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Development and validation of self- and caregiver-report of a distress screening tool for pediatric cancer survivors



To develop and validate the Distress Screening Tool (DST) for child and adolescent cancer survivors.


In part 1, items of the DST were generated through literature search and group interviews. Initially, the DST was tested on pediatric cancer survivors and their caregivers. In part 2, the modified version of the DST was retested with a different set of participants. Lastly, the psychometric properties and cutoff scores of the DST were evaluated on a separate set of survivors and caregivers.


In part 1, six items of the DST self- and caregiver-report versions were generated. The initial 6 DST items of both versions showed acceptable internal consistency, but low inter-item correlation. Following the item modification, both versions of the DST showed improved inter-item correlation. In part 2, the modified DST had acceptable internal consistency and convergent validity, with acceptable psychometric properties. Cutoff scores were also generated.


The DST could be a useful tool for pediatric cancer survivors.

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This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (HA16C0021).

Author information

Correspondence to Kyong-Mee Chung or Chuhl Joo Lyu.

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Institutional Review Board (IRB) of Severance Hospital, Yonsei University College of Medicine (IRB No. 4-2015-0919).

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

This article is based on the Master’s thesis of Soo Jin Yoon, submitted in December 2016, Yonsei University.

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Table 5 Distress Screening Tool

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Yoon, S.J., Chung, K., Han, J.W. et al. Development and validation of self- and caregiver-report of a distress screening tool for pediatric cancer survivors. Support Care Cancer 27, 4179–4187 (2019). https://doi.org/10.1007/s00520-019-04708-1

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  • Pediatric cancer
  • Survivors
  • Distress screening
  • Psychosocial services