The Basic Documentation for Psycho-Oncology (PO-Bado): An innovative tool to combine screening for psychological distress and patient support at cancer diagnosis

French adaptation of the PO-Bado short form, an interview-based expert rating scale for distress screening

OBJECTIVE

Basic Documentation for Psycho-Oncology (PO-Bado) is a hetero-assessment and psychosocial burden documentation tool for cancer patient caregivers (across all types and stages). Recently, the psychometric properties of the standard 12-item version of PO-Bado were published. However, the standard version is relatively time-consuming for the caregivers. Here, we developed and examined psychometric properties of a French short-form of PO-Bado (PO-Bado-FSF) with seven items derived from the validated standard version.

METHODS

One hundred and twenty-one cancer patients (M age = 58.4 years, SD = 13.9 years; 68.6% were women) participated in this study during a supportive care following the first diagnosis of cancer or a relapse. All patients completed the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), in addition to the PO-Bado-FSF.

RESULTS

PO-Bado-FSF scores exhibit sound psychometric qualities such as internal consistency, test-retest reliability, inter-rater reliability, and scalability (i.e. Mokken's scalability coefficients); all items loaded significantly on the single CFA factor and yielded coefficients 0.40 or higher.

CONCLUSIONS

The results of this study highlight the value of using PO-Bado-FSF to identify psychological distress in cancer patients in research and practice. PO-Bado-FSF presents good psychometric properties and is less time-consuming than the standard version.

Differences in depressive and anxiety symptoms between cancer and noncancer patients with psychological distress

BACKGROUND

Cancer patients are particularly vulnerable to psychological problems. The purpose of the present study was to compare differences in psychological difficulties, including depression and anxiety, between cancer patients and noncancer patients. This study assessed the differences in depressive and anxiety symptoms between patients with and without cancer.

MATERIALS AND METHODS

Participants included 219 patients at The Cancer Center, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea, who reported depressive or anxiety symptoms between April 2014 and April 2016. Patients were categorized into cancer and noncancer groups based on medical histories showing a diagnosis of any type of cancer. The Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate psychological distress at each patient's first visit. Patients' charts were reviewed for clinical data, including BDI and BAI scores and duration of cancer treatment, and for demographic data such as age and sex.

RESULTS

The results showed that patients in the cancer group experienced greater discomfort related to somatic symptoms; higher BDI subscale scores were related to work difficulties, insomnia, loss of appetite, somatic worries (fatigue), and loss of libido compared with patients in the noncancer group. The BAI subscale scores for fear of the worst happening, feeling unsteady, feeling terrified or afraid, a sense of choking, fear of dying, and feeling scared were higher in patients with than in those without cancer.

CONCLUSION

High levels of depressive symptoms related to somatic discomfort and anxiety symptoms related to fear of cancer were associated with considerable psychological distress in patients with cancer diagnosis and treatment.

[An interview guide for screening for psychological pain in oncology]

An interview guide has been introduced with patients treated in oncology in order to assess their psychological pain. It helps to structure the nurse interview. It also combines the identification of the patient's psychological needs with the creation of an opportunity to talk, thereby initiating a help relationship.

Screening for distress in patients with intracranial tumors during the first 6 months after diagnosis using self-reporting instruments and an expert rating scale (the basic documentation for psycho-oncology short form - PO-Bado SF)

OBJECTIVE

Psychosocial screening in brain tumor patients is of high importance. We applied The Basic Documentation for Psycho-Oncology Short Form (PO-Bado SF) in primary brain tumor patients and patients with metastasis. The aim was to evaluating consistency between physicians' perception and the results of the patients' self-assessment.

MATERIALS AND METHODS

140 patients with first diagnosis of a brain tumor were screened during their hospital stay (t1) using Distress Thermometer (DT) and Hornheide Screening Instrument (HSI), health-related quality of life was assessed by EORTC QLQ-C30 + BN20. After 3 (t2) and 6 months (t3), patients were re-evaluated. Attending neuro-oncologists completed the PO-Bado SF at all three time points (cut-off for being in need for support >8).

RESULTS

At t1, the mean of the PO-Bado SF total score was 7.71 (SD = 4.08), at t2 8.22 (SD = 5.40) and at t3 7.62 (SD = 5.72).The proportion of patients reaching a total score >8 was at t1: 43%, at t2: 41% and at t3: 47% (t1-3). Discrimination of PO-Bado SF total score, between patients in (DT ≥6) and those not in distress was more sensitive (cut-off 8.5, AUC 0.772, sens. 71.3%, spec. 67.6%) than discrimination compared to the HIS (cut-off 9.5, AUC 0.779, sens. 65.1%, spec. 77.7%). Higher PO-Bado-SF total score correlated with higher DT scores (r = 0.6, p < 0.0001) and lower EORTC GHS scores (r = -0.55, p < 0.0001).

CONCLUSION

Physicians' perception according to PO-Bado SF provides a different measure for psychosocial burden in patients with brain tumors, however does not completely reflect patients' wishes.

Psychometric Properties of the French Adaptation of the Basic Documentation for Psycho-Oncology (Po-Bado): A Distress Screening Tool

We translated and adapted the French version of the Basic Documentation for Psycho-Oncology (Po-Bado standard version) and we report its psychometric properties. The Po-Bado is a 12-item documentation instrument that measures psychosocial burden in cancer patients (all types and stages). The intensity of a patient's psychological suffering is evaluated by a health care professional (e.g., doctor, psychologist, nurse) in a semiguided interview. Overall, 252 cancer patients (M_age = 57 years, SD = 12.8 years) participated, completing the Po-Bado during a supportive care consultation following initial diagnosis. Our results show good reliability of the Po-Bado scores, with high internal consistency and interrater coefficients. Low temporal stability indicated that the Po-Bado measures a state-like phenomenon (vs. trait-like). Validity analysis showed significant correlations between cancer-specific psychosocial burden and negative mood (i.e., depression, anxiety) and psychological disturbance as assessed by the General Health Questionnaire (GHQ-12). Confirmatory factor analysis validated the Po-Bado's two-factor structure (i.e., somatic and psychological burdens). A receiver operating characteristic (ROC) curve determined the optimal cutoff score of 7.5. These results suggest that the Po-Bado is an easily applicable tool for clinicians and researchers to screen effectively for psychosocial burden in oncology.

The Basic Documentation for Psycho-Oncology Short Form (PO-Bado SF)--an expert rating scale for distress screening: development and psychometric properties

BACKGROUND

The aim of this study is to validate the Basic Documentation for Psycho-Oncology Short Form (PO-Bado SF), a six item interview-based expert rating scale for distress screening in cancer patients.

METHODS

Using a heterogeneous multicenter study sample (n = 1551), we examined validity, reliability, and dimensionality of the PO-Bado SF. The Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, the Questionnaire on Stress in Cancer, and the Patient Health Questionnaire were used to investigate convergent validity. Confirmatory factor analysis was applied to address unidimensionality. An optimal cutoff point was determined by ROC analysis and the maximum of Youden's index. An additional study with n = 41 audio recorded PO-Bado SF interviews was carried out to assess inter-rater reliability.

RESULTS

Mean age of the study sample was 64.0 (SD = 12.0), 42% were women. About 24% of the patients suffered from metastases. The one-factor solution was confirmed; internal consistency of the PO-Bado SF was high (α = 0.84). The PO-Bado SF total score correlated significantly with all psychosocial measures, the highest correlation was with the HADS total score (r = 0.64). Patients with severe disease conditions (metastases, psychological/psychiatric treatment in the past, low performance status) received higher distress ratings (p < 0.001). Using HADS total score (>13) as external criterion, an optimal PO-Bado SF cutoff score of >9 emerged (sensitivity 0.75; specificity 0.82). Inter-rater reliability was satisfactory for each of the six items (intra class correlation of 0.75 to 0.85).

CONCLUSIONS

The PO-Bado SF is a short, reliable and valid expert rating scale to identify distressed cancer patients.