title: Translating 'distress' and screening for emotional distress in multicultural cancer patients in Israel.
abstract: BACKGROUND
  The adaptability of the distress thermometer (DT) to multicultural groups has rarely been assessed.
  
  
  OBJECTIVE
  To assess DT adaptability to the Israeli population as a multicultural society.
  
  
  METHODS
  Participants were 496 cancer patients. They were recruited for 3 days a week in 2009-2010 (97% response rate). Participants completed the DT, a problem list, Hospital Anxiety and Depression Scale (HADS), and the Brief Symptom Inventory (BSI-18).
  
  
  RESULTS
  Receiver-operating characteristic (ROC) curve analyses of DT scores yielded area under the curve (AUC) of 0.63 as against HADS and of 0.78 as against BSI-18. ROC analysis revealed that the optimal cutoff score was ≥ 3. It yielded sensitivity and specificity of 0.74 and 0.65, as against the HADS, and 0.64 and 0.64, as against the BSI-18. The Jewish participants reported higher distress than the Arab participants, and the ROC properties were markedly higher for the Jewish subgroup alone.
  
  
  CONCLUSIONS
  The adapted DT was moderately efficient for detecting emotional distress in cancer patients in Israel. Cultural aspects related to distress should be taken into account for administration of the DT in multicultural societies.
authors.affiliation: Department of Gerontology, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel. cohenm@research.haifa.ac.il
authors.forename: Miri
authors.initials: M
authors.lastname: Cohen
authors.forename: Roni
authors.initials: R
authors.lastname: Gagin
authors.forename: Tali
authors.initials: T
authors.lastname: Cinamon
authors.forename: Tamar
authors.initials: T
authors.lastname: Stein
authors.forename: Marian
authors.initials: M
authors.lastname: Moscovitz
authors.forename: Abraham
authors.initials: A
authors.lastname: Kuten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018864:Cultural Diversity; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis* / Q000208:ethnology*; D011795:Surveys and Questionnaires; D055815:Young Adult