Psychometric Properties of the Generalized Anxiety Disorder Scale (GAD-7) in Older Adults With Advanced Cancer.

IF 3.3 2区医学 Q2 ONCOLOGY Psycho‐Oncology Pub Date : 2024-11-01 DOI:10.1002/pon.70012

Rebecca M Saracino, Lee A Kehoe, Michael B Sohn, Lu Wang, Supriya Mohile, Megan Wells, Karen Mustian, Gary Morrow, Thomas Bradley, Adedayo Onitilo, Jeffrey Giguere, Kelly M McConnell

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Abstract

Objectives: Over half of new cancer diagnoses occur in patients aged 65 or older, with up to 40% experiencing anxiety. The American Society of Clinical Oncology recommends using the Generalized Anxiety Disorder Scale (GAD-7) for anxiety screening, but the GAD-7 psychometric properties in this population are unknown. This study examined the GAD-7's reliability, validity, and item parameters, comparing its utility with the GAD-2 in older adults with cancer.

Methods: This cross-sectional secondary analysis of a nationwide multi-site two-arm cluster randomized trial in older adults (≥ 70) with advanced cancer. The GAD-7 was administered at baseline. Properties were evaluated with Cronbach's α, Pearson correlation coefficients, and a 2-parameter logistic model. Logistic regression models compared the GAD-2 and GAD-7.

Results: The sample included 718 participants (Mean age = 77, SD = 5) with mild anxiety (M = 3.74, SD = 4.74). Internal consistency was strong (Cronbach's alpha = 0.89) and item-total correlations ranged 0.53 to 0.78. Item 2 (Not being able to stop or control worrying) was the most discriminating and item 5 (Being so restless that it is hard to sit still) was least discriminating. Area Under the Curve (AUC) analyses demonstrated the GAD-2 had a 0.93-0.96 AUC.

Conclusions: Establishing the psychometric properties of anxiety screening measures is crucial in the older adults with cancer to maximize referral efficiency and accuracy. This study indicates that the GAD-7 is reliable and valid for older adults with cancer. Analyses suggest the GAD-2 may be as sufficient as the GAD-7 in identifying anxiety in older adults with cancer, thereby reducing assessment burden.

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晚期癌症老年患者广泛焦虑症量表 (GAD-7) 的心理测量特性。

目标：超过一半的新诊断癌症患者年龄在 65 岁或以上，其中多达 40% 的人有焦虑症。美国临床肿瘤学会建议使用广泛性焦虑症量表（GAD-7）进行焦虑筛查，但 GAD-7 在这一人群中的心理测量特性尚不清楚。本研究考察了 GAD-7 的信度、效度和项目参数，并将其与 GAD-2 在老年癌症患者中的实用性进行了比较：这项横断面二次分析是对一项全国范围内的多地点双臂群组随机试验进行的，研究对象为晚期癌症老年人（≥ 70 岁）。基线时进行 GAD-7 测量。用 Cronbach's α、皮尔逊相关系数和双参数逻辑模型对其特性进行了评估。逻辑回归模型对 GAD-2 和 GAD-7 进行了比较：样本包括 718 名轻度焦虑（M=3.74，SD=4.74）的参与者（平均年龄=77，SD=5）。问卷的内部一致性很好（克朗巴赫α=0.89），项目与项目之间的相关性为 0.53 至 0.78。第 2 项（无法停止或控制担忧）的区分度最高，第 5 项（坐立不安，难以静坐）的区分度最低。曲线下面积（AUC）分析表明，GAD-2 的 AUC 为 0.93-0.96：建立焦虑筛查方法的心理计量特性对于老年癌症患者来说至关重要，可最大限度地提高转诊效率和准确性。本研究表明，GAD-7 对老年癌症患者是可靠有效的。分析表明，GAD-2 与 GAD-7 一样足以识别癌症老年人的焦虑，从而减轻评估负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.