Mackenzi Pergolotti1, Michelle M Langer2, Allison M Deal3, Hyman B Muss4, Kirsten Nyrop4, Grant Williams5. 1. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. Electronic address: mpergolotti@selectmedical.com. 2. American Institutes for Research, Chapel Hill, NC, United States. 3. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. 4. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Division of Hematology Oncology, School of Medicine, University of North Carolina at Chapel Hill, NC, United States; Department of Geriatric Oncology, School of Medicine, University of North Carolina at Chapel Hill, NC, United States. 5. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Geriatric Oncology, School of Medicine, University of North Carolina at Chapel Hill, NC, United States.
Abstract
OBJECTIVES: The Mental Health Index (MHI) is widely used as a measure of mental health status, but has not been evaluated in the geriatric oncology population. This study evaluated the MHI-17 in a geriatric oncology population, to establish validity and scoring rules. MATERIALS AND METHODS: The Carolina Senior Registry (NCT01137825) was used to obtain data for 686 patients with cancer 65 and older who completed the MHI-17. The 17-item patient-reported measure produces one total score summing across four domains: anxiety, depression, positive affect, and sense of belonging. Cronbach's alpha (α), confirmatory factor analyses (CFA), item-response theory (IRT) analyses, and differential item functioning (DIF) analyses were used to evaluate internal consistency and validity. RESULTS AND DISCUSSION: The revised MHI retained the 13 best-fitting items from the MHI-17 and resulted in a final model that included two subscales: anxiety (four items, RMSEA 0.11; CFI 0.99; TLI 0.98) and depression (9 items, RMSEA 0.10; CFI 0.96; TL 0.95). IRT analyses of the four anxiety items indicated good fit (RMSEA 0.08) and precise measurement of adults with poor mental health, and the nine depression items also fit well (RMSEA 0.05). No meaningful differences were found by sex, education, or treatment stage. Scores were developed to provide meaningful norms. The new MHI-13 is a shorter, more accurate way to assess mental health in older adults with cancer and most importantly allows clinicians to separately identify anxiety and/or depression - a clinically important distinction as treatment differs among these two types of mental health impairment.
OBJECTIVES: The Mental Health Index (MHI) is widely used as a measure of mental health status, but has not been evaluated in the geriatric oncology population. This study evaluated the MHI-17 in a geriatric oncology population, to establish validity and scoring rules. MATERIALS AND METHODS: The Carolina Senior Registry (NCT01137825) was used to obtain data for 686 patients with cancer 65 and older who completed the MHI-17. The 17-item patient-reported measure produces one total score summing across four domains: anxiety, depression, positive affect, and sense of belonging. Cronbach's alpha (α), confirmatory factor analyses (CFA), item-response theory (IRT) analyses, and differential item functioning (DIF) analyses were used to evaluate internal consistency and validity. RESULTS AND DISCUSSION: The revised MHI retained the 13 best-fitting items from the MHI-17 and resulted in a final model that included two subscales: anxiety (four items, RMSEA 0.11; CFI 0.99; TLI 0.98) and depression (9 items, RMSEA 0.10; CFI 0.96; TL 0.95). IRT analyses of the four anxiety items indicated good fit (RMSEA 0.08) and precise measurement of adults with poor mental health, and the nine depression items also fit well (RMSEA 0.05). No meaningful differences were found by sex, education, or treatment stage. Scores were developed to provide meaningful norms. The new MHI-13 is a shorter, more accurate way to assess mental health in older adults with cancer and most importantly allows clinicians to separately identify anxiety and/or depression - a clinically important distinction as treatment differs among these two types of mental health impairment.
Authors: Cielito C Reyes-Gibby; Lu Ann Aday; Karen O Anderson; Tito R Mendoza; Charles S Cleeland Journal: J Pain Symptom Manage Date: 2006-08 Impact factor: 3.612
Authors: Arti Hurria; Supriya Gupta; Marjorie Zauderer; Enid L Zuckerman; Harvey J Cohen; Hyman Muss; Miriam Rodin; Katherine S Panageas; Jimmie C Holland; Leonard Saltz; Mark G Kris; Ariela Noy; Jorge Gomez; Ann Jakubowski; Clifford Hudis; Alice B Kornblith Journal: Cancer Date: 2005-11-01 Impact factor: 6.860
Authors: Trevor A Jolly; Allison M Deal; Kirsten A Nyrop; Grant R Williams; Mackenzi Pergolotti; William A Wood; Shani M Alston; Brittaney-Belle E Gordon; Samara A Dixon; Susan G Moore; W Chris Taylor; Michael Messino; Hyman B Muss Journal: Oncologist Date: 2015-03-12
Authors: D V Jeste; G S Alexopoulos; S J Bartels; J L Cummings; J J Gallo; G L Gottlieb; M C Halpain; B W Palmer; T L Patterson; C F Reynolds; B D Lebowitz Journal: Arch Gen Psychiatry Date: 1999-09
Authors: Tina Hsu; Matthew Loscalzo; Rupal Ramani; Stephen Forman; Leslie Popplewell; Karen Clark; Vani Katheria; Tao Feng; Rex Strowbridge; Redmond Rinehart; Dan Smith; Keith Matthews; Jeff Dillehunt; Arti Hurria Journal: Cancer Date: 2014-06-04 Impact factor: 6.860
Authors: Grant R Williams; Allison M Deal; Trevor A Jolly; Shani M Alston; Brittaney-Belle E Gordon; Samara A Dixon; Oludamilola A Olajide; W Chris Taylor; Michael J Messino; Hyman B Muss Journal: J Geriatr Oncol Date: 2014-04-03 Impact factor: 3.599
Authors: Mackenzi Pergolotti; Nicolò Matteo Luca Battisti; Lynne Padgett; Alix G Sleight; Maya Abdallah; Robin Newman; Kathleen Van Dyk; Kelley R Covington; Grant R Williams; Frederiek van den Bos; YaoYao Pollock; Elizabeth A Salerno; Allison Magnuson; Isabella F Gattás-Vernaglia; Tim A Ahles Journal: J Geriatr Oncol Date: 2019-10-14 Impact factor: 3.599
Authors: Grant R Williams; Kathryn E Weaver; Glenn J Lesser; Emily Dressler; Karen M Winkfield; Heather B Neuman; Anne E Kazak; Ruth Carlos; Lucy J Gansauer; Charles S Kamen; Joseph M Unger; Supriya G Mohile; Heidi D Klepin Journal: Oncologist Date: 2020-08-31
Authors: Gabriel F P Aleixo; Seul Ki Choi; Alyssa J Tan; Kirsten A Nyrop; Alyson M Deal; William A Wood; Trevor A Jolly; Hyman B Muss Journal: Oncologist Date: 2019-09-13
Authors: K A Nyrop; E M Damone; A M Deal; S B Wheeler; M Charlot; B B Reeve; E Basch; S S Shachar; L A Carey; K E Reeder-Hayes; E C Dees; T A Jolly; G G Kimmick; M S Karuturi; R E Reinbolt; J C Speca; W A Wood; H B Muss Journal: Breast Cancer Res Treat Date: 2021-11-05 Impact factor: 4.872
Authors: Melisa L Wong; Ying Shi; Alexander K Smith; Christine Miaskowski; W John Boscardin; Harvey Jay Cohen; Vivian Lam; Melissa Mazor; Lia Metzger; Carolyn J Presley; Grant R Williams; Kah Poh Loh; Carling J Ursem; Terence W Friedlander; Collin M Blakely; Matthew A Gubens; Gregory Allen; Dianne Shumay; Louise C Walter Journal: J Am Geriatr Soc Date: 2021-10-05 Impact factor: 5.562
Authors: Chad W Wagoner; Jordan T Lee; Erik D Hanson; Zachary Y Kerr; Kirsten A Nyrop; Hyman B Muss; Claudio L Battaglini Journal: Breast Cancer Date: 2022-06-24 Impact factor: 3.307
Authors: Gabriel F P Aleixo; Seul Ki Choi; Alyssa J Tan; Kirsten A Nyrop; Alyson M Deal; William A Wood; Trevor A Jolly; Hyman B Muss Journal: Oncologist Date: 2019-09-13
Authors: Heidi D Klepin; Ellen Ritchie; Brittny Major-Elechi; Jennifer Le-Rademacher; Drew Seisler; Libby Storrick; Ben L Sanford; Guido Marcucci; Weiqiang Zhao; Susan A Geyer; Karla V Ballman; Bayard L Powell; Maria R Baer; Wendy Stock; Harvey Jay Cohen; Richard M Stone; Richard A Larson; Geoffrey L Uy Journal: J Geriatr Oncol Date: 2019-10-24 Impact factor: 3.599
Authors: Christopher E Jensen; Sanah N Vohra; Kirsten A Nyrop; Allison M Deal; Hyman B Muss; Eben I Lichtman; Samuel M Rubinstein; William A Wood; Nicholas J Mangieri; Lee Jamison; Shakira J Grant; Sascha A Tuchman Journal: J Geriatr Oncol Date: 2021-08-11 Impact factor: 3.929
Authors: Zev M Nakamura; Allison M Deal; Kirsten A Nyrop; Yi Tang Chen; Laura J Quillen; Tucker Brenizer; Hyman B Muss Journal: Oncologist Date: 2020-10-02 Impact factor: 5.837