title: Cancer and treatment distress psychometric evaluation over time: A BMT CTN 0902 secondary analysis.
abstract: BACKGROUND
  Routine monitoring of cancer-related distress is recognized as essential to quality care and mandated by a major accrediting organization. However, to the authors' knowledge, few cancer-specific measures have been developed to date to assess the multiple cancer-related factors contributing to this distress. In the current study, the authors examined the psychometric properties of the Cancer and Treatment Distress (CTXD) measure over time in hematopoietic cell transplantation (HCT) recipients.
  
  
  METHODS
  As a secondary analysis of a multicenter randomized controlled clinical trial, adult patients undergoing autologous or allogeneic HCT completed patient-reported outcomes including the CTXD and the Medical Outcomes Study Short Form-36 (SF-36) before transplantation and 100 days and 180 days after HCT.
  
  
  RESULTS
  Across 21 transplantation centers, a total of 701 patients consented, underwent transplantation, and were included in the current analyses, 645 of whom were alive at 100 days and 618 of whom were alive at 180 days. Internal consistency reliability was found to be strong for the overall CTXD at the 3 time points: Cronbach alphas (α) were .94, .95, and .95, respectively. Subscale reliability met hypothesized levels of an α>.70 across time, with the lowest reliability noted for the Identity subscale at 180 days (α = .77). Correlations with the SF-36 Mental Health subscale were higher than with the Physical Functioning subscale at each time point, thereby supporting convergent and discriminant validity. Strong correlations of the pretransplantation CTXD with the posttransplantation CTXD and SF-36 Mental Health subscale supported predictive validity.
  
  
  CONCLUSIONS
  The CTXD is reliable and valid as a measure of cancer distress both before and after HCT. It may be a useful tool for measuring dimensions of distress and for defining those patients requiring treatment for distress during and after transplantation. Cancer 2017;123:1416-1423. © 2016 American Cancer Society.
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Syrjala
authors.affiliation: Biostatistics Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Sutton
authors.affiliation: Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Heather S L
authors.initials: HS
authors.lastname: Jim
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Knight
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: William A
authors.initials: WA
authors.lastname: Wood
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.affiliation: Division of Hematology/Oncology, Spectrum Health Cancer Center, Michigan State University, Detroit, Michigan.
authors.forename: Muneer H
authors.initials: MH
authors.lastname: Abidi
authors.affiliation: Biobehavioral Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Jean C
authors.initials: JC
authors.lastname: Yi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004644:Emotions; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: Cancer and Treatment Distress (CTXD); cancer distress measure; distress; hematopoietic cell transplantation; psychometrics; reliability; validity