65
Appendix I – – – – — – – – -68
Questionnaire. – – – – – – – -69

PSYCHOMETRIC PROPERTIES OF THE CANCER AND TREATMENT DISTRESS (CTXD) MEASURE IN HEMATOPOIETIC CELL TRANSPLANTATION PATIENTS

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