Development of An Assessment Tool for Early Detection of a Depressive State in Patients with Cancer

Abstract

Abstract

Objective: The purpose of this study was to develop an assessment tool for early detection of depressive states in patients with cancer. Method: The study was approved by the ethics board of the affiliated university. For the assessment tool （AT）, 28 items were developed based on a comprehensive review of the literature and the criteria for major depressive episodes according to the DSM-IV-TR. Content validity was confirmed with a three-round, modified Delphi technique administered to certified nurse specialists in cancer nursing or psychiatric mental health nursing in Japan. Inter-observer reliability was assessed in a pilot study. Item analysis, reliability, and validity were assessed in the main survey. Severity of AT scores was based on the severity of BDI-II scores. Nurses estimated depression severity using the AT for 7 days during day shifts, and patients were asked to use the BDI-II. Sample: The pilot study was conducted with 27 diagnosed cancer patients and 15 nurses, and the main survey was conducted with 377 diagnosed cancer patients and 79 nurses. Result: 1） The AT consisted of 24 items as a result of the literature review, according to the DSM-IV-TR major depressive episode definition, and the modified Delphi technique. 2） The inter-observer concordance rate was 93–100％. 3） Item analysis resulted in 21 final items. 4） A confirmatory factor analysis yielded a GFI of 0.768. The reliability of the AT was confirmed by a Cronbachʼs alpha internal consistency reliability coefficient of 0.932. A significant difference in severity classification between the BDI-II score and AT score （p<0.05） was found. Conclusion: The above findings indicate that the developed AT had content validity, interrater reliability, construct validity, reliability, and criterion-related validity. The subject of the next investigation will establish whether the AT can distinguish the severity of depression.