Background and aim: The negative impact of distress related conditions on cancer patients is well recognised, and brief screening tools i.e. the distress thermometer (DT), validated on cancer patients, have been developed. This study presents a validated e-tablet (iPad) tool based on a haematology cohort, covering a spectrum of malignant and non-malignant conditions. The tool was designed to distinguish psychological distress from fatigue for targeted follow-up, and to use touch-screen technology in line with research in effective screening implementations.
Method: The iPad tool (CANCIST), incorporated a horizontal DT, four items on psychological distress (from the PHQ-4), two on fatigue, and four covering unmet needs. The tool was trialled across 221 haematology adult patients (70% with malignancies, 30% non-malignant conditions) attending a hospital-based cancer care centre. Psychological distress and fatigue was validated using the Brief Symptom Inventory (BSI-18) and the Fatigue Symptom Inventory (FSI) respectively. A brief questionnaire assessed acceptance and ease of use, and measures of completion time were recorded.
Results: There was no statistically significant difference in distress between the malignant and non-malignant haematology sub-groups. The sensitivities and specificities were high: psychological distress (.86 and .80) and fatigue (.80 and .74). The horizontal DT weighted more heavily on psychological distress rather than fatigue. Participants reported high useability of this tool, with 93% responding very easy to use, and 94% responding to definitely using again. The mean time of completion was 108 seconds (SD = 49 seconds).
Conclusions: The CANCIST iPad tool is a reliable, brief, easy to use tool with high acceptance from participants, for psychological distress and fatigue screening, with useful sensitivities and specificities across the haematological cohort. Further validation in the general oncology population is needed.