Quality of Life Research

, Volume 11, Issue 1, pp 27–35 | Cite as

Rapid assessment of psychosocial well-being: Are computers the way forward in a clinical setting?

  • Allison Boyes
  • Sallie Newell
  • Afaf Girgis
Article

Abstract

Objective: To compare the agreement between anxiety, depression and supportive care needs data obtained using a touchscreen computer survey with traditional pen-and-paper surveys. Methods: The sample consisted of 1304 consecutive patients attending the medical or radiation oncology outpatient department in two public cancer treatment centres. Of the 357 eligible patients, 355 (99%) consented to participate and 350 (98%) completed both touchscreen computer and pen-and-paper versions of the Hospital Anxiety and Depression Scale (HADS) and short-form Supportive Care Needs Survey (SCNS-short). Results: Simple κ values indicated moderate agreement (\({\bar X}\) = 0.57) between the two modes of survey administration for most HADS items. Simple κ coefficients indicated only fair agreement (\({\bar X}\) = 0.28) when a simplified response option format was used in the computerised SCNS-short. When the paper and computerised survey used the same response format, simple kgr; coefficients increased and indicated moderate agreement (\({\bar X}\) = 0.44) for most SCNS-short items. κ Coefficients indicated at least moderate agreement (κ > 0.41) in identifying patients with elevated levels of anxiety and depression; there were no significant differences in the proportion of patients identified with elevated levels of anxiety and depression according to computer survey compared to paper survey. Prevalence-adjusted bias-adjusted κ (PABAK) coefficients indicated at least moderate agreement (\({\bar X}\) = 0.79) in identifying participants with moderate/high levels of unmet needs. However, participants tended to report lower levels of unmet needs with a simplified response format in the computerised SCNS-short compared to the paper survey. This was not observed when the response format of the computerised SCNS-short replicated the paper survey. Conclusions: Despite the advantages that computerised surveys offer for simplifying survey presentation, current results suggest the need to exactly replicate the question and response option format of the original paper survey to ensure the data collected are equivalent. This finding is particularly important given the potential application of computerised surveys in the clinical setting to quickly assess and identify patients' concerns requiring intervention by health care providers.

Anxiety Cancer Computer Depression Psychosocial assessment Unmet needs 

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References

  1. 1.
    Newell S, Sanson-Fisher R, Girgis A, Ackland S. The physical and psychosocial experiences of patients attending an outpatient medical oncology department: A crosssectional study. Eur J Cancer Care 1999; 8: 73–82.Google Scholar
  2. 2.
    Cull AM, Stewart M, Altman DG. Assessment of and intervention for psychosocial problems in routine oncology practice. Br J Cancer 1995; 72: 229–235.Google Scholar
  3. 3.
    Ford S, Lewis S, Fallowfield L. Psychological morbidity in newly referred patients with cancer. J Psychosom Res 1995; 39(2): 193–202.Google Scholar
  4. 4.
    Carroll BT, Kathol RG, Noyes R, Wald TG, Clamon GH. Screening for depression and anxiety in cancer patients using the Hospital Anxiety and Depression Scale. Gen Hos Psychiatr 1993; 15: 69–74.Google Scholar
  5. 5.
    Aass N, Fossa SD, Dahl AA, Moe TJ. Prevalence of anxiety and depression in cancer patients seen at the Norwegian Radium Hospital. Eur J Cancer 1997; 33(10): 1597–1604.Google Scholar
  6. 6.
    Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P and The Supportive Care Review Group. The unmet supportive care needs of patients with cancer. Cancer 2000; 88(1): 226–237.Google Scholar
  7. 7.
    Whelan TJ, Mohide EA, Willan AR, et al. The supportive care needs of newly diagnosed cancer patients attending a regional cancer center. Cancer 1997; 80(8): 1518–1524.Google Scholar
  8. 8.
    Girgis A, Boyes A, Sanson-Fisher RW, Burrows S. Perceived needs of women diagnosed with breast cancer: Rural versus urban location. Aust NZ J Publ Health 2000; 24: 166–173.Google Scholar
  9. 9.
    Gustafson DH, Taylor JO, Thompson S, Chesney P. Assessing the needs of breast cancer patients and their families. Qual Manage Health Care 1993; 2(1): 6–17.Google Scholar
  10. 10.
    Siegel K, Raveis VH, Houts P, Mor V. Caregiver burden and unmet patient needs. Cancer 1991; 68(5): 1131–1140.Google Scholar
  11. 11.
    Colleoni M, Mandala M, Peruzzotti G, Robertson C, Bredart A, Goldhirsch A. Depression and degree of acceptance of adjuvant cytotoxic drugs. Lancet 2000; 356: 1326–1327.Google Scholar
  12. 12.
    Shapiro T. How to help patients get through chemotherapy? Registered Nurse 1987; 83(2): 58–60.Google Scholar
  13. 13.
    Newell S, Sanson-Fisher R, Girgis A, Bonaventura A. How well do medical oncologists' perceptions reflect their patients' reported physical and phychosocial problems? Data from five oncologists. Cancer 1998; 8: 1640–1651.Google Scholar
  14. 14.
    Hardman A, Maguire P, Crowther D. The recognition of psychiatric morbidity on a medical oncology ward. J Psychosom Res 1989; 33(2): 235–239.Google Scholar
  15. 15.
    Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiat Scan 1983; 67: 361–370.Google Scholar
  16. 16.
    Bonevski B, Sanson-Fisher R, Girgis A, Burton L, Cook P, Boyes A and The Supportive Care Review Group. Evaluation of an instrument to assess the needs of patients with cancer. Cancer 2000; 88: 217–225.Google Scholar
  17. 17.
    Drummond HE, Ghosh S, Ferguson A, Brackenridge D, Tiplady B. Electronic quality of life questionnaires: A comparison of pen-based electronic questionnaires with conventional paper in a gastrointestinal study. Qual Life Res 1995; 4: 21–26.Google Scholar
  18. 18.
    Velikova G, Wright EP, Smith AB, et al. Automated collection of quality-of-life data: A comparison of paper and computer touch-screen questionnaires. J Clin Oncol 1999; 17(3): 998–1010.Google Scholar
  19. 19.
    Buxton J, White M, Osoba D. Patients' experiences using a computerized program with a touch-sensitive video monitor for the assessment of health-related quality of life. Qual Life Res 1998; 7: 513–519.Google Scholar
  20. 20.
    Taenzer PA, Speca M, Atkinson MJ, et al. Computerized quality-of-life screening in an oncology clinic. Cancer Pract 1997; 5(3): 168–175.Google Scholar
  21. 21.
    Newell S, Girgis A, Sanson-Fisher R, Stewart J. Are touchscreen computer surveys acceptable to medical oncology patients? J Psychosoc Oncol 1997; 15(2): 37–46.Google Scholar
  22. 22.
    Kleinman L, Leidy NK, Crawley J, Bonomi A, Schoenfeld P. A comparative trial of paper-and-pencil versus computer administration of the Quality of Life in reflux and Dyspepsia (QOLRAD) questionnaire. Med Care 2001; 39(2): 181–189.Google Scholar
  23. 23.
    Pouwer F, Snoek FJ, Van der Ploeg HM, Heine RJ, Brand AN. A comparison of the standard and the computerized versions of the Well-being Questionnaire (WBQ) and the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Qual Life Res 1998; 7: 33–38.Google Scholar
  24. 24.
    Schmitz N, Hartkamp N, Brinschwitz C, Michalek S, Tress W. Comparison of the standard and the computerized versions of the Symptom Check List (SCL-90-R): A randomized trial. Acta Phychiat Scan 2000; 102: 147–152.Google Scholar
  25. 25.
    Clay GE, Lankford JS, Wilson SE. The effects of computerised versus paper-and-pencil administration on measures of negative affect. Comput Hum Behav 1992; 8: 203–209.Google Scholar
  26. 26.
    Watson CG, Thomas D, Andersen PE. Do computer-administered Minnesota Multiphasic Personality Inventories underestimate booklet-based scores? J Clin Psychol 1992; 48(6): 744–748.Google Scholar
  27. 27.
    Ibbotson T, Maguire P, Selby P, Priestman T, Wallace L. Screening for anxiety and depression in cancer patients: The effects of disease and treatment. Eur J Cancer 1994; 30A(1): 37–40.Google Scholar
  28. 28.
    Hopwood P, Howell A, Maguire P. Screening for psychiatric morbidity in patients with advanced breast cancer: Validation of two self-report questionnaires. Br J Cancer 1991; 64: 353–356.Google Scholar
  29. 29.
    Moorey S, Greer S, Watson M, et al. The factor structure and factor stability of the Hospital Anxiety and Depression Scale in patients with cancer. Br J Psychiat 1991; 158: 255–259.Google Scholar
  30. 30.
    Everitt BS. The analysis of Contingency Tables. 1977 ed. London: Chapman & Hall, 1990.Google Scholar
  31. 31.
    Byrt T, Bishop J, Carlin JB. Bias, prevalence and j. J Clin epidemiol 1993; 46(5): 423–429.Google Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Allison Boyes
  • Sallie Newell
  • Afaf Girgis

There are no affiliations available

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