Validation of Malaysian translated distress thermometer with problem checklist among the breast cancer survivors in Malaysia

IntroductionDistress thermometer (DT) is a single-item measure generated to assess the psychological distress among cancer patients. The aim of this study was to validate the translated DT as a tool to determine the psychological distress level and assess the factors associated with distress among the working breast cancer survivors and also to compare with the Hospital Anxiety and Depression Scale (HADS).Methods150 working breast cancer survivors were interviewed using the Malay and Chinese language translated version of DT and HADS.ResultsBased on HADS, 23.3% were anxious, 19.3% were depressed whereas 15.3% experienced both anxiety and depression. About 14.7% of the respondents reported distress (cutoff ≥ 5) on DT. A significant association was found between the DT and HADS which indicated that both were measuring the same construct, Hospital Anxiety and Depression Scale-T (F = 71.34, p < 0.001), Hospital Anxiety and Depression Scale-A (F = 65.81, p < 0.001), Hospital Anxiety and Depression Scale-D (F = 74.28, p < 0.001). This study also showed that a cut-off of ≥5 on DT yielded an area under Receiver analysis characteristic curve (AUC) of 0.95 with a sensitivity of 90.9% and specificity of 89.8% for HADS-T score defined as cases. On the problem checklist, respondents scoring above the cut-off of 5 on DT had a greater number of problems with family (70.0%), emotional (65.0%), physical (60.0%), practical (50.0%) and spiritual/religious (15.0%) issues.DiscussionOverall, DT was a useful and simple screening tool to indicate psychological distress. The translated DT has a good sensitivity and specificity for screening psychological distress among the Malaysian breast cancer survivors.