Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties.

BACKGROUND: Family caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools. AIM: This study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC). DESIGN: Multicentre, cross-sectional study. SETTINGS/PARTICIPANTS: Family caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA). RESULTS: 138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach's alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale. CONCLUSIONS: The DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.

Evaluación de las propiedades psicométricas de la Escala de Detección de la Soledad Existencial en pacientes con enfermedades avanzadas / Assessment of the psychometric properties of the Scale of Detection of Existential Loneliness in patients with advanced diseases

Objetivo: Analizar las propiedades psicométricas y la utilidad clínica de la Escala de Soledad Existencial (EDSOL) en enfermos hospitalizados con enfermedad avanzada. Método: Para determinar las propiedades psicométricas de la escala, se administró la escala EDSOL junto con otros instrumentos a 103 pacientes adultos con enfermedades avanzadas ingresados en 5 unidades de cuidados paliativos de hospitales catalanes. Resultados: La escala presenta una excelente fiabilidad medida a través del alfa de Cronbach (0,902) y una adecuada estabilidad temporal (r=0,71). La escala mostró correlaciones positivas y significativas con ansiedad y depresión de la escala HADS y con la suma total de la misma, así como con la valoración clínica psicológica (p<0,01). A través del análisis estadístico de las curvas ROC se determinó que la escala presentaba una sensibilidad del 79,8% y una especificidad del 74,6% y se sugiere que el punto de corte para la detección de la EDSOL sea una puntuación de 5. Conclusiones: La EDSOL presenta unas buenas propiedades psicométricas, es sencilla, breve, fiable y fácil de administrar. Consideramos que es una escala útil para detectar la presencia de soledad existencial en enfermos hospitalizados que padecen enfermedades avanzadas

Aim: To analyze the psychometric properties and the clinical utility of the Scale of Existential Loneliness (EDSOL) in hospitalized patients with advanced disease. Method: To determine the psychometric properties of the scale, the EDSOL scale was administered along with other instruments to 103 adult patients with advanced diseases admitted to 5 palliative care units of Catalan hospitals. Results: The scale presents an excellent reliability measured through Cronbach’s alpha (0.902) and adequate temporal stability (r = 0.71). The scale showed positive and significant correlations with anxiety and depression of the HADS scale and with the overall score of HADS, as well as with the clinical psychological assessment (p <0.01). Through the statistical analysis of the ROC curves, it was determined that the scale had a sensitivity of 79.8% and a specificity of 74.6% and it is suggested that the cut-off point for the detection of EDSOL be a score of 5. Conclusions: The EDSOL scale has good psychometric properties, is simple, brief, reliable and easy to administer. We consider that is an useful scale to detect the presence of existential loneliness in hospitalized patients suffering from advanced diseases

Desarrollo de la escala "EDSOL" para la detección de la soledad existencial en enfermos al final de la vida / Development of the EDSOL scale for the detection of existential loneliness in patients at end of life

Objetivo: Presentar el desarrollo de la escala de detección de la soledad existencial (EDSOL) en personas con enfermedades avanzadas en tratamiento paliativo. Método: Se describe el proceso de elaboración de la escala Detección de la Soledad Existencial EDSOL. Para ello, 1) se ha revisado la bibliografía existente sobre el tema; 2) se ha establecido un marco teórico de referencia; 3) se han definido los criterios que debía cumplir el instrumento de cribado; y 4) se ha consultado con expertos y enfermos la adecuación de los ítems de la escala. Resultados: Se presenta a la escala EDSOL, que consta de dos partes: 1) tres preguntas dirigidas a los enfermos; y 2) diferentes observaciones realizadas por el personal sanitario acerca de la presencia de signos externos de soledad existencial. La escala final fue revisada por enfermos y profesionales. Conclusión: La escala EDSOL es una herramienta apropiada para identificar la presencia de Soledad Existencial en pacientes al final de la vida. En este caso, se propondrá su uso sistemático en la detección temprana de la Soledad Existencial y la implementación de intervenciones asistenciales específicas (AU)

Aim: This paper presents the development of Detection of Existential Loneliness Scale (EDSOL) of patients with advanced disease/terminal illness that receiving palliative care. Method: The process of preparing the scale is described. For this: 1) the literature on the subject has been revised, 2) theoretical framework has been established, 3) it has been defined the criteria to be met by the screening tool, and 4) the final scale was reviewed by patients and experts. Results: The EDSOL scale consists of two parts: 1) three questions addressed to patients and; 2) several questions addressed to health staff about the observation of external signs of Existential Loneliness. The final scale was reviewed by patients and experts (facie validity) showing good validity. Conclussion: The EDSOL scale will be an appropriate tool for identifying the Existential Loneliness of patients at the end of life or advanced illness. In this case, we will propose the systematic use of EDSOL for early detection and specific interventions on existential loneliness experiences (AU)