IJCS | Volume 32, Nº5, September/October 2019

DOI: 10.5935/2359-4802.20190030 438 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(5):438-446 Mailing Address: Isabella Barros Rabelo Gontijo Departamento de Ciências da Saúde da Faculdade de Medicina R. 235, s/n, Setor Leste Universitário. Postal Code: 74605-050, Goiânia - GO - Brazil. E-mail: isabellagontijo1@gmail.com Validation of the Brazilian Version of the Screening Tool for Psychosocial Distress (Stop-D) for Cardiac Patients Isabella Barros Rabelo Gontijo, 1 J uciléia Rezende Souza, 2 D aniel Fernandes Barbosa, 3 S alvador Rassi 1 Hospital das Clínicas da Universidade Federal de Goiás, 1 Goiás, GO - Brazil Hospital Universitário de Brasília (HUB), 2 Brasília, DF - Brazil Centro Universitário Unieuro, 3 Brasília, DF - Brazil Manuscript received August 28, 2018; revised manuscript April 10, 2018; accepted September 24, 2018. Abstract Background: Distress has a potentiating effect on complications of heart disease. Early identification of distress and psychosocial management could help patients to deal with the disease and improve their quality of life. However, in Brazil, there is no specific instrument for evaluation of distress in cardiac patients. Objectives: To describe the validation process of the Screening Tool for Psychosocial Distress (STOP-D) for the Brazilian population. Methods: Cross-sectional, observational study with a quantitative approach. A total of 144 patients (including outpatients and inpatients) were interviewed at the waiting room of the outpatient cardiology clinic or in cardiology wards. Sociodemographic and clinical data were collected, and distress was assessed using two instruments – the Brazilian version of the STOP-D and the Hospital Anxiety and Depression Scale (HADS). First, we performed an exploratory factor analysis and analysis of the accuracy of the STOP-D score by the receiver operating characteristic (ROC) curvet. Results: The factorability analysis of the correlation matrix did not detect any factor that made the factorial solution unfeasible. The instrument showed a single-factor nature, confirmed by the criterion of eigenvalues, with an 85% accuracy in predicting distress. A cut-off point of 15.5 was chosen for distress using the ROC curve. Conclusions: The Brazilian version of the STOP-D is an adequate instrument for the screening of heart disease patient for distress. It can be easily used by any health professional and would contribute to the promotion of a comprehensive support to cardiac patients. (Int J Cardiovasc Sci. 2019;32(5):438-446) Keywords: Stress,Psychological; Health Delivery; Cardiovascular Diseases; Social Conditions; Quality of Life; Anxiety; Depression. Introduction Regardless of the disease stage, a cardiac patient is in an “alert state”, and a negative perception of illness may lead to a high level of distress that affects treatment response and disease progression. 1 In 1976, Selye proposed different definitions for positive and negative stress, naming them as “eustress” and “distress”, respectively. Eustress refers to a bearable level of stress; motivation is present in spite of threatening factors. It can be described as the ideal level of stress, compatible with the psychosocial resources of an individual. On the other hand, distress refers to an overload, i.e., an unbearable level of stress related to suffering towards the need of adaptation; when experienced for a long time, distress can cause exhaustion and make the individual more vulnerable to psychological disorders. 2,3 In clinical practice, five implications of distress have been recognized – difficulty in coping with