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The Integrated Wellbeing Inventory (IWI) by Virginia M. Westerberg

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The Integrated Wellbeing Inventory (IWI) is a psychometric tool to assess for distress in the non-communicable disease population.

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The Integrated Wellbeing Inventory (IWI) by Virginia M. Westerberg

  1. 1. INTEGRATED WELLBEING INVENTORY© [IWI] Created by Virginia M. Westerberg (2014) Copyright Policy The Integrated Wellbeing Inventory (IWI) by Virginia M. Westerberg is licensed under a Creative Commons Attribution 4.0 International License. Based on a work at http://www.slideshare.net/kiwes8/the-integrated-wellbeing-inventory-iwi-by-virginia-mwesterberg. Permissions beyond the scope of this license may be available at the above website. You are free to copy, distribute, and adapt the work, as long as you attribute the work to Westerberg, V.M. (2014) and abide by the licence terms. https://tinyurl.com/lvxg9bk
  2. 2. THE DEVELOPMENT OF THE IWI SCALE FOR NON-COMMUNICABLE DISEASE DISTRESS ASSESSMENT INTRODUCTION Psychological distress is known to be highly prevalent among individuals with chronic diseases. A lifetime of medication dependence and lifetime changes, disease type and severity, age, and social support all have an impact on the degree of psychological distress experienced (Taylor et al., 2009). However, a review of the literature for the current study has revealed that the terms “stress” and “distress” are used by the scientific and lay community interchangeably. Moreover, all the studies done for the development of distress scales never included a validated definition of “distress”. A validated operational definition of both terms is needed for the sake of scientific consensus so that researchers be able to communicate with each other and with the public. Distress can be described as a chronic state characterised by an inability to adapt to one or more acute stressors. The result is that the individual is no longer able to cope with the circumstances leading to the compromise of well-being. Defining distress as a chronic condition and stress as an acute or acute-on-chronic condition is the first objective of this work. With regard to the procedures included in the definition of distress, the authors propose that researchers use the World Health Organisation’s (WHO) (2013a) conceptualisation of distress as shown in Figure 1: DEPRESSIVE SYMPTOMS ANXIETY SYMPTOMS Sadness Anxiety Withdrawal Worry Guilt / Shame Fear ↓ or ↑ Appetite Hypervigilance Irritability ↓ or ↑ Sleep ↓ or ↑ Motor activity Anger Concentration problems Concentration problems Fatigue DISTRESS Fatigue CONDUCT DISTURBANCE EMOTIONAL SYMPTOMS DISTURBAN CE Not able to care for self or dependent others SYMPTOMS Grief Crying Figure 1. Conceptualisation of distress by the WHO (2013)
  3. 3. The study of disease-related distress started in the late 50’s but it was not until two decades later that a structured and clinicallyapplicable instrument was developed: The Symptom Distress Scale (SDS) (Beecher, 1957; McCorkle & Young, 1978). Oncology patients were the first and are the most studied population group for the impact of diagnosis and symptoms on their well-being. Looking now at the literature regarding the reimaing non-communicable disorders population, distress is rarely measured with diseasespecific instruments. Generic instruments are not specific for a particular disorder and aim to be relevant to a wide range of patients and the general population. Disease-specific instruments tend to be more appealing to researchers. The commonly used generic distress tools are the HADS, the GHQ-20 and the EQ-5D (Fitzpatrick et al., 2006).. However, an instrument that is too specific risks not being sensitive to co-morbid complaints. That is why most clinicians and researchers use a combination of generic and specific instruments in the assessment of health outcomes. That said, methodological weaknesses relating to the exclusive use of non-specific tools means that somatic and psychological distress symptoms may be confounded in the literature. The validity and acceptability of the Distress Thermometer (DT) (Roth et al., 1998) has been shown in multiple international studies in the oncology population (Mitchell, 2007; Donovan, Grassi, McGinty, & Jacobsen, 2013). In an aim to enhance the validity of the DT, Akizuki and his collaborators developed an Impact Thermometer (IT) to be used in combination with the DT as a “brief screening tool for adjustment disorders and/or major depression in cancer patients” (Akizuki, Yamawaki, Akechi, Nakano, & Uchitomi, 2005). The synergy of the combined effects of the DT and the IT has been the subject of relevant international and New Zealand articles (Mitchell, 2007; Baken & Woollie, 2011). For the development of both the DT and the IT, developers have asked healthcare professionals and patients a battery of questions and selected the most relevant ones to be included in their final instrument. An in depth research of the literature has shown the absence of an instrument that uses the internationally validated diagnostic standards of the DSM (APA, 2013). The aim here is to develop an instrument that can reliably be used by clinicians to assess not only oncology patients but also those with the most prevalent chronic conditions in developed countries. The tool that will be validated in the current study will use the WHO definition of distress, which meets the DSM-V criteria of Adjustment Disorder With Mixed Anxiety and Depressed Mood (309.28) and Adjustment Disorder With Mixed Disturbance of Emotions and Conduct (309.4) (APA, 2013). Our rationale is that many chronic patients find themselves unable to adjust to their condition and sometimes they may not be aware of it or willing to admit it. This situation is different from a mood disorder or anxiety associated with a medical condition that can be cured, like an infection or many one-off surgical procedures. We have developed an instrument that will assess for distress in the oncology and chronic disease population and we call this new tool the “Integrated Wellbeing Inventory” or IWI.
  4. 4. Making tests short, easy, visually appealing and free of charge for patients and administrators all improve acceptability. Table 1 shows the inclusion and exclusion criteria considered for the development of our tool. Table 1. IWI inclusion and exclusion criteria. Table 2. Health-instrument domains in the IWI. Exclusion criteria The instrument is free of charge. Researcher or clinician administration. There is considerable published evidence of the instrument's reliability, validity and acceptability in the target population. Psychological symptoms Anxiety; depression; impaired memory, alertness, cognition, emotion, and/or behaviour / conduct. Stigma; communication problems; impaired social interaction and integration; role relationships (with partner, family, friends, peers); work; leisure; healthcare service availability and satisfaction. Spiritual changes Increased religious beliefs. Concerns about purpose of life. Long and difficult to understand tools. The instrument is self-reported. Mobility, pain, fatigue, altered appetite, gastrointestinal complaints, cramps, altered sleep pattern. Paying instruments. The instrument is short and simple. Physical symptoms Social impairment symptoms Inclusion criteria Insufficient empirical evidence regarding the instrument’s properties. The instrument has been recommended for use by clinicians and researchers over the years in patients with the target diseases. The bulk of the literature comes from the instrument’s developers or their collaborators. The instrument was developed in a country with the most language and cultural similarities to NZ, namely North America, the UK, Australia, or NZ. Culturally insensitive instruments. The three dimensions most commonly assessed in patient-reported health instruments (Garratt, Schmidt, Mackintosh, & Fitzpatrick, 2002) considered for the validation of the chronic disease distress thermometer are depicted in Table 2. The author added a fourth one – spirituality - in the IWI to integrate a key component of mankind since prehistory. THE INTEGRATED WELLBEING INVENTORY [IWI] The IWI is a one-page questionnaire containing a screening form and a complete form. The screening form integrates in one thermometer the Distress Thermometer (DT) and the Impact Thermometer (IT). It also collects demographic information about the patient: Age, ethnicity, and gender. The complete version [IWI-CV] has been designed using the WHO conceptualisation of distress and the DSM-V symptoms of 6 of the 7 domains included.
  5. 5. REFERENCES Aikens, J. E. (2012). Prospective associations between emotional distress and poor outcomes in type 2 diabetes. Diabetes Care, 35(12), 2472-2478. Retrieved from www.scopus.com Akizuki, N., Yamawaki, S., Akechi, T., Nakano, T., & Uchitomi, Y. (2005). Development of an Impact Thermometer for use in combination with the Distress Thermometer as a brief screening tool for adjustment disorders and/or major depression in cancer patients. Journal of Pain Symptom Management, 29, 91–99. Retrieved from www.scopus.com American Psychological Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Washington, DC: Author. Anderson, R.M., Fitzgerald, J.T., Funnell, M.M., & Grupen, L.D. (1998). The third version of the diabetes attitude scale (DAS-3). Diabetes Care, 21(9), 1403-1407. Retrieved from www.scopus.com Anderson, R.M., Fitzgerald, J.T., Gruppen, L.D., & Funnell, M.M. (2003). The diabetes empowerment scale-short form (DES-SF). Diabetes Care 26, 1641-1643. Retrieved from www.scopus.com Baer, L., Jacobs, D. G., Meszler-Reizes, J., Biais, M., Fava, M., Kessler, R., . . . O'Laughlen, J. (2000). Development of a brief screening instrument: The HANDS. Psychotherapy and Psychosomatics, 69(1), 35-41. Retrieved from www.scopus.com Baken, D. M., & Woolley, C. (2011). Validation of the distress thermometer, impact thermometer and combinations of these in screening for distress. Psycho-Oncology, 20(6), 609-614. Retrieved from www.scopus.com Bech, P. (2004). Measuring the dimensions of psychological general well-being by the WHO-5. QoL Newsletter, 32, 15-16. Retrieved from www.scopus.com Beck AT, Epstein N, Brown G, Steer RA (1988). "An inventory for measuring clinical anxiety: Psychometric properties". Journal of Consulting and Clinical Psychology 56, 893–897. Retrieved from http://beck-anxiety-inventory.soft112.com/ Beck AT, Ward C, Mendelson M (1961). "Beck Depression Inventory (BDI)". Archives of General Psychiatry 4 (6), 561–571. Retrieved from http://beck-depression-inventory.soft112.com/ Beecher, H. K. (1957). Measurement of pain: Prototype for the quantitative study of subjective responses. Pharmacological Review, 9, 59-209. Boyer, J. G., & Earp, J. A. L. (1997). The development of an instrument for assessing the quality of life of people with diabetes: Diabetes-39. Medical Care, 35(5), 440-453. Retrieved from www.scopus.com Bradley, C. (Ed)(1994). Diabetes treatment satisfaction questionnaire. Chur, Switzerland: Harwood Academic Publishers. Retrieved from www.scopus.com Braunwald, E., Fauci, A.S., Hauser, S.L., Jameson, J.L., Kasper, D.L., & Longo, D.L. (2008). Harrison's Principles of Internal Medicine (17th ed.). Columbus, OH: McGraw-Hill. Broadbent, E., Petrie, K.J., Main, J., & Weinman, J. (2006). The Brief Illness Perception Questionnaire. Journal of Psychosomatic Research, 60 (6), 631-637. Retrieved from www.scopus.com Carey, M. P., Jorgensen, R. S., Weinstock, R. S., Sprafkin, R. P., Lantinga, L. J., Carnrike, C. L. M., Jr., Baker, M. T., & Meisler, A. W. (1991). Reliability and validity of the appraisal of diabetes scale. Journal of Behavioral Medicine, 14, 43-51. Retrieved from www.scopus.com Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100. Retrieved from http://link.springer.com/article/10.1207%2Fs15327558ijbm0401_6#page-1 Delahanty, L. M., Grant, R. W., Wittenberg, E., Bosch, J. L., Wexler, D. J., Cagliero, E., & Meigs, J. B. (2007). Association of diabetes-related emotional distress with diabetes treatment in primary care patients with type 2 diabetes. Diabetic Medicine, 24(1), 48-54. Retrieved from www.scopus.com Delamater, A.M. (2013). Improving Patient Adherence. Clinical Diabetes 24, 71-77. Retrieved from www.scopus.com Donovan, K. A., Grassi, L., Mcginty, H. L., & Jacobsen, P. B. (2013). Validation of the distress thermometer worldwide: State of the science. Psycho-Oncology 19(2), 125-133, Retrieved from www.scopus.com EuroQoL Group. (1990). European quality of life questionnaire. Health Policy, 16, 199–208. Retrieved from http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/User_Guide_v2_March_2009.pdf Fisher, L., Glasgow, R. E., Mullan, J. T., Skaff, M. M., & Polonsky, W. H. (2008). Development of a brief diabetes distress screening instrument. Annals of Family Medicine, 6(3), 246-252. Retrieved from www.scopus.com Fisher, L., Glasgow, R. E., & Strycker, L. A. (2010). The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes. Diabetes Care, 33(5), 1034-1036. Retrieved from www.scopus.com Fisher, L., Polonsky, W., Parkin, C. G., Jelsovsky, Z., Amstutz, L., & Wagner, R. S. (2011). The impact of blood glucose monitoring on depression and distress in insulin-nave patients with type 2 diabetes. Current Medical Research and Opinion, 27(SUPPL. 3), 39-46. Retrieved from www.scopus.com Fisher, L., Skaff, M. M., Mullan, J. T., Arean, P., Glasgow, R., & Masharani, U. (2008). A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with type 2 diabetes. Diabetic Medicine, 25(9), 1096-1101. Retrieved from www.scopus.com Fitzgerald, J.T., Davis, W.K., Connell, C.M., Hess, G.E., Funnell, M.M., & Hiss, R.G. (1996) "Development and Validation of the Diabetes Care Profile," Evaluation and the Health Professions, 19(2), 209-231. Retrieved from www.scopus.com Fitzpatrick, R., Davey, C., Buxton, M.J., & Jones, D.R. (1998). Evaluating patient-based outcome measures for use in clinical trials. Health Technology Assessment 2(14), 23-30 Fitzpatrick, R., Bowling, A., Gibbons, E., Haywood, K., Jenkinson, C., Mackintosh, A., & Peters, M. (2006). A structured review of patient-reported measures in relation to selected chronic conditions, perceptions of quality of care and carer impact. National Center for Health Outcomes Development, University of Oxford: Author. Fleer, J., Tovote, K. A., Keers, J. C., Links, T. P., Sanderman, R., Coyne, J. C., & Schroevers, M. J. (2013). Screening for depression and diabetes-related distress in a diabetes outpatient clinic. Diabetic Medicine, 30(1), 88-94. Retrieved from www.scopus.com Franks, M. M., Sahin, Z., Seidel, A. J., Shields, C. G., Oates, S. K., & Boushey, C. J. (2012). Table for two: Diabetes distress and diet-related interactions of married patients with diabetes and their spouses. Families, Systems and Health, 30(2), 154-165. Retrieved from www.scopus.com Goldberg. D. & William. P. (1988). A user’s guide to the General Health Questionnaire. Slough: NFER-Nelson. Garratt, A.M., Schmidt, L., Mackintosh, A, & Fitzpatrick, R. (2002) Quality of life measurement: bibliographic study of patient assessed health outcome measures. British Medical Journal, 324 (7351), 1417-1421. Graue, M., Haugstvedt, A., Wentzel-Larsen, T., Iversen, M. M., Karlsen, B., & Rokne, B. (2012). Diabetes-related emotional distress in adults: Reliability and validity of the Norwegian versions of the problem areas in diabetes scale (PAID) and the diabetes distress scale (DDS). International Journal of Nursing Studies, 49(2), 174-182. Retrieved from www.scopus.com Gross, C. C., Scain, S. F., Scheffel, R., Gross, J. L., & Hutz, C. S. (2007). Brazilian version of the problem areas in diabetes scale (B-PAID): Validation and identification of individuals at high risk for emotional distress. Diabetes Research and Clinical Practice, 76(3), 455-459. Retrieved from www.scopus.com Joensen, L. E., Tapager, I., & Willaing, I. (2013). Diabetes distress in type 1 diabetes-a new measurement fit for purpose. Diabetic Medicine, 30 (9), 1132-1139. Retrieved from www.scopus.com Jones, P.W., Quirk, F.H., & Baveystock, C.M. (1991). The St. George's Respiratory Questionnaire. Respiratory Medicine, 85 (suppl B), 2531. Retrieved from www.scopus.com Kessler, R.C., Barker, P.R., Colpe, L.J., Epstein, J.F., Gfroerer, J.C., Hiripi, E.,..., & Zaslavsky, A.M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60 (2), 184-189. Retrieved from www.scopus.com Kooi, H.H., Tuinenga, M.G., Schokker, S., & Molen, T. (2003). How to measure clinical control in patients with COPD. The Development of the Clinical COPD Questionnaire (CCQ). QoL Newsletter, 31, 9-11. Retrieved from www.scopus.com Leyva, B., Zagarins, S. E., Allen, N. A., & Welch, G. (2011). The relative impact of diabetes distress vs depression on glycemic control in hispanic patients following a diabetes self-management education intervention. Ethnicity and Disease, 21(3), 322-327. Retrieved from www.scopus.com Lloyd, C. E., Pambianco, G., & Orchard, T. J. (2010). Does diabetes-related distress explain the presence of depressive symptoms and/or poor self-care in individuals with type 1 diabetes? Diabetic Medicine, 27(2), 234-237. Retrieved from www.scopus.com McCorkle, R. & Young, K. (1978). Development of a Symptom Distress Scale. Cancer Nursing, 1, 373-378. McGuire, B. E., Morrison, T. G., Hermanns, N., Skovlund, S., Eldrup, E., Gagliardino, J., . . ., & Snoek, F. J. (2010). Short-form measures of diabetes-related emotional distress: The problem areas in diabetes scale (PAID)-5 and PAID-1. Diabetologia, 53 (1), 66-69. Retrieved from www.scopus.com Ministry of Health (2009). Mortality and demographic data 2006. Wellington: Ministry of Health. Retrieved from http://www.health.govt.nz/system/files/documents/publications/mortality-demographic-data06.pdf Mitchell, A.J. (2007). Pooled results from 38 analyses of the accuracy of Distress Thermometer and other ultra-short methods of detecting cancer-related mood disorders. Journal of Clinical Oncology, 25, 4670–4681 Mitchell, A. J., Baker-Glenn, E. A., Park, B., Granger, L., & Symonds, P. (2010). Can the distress thermometer be improved by additional mood domains? part II. what is the optimal combination of emotion thermometers? Psycho-Oncology, 19 (2), 134-140. Retrieved from www.scopus.com Papathanasiou, A., Shea, S., Koutsovasilis, A., Melidonis, A., Papavasiliou, E., & Lionis, C. (2008). Reporting distress and quality of life of patients with diabetes mellitus in primary and secondary care in Greece. Mental Health in Family Medicine, 5 (2), 85-93. Retrieved from www.scopus.com Pavot, W., & Diener, E. (2008). The Satisfaction With Life Scale and the emerging construct of life satisfaction. Journal of Positive Psychology, 3, 137–152. Retrieved from www.scopus.com Peyrot, M., Rubin, R. R., & Polonsky, W. H. (2008). Diabetes distress and its association with clinical outcomes in patients with type 2 diabetes treated with pramlintide as an adjunct to insulin therapy. Diabetes Technology and Therapeutics, 10(6), 461-466. Retrieved from www.scopus.com Polonsky, W. H., Anderson, B. J., Lohrer, P. A., Welch, G., Jacobson, A. M., Aponte, J. E., & Schwartz, C. E. (1995). Assessment of diabetes-related distress. Diabetes Care, 18 (6), 754-760. Retrieved from www.scopus.com Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing psychosocial distress in diabetes: Development of the diabetes distress scale. Diabetes Care, 28 (3), 626-631. Retrieved from www.scopus.com Pouwer, F., Wijnhoven, H. A. H., Ujcic-Voortman, J. K., de Wit, M., Schram, M. T., Baan, C. A., & Snoek, F. J. (2013). Ethnic aspects of emotional distress in patients with diabetes - the Amsterdam health monitor study. Diabetic Medicine, 30 (1), 25-31. Retrieved from www.scopus.com Reddy, J., Wilhelm, K., & Campbell, L. (2013). Putting PAID to diabetes-related distress: The potential utility of the problem areas in diabetes (PAID) scale in patients with diabetes. Psychosomatics, 54 (1), 44-51. Retrieved from www.scopus.com Roth, A.J., Kornblith, A.B., Batel-Copel, L., Peabody, E., Scher, H.I,, & Holland, J.C. (1998). Rapid screening for psychological distress in men with prostate carcinoma: A pilot study. Cancer, 15(82), 1904-1908. Retrieved from www.scopus.com Snoek, F. J., Pouwer, F., Welch, G. W., & Polonsky, W. H. (2000). Diabetes-related emotional distress in Dutch and U.S. diabetic patients: Cross-cultural validity of the problem areas in diabetes scale. Diabetes Care, 23 (9), 1305-1309. Retrieved from www.scopus.com Streiner, D.L. & Norman, G.R. (1995). Health measurement scales: A practical guide to their development and use (2nd ed.). Oxford: Oxford Medical Publications. Taylor. A, Chittleborough, C., Gill, T., Winefield, H., Koster, C., Hornibrook, L. (January, 2009). Consensus Statement on Chronic Disease and Psychological Distress. The Assessment of the Determinants and Epidemiology of Psychological Distress (ADEPD) Study. Adelaide: University of Adelaide: Author. Tellegen, A., Ben-Porath, Y.S., McNulty, J.L., Arbisi, P.A., Graham, J.R., & Kaemmer, B. (2003). The MMPI-2 Restructured Clinical Scales: Development, validation, and interpretation. Minneapolis, MN: University of Minnesota Press. Ting, R. Z. W., Nan, H., Yu, M. W. M., Kong, A. P. S., Ma, R. C. W., Wong, R. Y. M., . . . Chan, J. C. N. (2011). Diabetes-related distress and physical and psychological health in chinese type 2 diabetic patients. Diabetes Care, 34(5), 1094-1096. Retrieved from www.scopus.com Van Bastelaar, K. M. P., Pouwer, F., Geelhoed-Duijvestijn, P. H. L. M., Tack, C. J., Bazelmans, E., Beekman, A. T., . . . Snoek, F. J. (2010). Diabetes-specific emotional distress mediates the association between depressive symptoms and glycaemic control in type 1 and type 2 diabetes. Diabetic Medicine, 27(7), 798-803. Retrieved from www.scopus.com Van Dijk-De Vries, A., Van Bokhoven, M. A., Terluin, B., Van Der Weijden, T., & Van Eijk, J. T. M. (2013). Integrating nurse-led self-management support (SMS) in routine primary care: Design of a hybrid effectiveness-implementation study among type 2 diabetes patients with problems of daily functioning and emotional distress: A study protocol. Family Practice, 14, 38-49. Retrieved from www.scopus.com Welch, G., Schwartz, C. E., Santiago-Kelly, P., Garb, J., Shayne, R., & Bode, R. (2007). Disease-related emotional distress of hispanic and non-hispanic type 2 diabetes patients. Ethnicity and Disease, 17(3), 541-547. Retrieved from www.scopus.com West, C., & McDowell, J. (2002). The distress experienced by people with type 2 diabetes. British Journal of Community Nursing, 7(12), 606-613. Retrieved from www.scopus.com World Health Organization (WHO) (November, 2013a) Fact sheet N°383: Symptoms of distress. Retrieved from http://www.who.int/mediacentre/factsheets/fs383/en/ World Health Organization (WHO) (2013b). Global mortality non-communicable diseases, COPD related both sexes all ages. Retrieved from http://apps.who.int/gho/data/node.main.CODWORLD?lang=en World Health Organization (WHO)(2013c). The impact of chronic disease in New Zealand. Retrieved from http://www.who.int/chp/chronic_disease_report/media/impact/new_zealand.pdf WHOQoL Group. (1994). Development of the WHOQoL: Rationale and current status. International Journal of Mental Health, 23 (3), 24-56. Retrieved from www.who.org Wycherley, T. P., Clifton, P. M., Noakes, M., & Brinkworth, G. D. (2013). Weight loss on a structured hypocaloric diet with or without exercise improves emotional distress and quality of life in overweight and obese patients with type 2 diabetes. Journal of Diabetes Investigation, Retrieved from www.scopus.com Zigmond, A.S. & Snaith, R.P. 5

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