Authors (including presenting author) :
Kitty K WU 1 Damaris HUNG 2 Mary WONG 3 Valda CHO 4 Queenie KWAN 5
Affiliation :
1 Department of Clinical Psychology, Kowloon West Cluster 2 Department of Clinical Psychology, Queen Mary Hospital & Grantham Hospital 3 Department of Clinical Psychology, Pamela Youde Nethersole Hospital 4 Department of Clinical Psychology, Caritas Medical Centre 5 Department of Clinical Psychology, TWGHs Wong Tai Sin Hospital
Introduction :
Validation of psychological screening measures for patients and their family caregivers is essential for identification of service needs in palliative care.
Objectives :
We examined the psychometric properties of psychological screening measures for patients and family caregivers served in Palliative Care Units (PCUs).
Methodology :
The sample consisted of 121 patients and 104 family caregivers served in 4 clusters (HKE, HKW, KCC and KWC) from July 2018 to April 2019. In Phase I, screening measures completed by patients were: Psychological Wellbeing Scale-Patient (PWS-P), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Distress Thermometer (DT), and Death and Dying Distress Scale (DADDS). Screening measures completed by caregivers were: Psychological Wellbeing Scale-Caregiver (PWS-C), PHQ-9, GAD-7, DT and Depression Anxiety Stress Scales (DASS-21). In Phase II, clinical interviews were conducted by clinical psychologists (CP) within a week after the screening to determine the need for clinical psychology follow up. Scores of various screening measures and clinical interviews (i.e., whether a patient required CP follow-up) were compared.
Result & Outcome :
Results for patients showed good internal consistency for PHQ-9 (Cronbach’s α = .82), GAD-7 (Cronbach’s α =.90) and DADDS (Cronbach’s α = .93). Most of the psychological screening measures which included PWS-P subscales, GAD-7, PHQ-9, DADDS and DT were found to be significantly correlated with each other (rs = -.33 to .68), ps < .05 to .001. Independent samples t-tests found that patients requiring CP follow-up according to clinical interviews showed significantly higher scores on GAD-7, PHQ-9, ED scale of PWS-P and DT than patients who did not require CP follow-up, ts =2.11 to 3.56, ps < .05 to .005.
Results for caregivers demonstrated good internal consistency for PHQ-9 (Cronbach’s α = 0.86) and GAD-7 (Cronbach’s α=0.90). Most of the psychological screening measures including PWS-C subscales, GAD-7, PHQ-9, DASS and DT were found to be significantly correlated with each other (rs = -.50 to .84), ps < .05 to .001. Independent samples t-tests found that caregivers requiring CP follow-up according to clinical interviews showed significantly higher scores on GAD-7, PHQ-9, LM and ED scales of PWS-C, DASS and DT than caregivers who did not require CP follow-up, ts = -2.23 to 4.12, ps < 0.05 to 0.001.
GAD-7 and ED scale of PWS-C had the highest true positive rate for patients (68%) and caregivers (79%), respectively.
Conclusion: Standardized psychological measures could contribute to early identification of service needs and outcome-driven psychological services.
