Preliminary validation of a brief PROM assessing psychological distress in patients with malignant mesothelioma: The mesothelioma psychological distress tool-Patients

Fanny Guglielmucci; Michela Bonafede; Danila Azzolina; Alessandro Marinaccio; Isabella Giulia Franzoi; Enrica Migliore; Carolina Mensi; Elisabetta Chellini; Elisa Romeo; Federica Grosso; Antonella Granieri

doi:10.3389/fpsyg.2022.974982

Preliminary validation of a brief PROM assessing psychological distress in patients with malignant mesothelioma: The mesothelioma psychological distress tool-Patients

Front Psychol. 2022 Nov 25:13:974982. doi: 10.3389/fpsyg.2022.974982. eCollection 2022.

Affiliations

¹ Department of Philosophy, Communication and Performing Arts, University of Roma Tre, Rome, Italy.
² Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy.
³ Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy.
⁴ Department of Psychology, University of Turin, Turin, Italy.
⁵ COR Piedmont, Unit of Cancer Epidemiology, University of Turin and CPO-Piedmont, Turin, Italy.
⁶ COR Lombardy, Epidemiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and University of Milan, Milan, Italy.
⁷ COR Tuscany, Cancer Prevention and Research Institute, Unit of Environmental and Occupational Epidemiology, Florence, Italy.
⁸ COR Lazio, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.
⁹ Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.

Abstract

Objective: Psychological suffering in malignant mesothelioma (MM) differs from that in other cancers because of its occupational etiology, and we aimed to develop specific patient-reported outcome measures to assess it.

Methods: We used a multi-method prospective observational multicentric study (N = 149), and a preliminary questionnaire validation was performed through a Bayesian approach.

Results: Item analysis showed a good internal consistency and reliability (Cronbach alpha = 0.79 [95% CI = 0.74-0.93]. Twenty of the 41 initial items were selected as posterior 95% highest density interval factor loading standardized effect size fell outside of the region of practical equivalence. Bayesian exploratory factor analysis showed a two-factor structure: (1) Trauma-related reactions (TR, 13 items) and (2) Claim for justice (CJ, 7 items), confirmed by the Bayesian confirmatory factor analysis. Latent factors were poorly correlated (Posterior median: 0.13; 95% CI = -0.079 to 0.323). The 90% root mean square error of approximation posterior median was 0.04 [90% CI = 0.03-0.58]; the 90% chi-square posterior median was 242 [90% CI = 209-287].

Conclusion: Psychological suffering in MM patients implies negative cognitive, emotional, and somatic reactions related to the traumatic impact of the disease and the need to obtain justice through economic compensation. Our findings provide preliminary evidence that the Mesothelioma Psychological Distress Tool-Patients could be a promising and reliable instrument to assess MM patients' psychological distress.

Keywords: asbestos; cancer; mental health; mesothelioma; patient-reported outcome measures; posttraumatic stress disorder; psycho-oncology; psychological distress.