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Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties
  1. Joaquín T Limonero1,
  2. Jorge Maté-Méndez1,2,
  3. María José Gómez-Romero1,3,
  4. Dolors Mateo-Ortega4,
  5. Jesús González-Barboteo5,
  6. Montserrat Bernaus6,
  7. Montserrat López-Postigo6,
  8. Agustina Sirgo7,
  9. Silvia Viel1,8,
  10. Cruz Sánchez-Julve9,
  11. Ramon Bayés1,
  12. Xavier Gómez-Batiste10,11 and
  13. Joaquín Tomás-Sábado12
  1. 1 School of Psychology, Stress and Health Research Group, Universitat Autonoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalunya, Spain
  2. 2 Psycho-oncology Care Unit, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
  3. 3 Psychology Unit, Egarsat, Mutua Colaboradora con la Seguridad Social nº 276, Terrassa, Barcelona, Spain
  4. 4 Palliative Care Unit, Consorci Sanitari de Terrassa, Terrassa, Catalunya, Spain
  5. 5 Palliative Care Unit, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
  6. 6 Palliative Care Unit, Consorci Corporació Sanitària Parc Taulí de Sabadell, Sabadell, Barcelona, Spain
  7. 7 Psycho-oncology Unit, Oncology Department, University Hospital Sant Joan de Reus, Reus, Barcelona, Spain
  8. 8 Member of the Group of Psychologists of the Catalan-Balearic Society for Palliative Care, Barcelona, Spain
  9. 9 Palliative Care Unit, Sant Camil Hospital-Residence Foundation-Sant Pere de Ribes, Sant Pere de Ribes, Barcelona, Spain
  10. 10 The 'Qualy' Observatory. WHO Collaborating Centre for Public Health Palliative Care Programmes, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
  11. 11 Chair of Palliative Care, University of Vic, Vic, Barcelona, Spain
  12. 12 University of Gimbernat and Tomas Cerda School of Nursing, Sant Cugat del Vallés, Barcelona, Spain
  1. Correspondence to Professor Joaquín T Limonero, School of Psychology. Stress and Health Research Group, Universitat Autonoma de Barcelona Facultat de Psicologia, 08193 Bellaterra, Catalunya, Spain; joaquin.limonero{at}uab.cat

Abstract

Background Family caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools.

Aim This study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC).

Design Multicentre, cross-sectional study.

Settings/participants Family caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA).

Results 138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach’s alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale.

Conclusions The DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.

  • terminal care
  • supportive care
  • psychological care
  • hospice care
  • clinical assessment
  • family management

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjspcare-2020-002608

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Twitter @JTLimonero

    • Contributors JTL, JM-M, DM and MJG-R designed the study. JM-M, DM, MJG-R, MB, ML-P, AS, SV and CS-J collected data. JTL, JM-M, RB and JT-S analysed data. JTL, JM-M, JG-B and XG-B interpreted results. JTL, JM-M and JG-B wrote the manuscript. All authors reviewed the manuscript.

    • Funding This research was carried out, thanks in part to grant PSI2017-85134-R from the Spanish Ministry of Economy and Competitiveness (MINECO).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.