title: Validation and practical implementation of a multidisciplinary cancer distress screening questionnaire.
abstract: BACKGROUND
  In order to identify cancer patients with psychosocial needs during radiotherapy, a routine screening questionnaire is widely recommended in the literature. Several tools focusing mainly on psychological issues have been developed during the past decade. However, problems with their implementation into clinical routine have been repeatedly reported, due to a lack of practicability for clinicians and nurses. This study reports the compilation of a multidisciplinary screening questionnaire and an analysis of the effectiveness of its implementation into clinical routine at the Department of Radiotherapy, Medical University of Vienna.
  
  
  METHODS
  The screening questionnaire is based on a compilation of several subscales from established and validated assessment tools. It focuses on comprehensive information with high a clinical relevance for all professions. In a pilot study, patients' acceptance was assessed qualitatively. Analysis of missing screening data in consecutively admitted patients reflects the effectiveness of implementation and representativity of the data. A validation analysis of the psychological subscales was performed using external criteria and its internal consistency was tested with Cronbachs' α.
  
  
  RESULTS
  Qualitative patient acceptance of the screening questionnaire is good. The overall response rate in the screening procedure was 75 %. Missing patient screening data sets arose randomly-mainly due to organizational problems-and did not result in systematic errors. The psychological subscales identify highly distressed patients with a sensitivity of 89 and 78 %, and an internal consistency of 0.843 and 0.617.
  
  
  CONCLUSIONS
  The multidisciplinary screening questionnaire compiled in this study has a high patient acceptance, provides reliable and representative data and identifies highly distressed patients with excellent sensitivity. Although requiring additional personnel resources, it can be implemented successfully in clinical routine with benefits for both the patient and the professional team.
authors.affiliation: Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. kathrin.kirchheiner@meduniwien.ac.at
authors.forename: K
authors.initials: K
authors.lastname: Kirchheiner
authors.forename: A
authors.initials: A
authors.lastname: Czajka
authors.forename: E
authors.initials: E
authors.lastname: Ponocny-Seliger
authors.forename: E
authors.initials: E
authors.lastname: Komarek
authors.forename: G
authors.initials: G
authors.lastname: Hohenberg
authors.forename: R
authors.initials: R
authors.lastname: Pötter
authors.forename: W
authors.initials: W
authors.lastname: Dörr
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology*; D001943:Breast Neoplasms / Q000523:psychology / Q000532:radiotherapy; D015331:Cohort Studies; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D033183:Interdisciplinary Communication; D008403:Mass Screening; D009369:Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010865:Pilot Projects; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012803:Sick Role; D012944:Social Support; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000523:psychology / Q000532:radiotherapy