Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool-Caregivers

Our plain-English summary of Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool-Caregivers, by M. Bonafede, C. Chiorri, D. Azzolina, et al (Psycho-oncology, 2022).

The study

• Authors: M. Bonafede, C. Chiorri, D. Azzolina, A. Marinaccio, E. Migliore, C. Mensi, E. Chellini, E. Romeo, F. Grosso, I.G. Franzoi, A. Granieri, F. Guglielmucci
• Journal: Psycho-oncology
• Published: 2022;31(1):122-129
• Type of article: Systematic review
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: To develop a short, flexible, and comprehensive tool to measure psychological distress in caregivers of malignant mesothelioma (MM) patients: the Mesothelioma Psychological Distress Tool-Caregivers version (MPDT-C).

Methods: Based on a systematic review of the relevant literature, aspects associated with caregiver distress were derived. Expert researchers/clinicians developed a pool of items for each identified aspect. Content validity was assessed through a multiple mixed-methods approach. A multicenter study was conducted to explore the factorial structure of the 47-item MPDT-C through Bayesian factor analysis.

Results: The Bayesian exploratory factor analysis revealed an underlying three-factor structure. Factors were labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. All scales showed sufficient reliability and corrected item-total correlations. Females scored higher than males for Engagement in Caring.

Conclusions: Taking care of malignant mesothelioma patients is a stressful process that influences the caregiver's physical, emotional, and social wellbeing. Our study offers preliminary evidence in support of the adequate psychometric properties of the MPDT-C, and these should now be replicated. Results suggest that the MPDT-C is a reliable tool with which to detect the psychological distress of this traumatized population.

© 2021 John Wiley & Sons Ltd.

In plain English

This Italian study developed and first tested a 47-item questionnaire, the Mesothelioma Psychological Distress Tool, Caregivers version (MPDT-C). It is meant to measure psychological distress in people caring for patients with malignant mesothelioma. Items came from a literature review and were refined with expert and caregiver focus groups and expert ratings. Of 707 caregivers recruited through the Italian National Mesothelioma Registry in four regions, 144 agreed to take part. Most were women (99), and most were the patient's child (63) or spouse (51). Statistical analysis grouped the items into three scales, which the authors labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. Two items were removed. Reliability was rated optimal for the first and third scales and sufficient for the second. Women scored higher than men on Engagement in Caring. The authors concluded that their study offered preliminary evidence that the questionnaire's measurement properties were adequate, and that this should be replicated. They noted the small sample and that stability over time and comparison against an outside standard were not tested. The article reported no asbestos exposure data.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Questionnaire development and preliminary validation; prospective, observational, multicentre study using Bayesian exploratory factor analysis
• Who was studied: Caregivers of malignant mesothelioma patients, contacted through the Italian National Mesothelioma Registry (ReNaM) in Tuscany, Piedmont, Lombardy and Lazio. Of 707 recruited, 144 agreed to take part: 99 women and 40 men (5 missing). Mean age was 56.02 years. Most were the patient's child (63) or spouse (51). For 105 caregivers the cared-for person was no longer alive. Interviewers were trained March to June 2018.
• Exposure: Caring for a patient with malignant mesothelioma. The study measured caregivers' psychological distress with the 47-item MPDT-C. The article reported no asbestos exposure or fiber-type data for these participants, although the registry used for recruitment investigates how asbestos exposure occurred.
• Main results:
  • Factor analysis found three factors (probability = 0.95), labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. Two of the 47 items were removed.
  • Reliability (omega) was optimal for Secondary Traumatic Stress (0.96 [0.70, 1.00]) and Meaningful Cognitive Restructuring (0.88 [0.58, 0.96]), and sufficient for Engagement in Caring (0.73 [0.56, 0.99]), with 89% credible intervals in brackets.
  • Correlations between scales: Secondary Traumatic Stress with Engagement in Caring 0.57 (-0.15, 0.84); Secondary Traumatic Stress with Meaningful Cognitive Restructuring 0.06 (-0.29, 0.79); Engagement in Caring with Meaningful Cognitive Restructuring 0.42 (0.18, 0.66).
  • The only relevant predictor of scale scores was the participant's sex: women scored higher than men on Engagement in Caring. The Bayes factor was 15.80, which the authors described as strong evidence for this effect.
• The authors' conclusion: The authors concluded that they had developed a multidimensional, short, flexible measure of distress in caregivers of malignant mesothelioma patients. They described their evidence for its measurement properties as preliminary and said it should be replicated.
• Limitations the authors state:
  • The sample could be considered small or not very representative.
  • Stability over time (test-retest reliability) was not assessed.
  • The questionnaire was not checked against an external criterion (no external-criterion validity assessment).

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelioma, Systematic Review.

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