Brief emotional screening in oncology: Specificity and sensitivity of the emotion thermometers in the Portuguese cancer population

Abstract

ObjectiveThis study aimed to determine the cutoff and the specificity and sensitivity of the Emotion Thermometers (ET) in a Portuguese sample of cancer patients.MethodA total of 147 patients (mean age = 49.2; SD = 12.6) completed the ET, the Brief Symptom Inventory (BSI), and the Subjective Experiences of Illness Suffering Inventory. Data were collected in a cancer support institution and in a major hospital in the North of Portugal.ResultThe optimal cutoff for the Anxiety Thermometer was 5v6 (until 5 and 6 or more), which identified 74% of the BSI-anxiety cases and 70% of noncases. The Depression Thermometer cutoff was 4v5 (until 4 and 5 or more), which identified 85% of BSI-depression cases and 82% of noncases. Cutoff for the Anger Thermometer was 4v5 (until 4 and 5 or more), which identified 83% of BSI-hostility cases and 73% of noncases; for the Distress Thermometer, the optimal cutoff was 4v5 (until 4 and 5 or more), which identified 84% of the suffering cases and 73% of noncases. Finally, for the Help Thermometer, it was 3v4 (until 3 and 4 or more), which helped to identify 93% of the suffering cases and 64% of noncases.Significance of resultsResults supported the Portuguese version of the ET as an important screening tool for identifying the emotional distress in cancer patients.

Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool

“…Overall, the results showed, as expected, that most of the patients experienced high levels of distress, with 87% of patients being above the cut-off (≥5) proposed by Teixeira et al [23]. Thus, it confirms the results of previous studies showing that cancer patients tend to experience a wide range of negative outcomes [2][3][4][5][6].…”

“…In a recent review concerning the use of ETs among individuals diagnosed with cancer, Harju et al stated that overall ETs are a sensitive tool to screen for distress, as found by five validation and two exploratory studies, that recommended a cut-off equal to or greater than four [22]. In Portugal, the ETs were validated by Teixeira et al using a sample of 147 cancer patients [23]. The authors found that the ETs have excellent discrimination and identified the optimal cut-off values for each ET.…”

Epidemiology of mental health problems among patients with cancer during COVID-19 pandemic

“…Depression was measured by the Patient Health Questionnaire-9 (PHQ-9), using a 9-item 4-point Likert scale, with higher total scores indicating a higher level of depression symptoms; a cut-off score of 7 indicated high risk of clinical depression 30 , 31 . Hostility was measured by hostility subscale of the Brief Symptom Inventory (BSI), which consists of five items with rating from 0 (not at all) to 4 (extremely);a cut-off scores of 4 indicated higher risk of hostility 32 , 33 . COVID-19-related PTSD was measured by the Impact of Events Scale-Revised (IES-R), which is a 22-item 5-point Likert scale; higher total scores indicate severe PTSD symptoms, with a cut-off score of 33 to recommended PTSD diagnosis 34 .…”

Hostility in cancer patients as an underexplored facet of distress

“…The “Anger Thermometer” was able to detect cases of significant distress (cut‐off score of 4) that were not identified by using the conventional Distress Thermometer (DT) only. Again, “caseness” of anger on the Anger‐ET was found in 15% of 149 breast cancer patients 31 and in 24% in a large sample of over 2,000 cancer patients, 32 in 18% of 158 long survivors of cancer by using the Anger/Hostility dimension of the Profile of Mood sates (POMS), 33 and in 28% out of 147 cancer patients by using the BSI‐HOS subscale 34 . This suggests that carefully exploring these dimensions among the several emotional reactions to cancer in structured program for early screening in cancer care is necessary and clinically useful 35,36 …”