Development process, clinical utility, and preliminary psychometric evidence of a new tool for screening psychological distress in renal care settings: the Hemodialysis Distress Thermometer (HD-DT)

Abstract

Objective This study aimed to develop, evaluate the clinical utility, and test the psychometric properties of a new tool – the Hemodialysis Distress Thermometer (HD-DT) – designed to screen self-reported psychological distress and its sources in adults receiving hemodialysis. Methods and Measures Phase 1 focused on the process of developing and evaluating the content validity and clinical utility of the HD-DT using a stepwise mixed-methods approach; in Phase 2, the measurement properties of the European Portuguese version of the HD-DT were tested against reference measures in a cross-sectional study (n = 134 people on hemodialysis); while in Phase 3 the HD-DT was translated and culturally adapted into American English using forward-backward translation and review by a panel of experts. Results Qualitative findings suggested that the HD-DT was perceived by feedback panels as practical and useful for rapidly screening psychological distress in nephrology centers. The European Portuguese version of this new tool showed good test-retest reliability and high diagnostic accuracy using a cutoff point of ≥ 6 for total distress. High convergent validity was found with reference measures that assess psychological health, and symptoms of anxiety and depression. Conclusion This study highlights the potential clinical utility of the HD-DT as an acceptable, reliable, and valid measure that can be used by health psychologists in clinical practice and research in renal care settings. Data collection to validate the American English version of the HD-DT is currently underway.