Distress screening in oncology - Evaluation of the Questionnaire on Distress in Cancer Patients - Short form (QSC-R10) in a German sample

Objective: The aim was to examine the psychometric properties of the Questionnaire on Stress in Cancer Patients (QSC-R10), a 10-item screening instrument for self-assessment of psychosocial distress in cancer patients. Methods: A total of 1850 cancer patients were assessed with the QSC-R10. Patients were recruited from different inpatient and outpatient settings in Germany between 2007 and 2009. Results: Mean age of the sample was 62.9 (SD=12.4) with breast cancer as the most frequent diagnosis (35.2%). The analysis indicated high reliability (Cronbach's α=0.85) and test-retest reliability (ICC=0.89). Validation scales included the Hospital Anxiety and Depression Scale (HADS), Distress-Thermometer (DT), European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30) and Karnofsky Performance Status (KPS). Convergent validity was highest for the HADS total score (r=0.74) and the lowest correlation for KPS (r=-0.36). The QSC-R10 significantly distinguished subgroups by their clinical characteristics (metastases, illness duration, previous psychiatric treatment and psycho-oncological support; p<0.001). A cutoff score of >14 demonstrated good sensitivity (81.0%) and specificity (73.2%) and is suitable to determine the need for psychosocial support. Conclusion: The QSC-R10 is a valid and reliable questionnaire to detect distress in cancer patients with high acceptance among professionals and patients.