Initiation of distress screening in oral cancer clinics in Sri Lanka

Objective This paper describes the initiation of distress screening in oral cancer clinics, among patients with oral cancer in Sri Lanka, addressing the service gap of lack of psychosocial oncology services. This involved validation of the Sinhala version of the Distress Thermometer (DT) and Problem...

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Published in:Psycho-oncology (Chichester, England) England), 2023-07, Vol.32 (7), p.1013-1021
Main Authors: Ratnasekera, Nadisha, Perera, Irosha, Kandapola Arachchige, Pushpakumara, Jayasekara, Prasanna
Format: Article
Language:English
Subjects:
Adjustment disorder
cancer
Clinics
distress thermometer
Hospitals
Kappa coefficient
Medical diagnosis
Medical screening
Oncology
Oral cancer
palliative care
problem list
Psychiatrists
Psychological distress
Psychosocial factors
Psychosocial intervention
psychosocial supportive care
Reliability
screening tool
Sinhala language
Social problems
Value
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Summary:Objective This paper describes the initiation of distress screening in oral cancer clinics, among patients with oral cancer in Sri Lanka, addressing the service gap of lack of psychosocial oncology services. This involved validation of the Sinhala version of the Distress Thermometer (DT) and Problem List (PL) as an adjustment disorder (AD) screening tool. Methods The DT and PL were translated into the Sinhala language and cross‐culturally adopted by the “modified Delphi” technique. The judgment validity was obtained through face, content, and consensual validation. The criterion validation of DT was performed among 95 oral cancer patients from two oro‐maxillofacial‐oncological hospitals in Sri Lanka, against the AD diagnosis of two consultant psychiatrists. Results The DT and the PL revealed good judgment validity. The optimal cut‐off point of DT was 4 with a sensitivity of 91.8% (95% CI = 80.8%–96.8%), specificity of 78.3% (95% CI = 64.4%–87.7%), positive predictive value of 0.81 (95% CI = 0.53%–1.1%) and negative predictive value of 0.90 (95% CI = 0.2%–1.7%). The test re‐test reliability of DT was excellent (Kappa coefficient 0.894). The area under the curve was 0.843. The PL demonstrated poor internal consistency in practical problems (KD‐20 = 0.4), social problems (KD‐20 = 0.3) and spiritual problems (KD‐20 = 0.6). Conclusions The Sinhala version of DT and PL were deemed a valid AD screening tool for patients with oral cancer in Sri Lanka to initiate distress screening in busy oral cancer clinics. However, further validation for the full spectrum of distress is needed, preferably with improvements to PL.
ISSN:1057-9249
1099-1611
DOI:10.1002/pon.6098