Background: Evidence-based palliative care is dependent upon valid measurements of anxiety and depression. Time and energy is limited and valuable for subjects within the palliative setting, hence, we investigated the validity of simple visual-digital scales for measurement of anxiety and depression.
Methods: Data were retrieved from 3057 individuals; cervix cancer patients, urinary bladder- and prostate cancer patients, widows who had lost their husband to cancer and parents who lost a child to cancer, as well as population controls. All questionnaires contained two psychometric scales: the Centre for Epidemiological Depression Scale (CES-D) and Spielberger’s Trait measure from the Stait-Trait Anxiety Inventory (STAI-T). Also included were two seven-point visual digital scales enquiring about anxiety (vds-anxiety) and depression (vds-depression).
Results: Response rate was 76%. Each score at the vds-depression corresponded to a stepwise increase of mean score at CES-D and was statistically differentiated from each other. Sensitivity and specificity for vdsdepression with CES-D as reference (’’golden standard’’) was 80% and 7% respectively. Correlation was not as high between vds-anxiety and STAI-T, sensitivity and specificity being 53% and 86% respectively. Missing data for STAI-T (<17 of 20 items) were 6% and 9% for CES-D, while the same figures were a little less than 3% for both vds- anxiety and depression scales. In the elderly (68 years or older), these figures were 17% for CES-D, 13% for STAI-T and 4% for both the visual digital scales.
Conclusion: Owing to lower attrition and high agreement with more lengthier psychometric scales, the simple and short visual-digital scales may be valuable measures of depression in the palliative care setting. More research is needed to establish if visual digital scales for anxiety can replace other psychometric ‘‘state’’ measures of anxiety.