The Hemodialysis Distress Thermometer for Caregivers (HD-DT-C): development and testing of the psychometric properties of a new tool for screening psychological distress among family caregivers of adults on hemodialysis

Qual Life Res. 2024 Jun;33(6):1513-1526. doi: 10.1007/s11136-024-03627-x. Epub 2024 Mar 7.

Abstract

Purpose: To develop and test the measurement properties of the HD-DT-C, a new tool designed to facilitate the screening of psychological distress and its sources in family caregivers of adults on hemodialysis.

Methods: The present investigation was carried out in three phases: Phase 1 focused on the process of developing and exploring the content validity and clinical utility of the HD-DT-C using a mixed-methods approach and feedback panels; Phase 2, where the psychometric properties of this new tool were tested in a cross-sectional study (n = 106 caregivers); and Phase 3, where the European Portuguese version of the HD-DT-C was translated and culturally adapted into American English using a forward-backward translation procedure, followed by an expert panel review.

Results: Findings suggested that the HD-DT-C was perceived by feedback panels as practical, appropriate, and useful for increasing dialysis provider/family caregiver communication in nephrology centers. The European Portuguese version of the HD-DT-C showed good test-retest reliability (ICC = 0.991 for the barometer and κ ≥ 0.80 in 77% of the checklist items), high diagnostic accuracy (AUC = 0.956), and strong convergent validity (all r ≥ 0.50) with reference measures that assess quality of life, caregiver burden, and symptoms of anxiety and depression. Cutoff scores with good clinical utility (CUI + ≥ 0.70) were recommended for screening distress in research (≥ 6) and clinical practice (≥ 5).

Conclusion: The HD-DT-C is a brief, reliable, valid, and acceptable measure for identifying self-reported psychological distress and its sources among people caring for a family member or friend on hemodialysis. Future research is needed to explore the measurement properties of the American English version of this new tool.

Keywords: Caregiver; Dialysis; Distress; Health-related outcome measure; Kidney failure; Quality of life.

MeSH terms

  • Adult
  • Aged
  • Caregivers* / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Portugal
  • Psychological Distress*
  • Psychometrics*
  • Quality of Life / psychology
  • Renal Dialysis* / psychology
  • Reproducibility of Results
  • Stress, Psychological
  • Surveys and Questionnaires