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Objective@#The study aimed to assess the validity of the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT) for determining psychosocial distress, as applied to Filipino patients with cancer. @*Methods@#We conducted a cross-sectional descriptive study that included adult patients with cancer undergoing treatment at a tertiary private hospital. The NCCN-DT was administered to the patients together with the Patient Health Questionnaire-8 (PHQ-8) as the gold standard diagnostic test for psychosocial distress. Receiver Operating Characteristic (ROC) analysis was done to determine the accuracy of the NCCN-DT as a screening tool. @*Results@#We included 114 Filipino adults with cancer. The ROC analysis showed an Area Under the ROC Curve (AUC) score of 0.98 for the NCCN-DT against the PHQ-8. The cut-off score of ≥7 showed a sensitivity of 100% and specificity of 89.3% for detecting distress. The positive predictors for distress were identified: sadness (P<0.001), fear (P=0.001), depression (P=0.002), worry (P=0.02), childcare (P=0.03), fatigue (P=0.03), treatment decisions (P=0.04), loss of interest in usual activities (P=0.04), and memory/concentration (P=0.04). @*Conclusion@#The NCCN-DT had satisfactory diagnostic accuracy in agreement with PHQ-8 for screening of psychosocial distress among Filipino cancer patients. A cut-off score of ≥7 using the NCCN-DT gave the highest sensitivity and specificity for detecting distress in this population. The findings of this study can be used as validation of the NCCN-DT screening tool for a prospective application.
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Anxiety , Depression , Fear , Sadness , Patient Health QuestionnaireABSTRACT
@#Objective To evaluate the degree of psychological pain for cancer patients undergoing surgical treatment and analyze the contributory factors to provide the theoretical basis for psychological intervention for cancer patients with surgical treatment. Methods The clinical data of 455 cancer patients who received surgeries in our hospital from November 2020 to January 2021 were retrospectively analyzed, including 225 males and 230 females aged 53.80±13.50 years. By applying the method of convenient sampling, a cross-sectional survey was carried out by gathering the general information of the patients and evaluating their mental condition with the distress thermometer. The contributory factors were discussed by logistic regression analysis. Results The score for the psychological pain of the patients was 4.11±2.49 points. The main factors contributing to the psychological pain were physical problems, emotional problems and family matters. The logistic regression analysis showed that the main factors related to the degree of psychological pain were cancer types (P=0.023), religious belief (P=0.046), number of niduses (P=0.016), respiratory status (P=0.004), medical expense (P=0.007), grief (P=0.001) and anxiety (P=0.040). Conclusion Nearly half of the patients have been subjected to apparent psychological pain, and emotion and physical problems are the main factors. It is crucial to pay attention to the patients’ mental problems, seek convenient tools for psychological evaluation, and take actions to deal with the psychological problems and physical symptoms.
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OBJECTIVES@#This study aims to validate the Distress Thermometer Filipino version, (DT-F) in head and neck cancer patients and identify the cut off score of DT-F for psychosocial distress at which to make referrals for clinical intervention.@*METHODOLOGY@#After obtaining permission from the National Comprehensive Cancer Network (NCCN), translation and back-translation of the Distress Thermometer (DT) were done. One hundred ninety- two patients who fit the inclusion criteria were included in the study. They were from the outpatient clinic and ward of both the Cancer Institute and Otorhinolaryngology Department and each participant accomplished a socio-demographic form, the DT-F and Problem List, The Hospital Anxiety and Depression Scale-Pilipino (HADS P) and had a brief psychiatric interview.@*RESULTS@#Receiver Operating Characteristic (ROC) curve analyses generated area under the curve (AUC) of 0.7506, suggesting good discrimination using the HADS P cut off score of 11. The optimal cut off score in DT-F is 4, with a sensitivity of 77% and specificity of 58%. Hence, using this cut off score, head and neck cancer patients who score 4 and above in the DT-F were identified to experience clinically relevant psychosocial distress than those who score below the cut off.@*CONCLUSION@#The Filipino version of DT is a valid tool for screening psychosocial distress in head and neck cancer patients. Using a cut off score of 4 is recommended for appropriate and timely referral for further evaluation.
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Head and Neck NeoplasmsABSTRACT
OBJECTIVES@#Patients with cervical cancer who have received radiotherapy often suffer from systemic muscle volume reduction and quality of life decline due to systemic effects of tumor and side effects of radiotherapy. The purpose of this study was to investigate the status of muscle fitness, quality of life, and psychological pain in patients with cervical cancer who received radiotherapy, and to explore the correlation between muscle fitness, quality of life, and psychological pain.@*METHODS@#A total of 202 cervical cancer patients aged 19-71, who received radiotherapy in Hunan Cancer Hospital from July 2020 to February 2021, were selected by convenience sampling method. Functional Assessment of Cancer Therapy Cervix (FACT-CX) and Distress Thermometer (DT) were used for the survey. The patient's grip strength was assessed by a handgrip meter and compared with that of healthy Chinese women of the same age. The correlation between muscle fitness and quality of life and psychological pain was analyzed.@*RESULTS@#The grip strength of cervical cancer patients receiving radiotherapy was significantly lower than that of healthy Chinese women at the same age (@*CONCLUSIONS@#The grip strength of patients with cervical cancer undergoing radiotherapy is generally decreased, which is affected by many factors, and is closely related to the quality of life and psychological pain of patients. In the future, dynamic attention should be paid to the changes of grip strength and related functions in patients receiving radiotherapy for cervical cancer, the potential risks in the treatment should be identified early, and targeted intervention should be taken.
Subject(s)
Female , Humans , Anxiety , Hand Strength , Psychological Distress , Quality of Life , Uterine Cervical Neoplasms/radiotherapyABSTRACT
Objective@#To evaluate the degree of psychological distress and analyze the influential factors of cancer patients receiving radiotherapy, aiming to provide theoretical basis for individualized psychological interventions.@*Methods@#A cross-sectional survey of 157 cancer patients treated with radiotherapy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University in the previous year was conducted in terms of data collection and mean score of NCCN distress thermometer by using the convenience sampling method. Tumor types included nasopharyngeal cancer, breast cancer and cervical cancer, etc. The influential factors were analyzed by using logistic regression method.@*Results@#The mean score of NCCN distress thermometer in 157 cancer patients was 4.07±0.19. Among them, 87 cases (55.41%) experienced significant psychological distress (NCCN distress thermometer score≥4). The main influential factors of psychological distress consisted of depression, loneliness, fear, appearance changes, urination changes, nausea, poor appetite, eating trouble, diarrhoea, constipation, pain and radiodermatitis. Logistic regression analysis demonstrated that nausea and urination changes were the independent influential factors of psychological distress.@*Conclusions@#Over half of cancer patients undergoing radiotherapy present with evident psychological distress. Somatic problems and emotional situations are the main factors of psychological pain. Consequently, it is highly necessary to emphasize the psychological health and actively resolve the somatic and emotional symptoms of cancer patients receiving radiotherapy.
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Objective To evaluate the degree of psychological distress and analyze the influential factors of cancer patients receiving radiotherapy,aiming to provide theoretical basis for individualized psychological interventions.Methods A cross-sectional survey of 157 cancer patients treated with radiotherapy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University in the previous year was conducted in terms of data collection and mean score of NCCN distress thermometer by using the convenience sampling method.Tumor types included nasopharyngeal cancer,breast cancer and cervical cancer,etc.The influential factors were analyzed by using logistic regression method.Results The mean score of NCCN distress thermometer in 157 cancer patients was 4.07± 0.19.Among them,87 cases (55.41％) experienced significant psychological distress (NCCN distress thermometer score ≥ 4).The main influential factors of psychological distress consisted of depression,loneliness,fear,appearance changes,urination changes,nausea,poor appetite,eating trouble,diarrhoea,constipation,pain and radiodermatitis.Logistic regression analysis demonstrated that nausea and urination changes were the independent influential factors of psychological distress.Conclusions Over half of cancer patients undergoing radiotherapy present with evident psychological distress.Somatic problems and emotional situations are the main factors of psychological pain.Consequently,it is highly necessary to emphasize the psychological health and actively resolve the somatic and emotional symptoms of cancer patients receiving radiotherapy.
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Objective To investigate the degree of psychological distress in patients with lower extremity arteriosclerosis obliterans, and to understand the causes and to analyze the influencing factors. Methods The general information questionnaire, psychological distress thermometer, family APGAR index and family burden scale questionnaire were used to conduct a cross-sectional survey in 145 patients with obliterans in hospital during the period from July 2015 to July 2017. Results The average score of psychological pain of all patients was (4.7±2.2) points, the patients with significant psychological distress was 102 cases, accounting for 70.3% (DT score≥4 points). The main reason caused by lower extremity arterial occlusive disease in patients with psychological distress among the top 10 were: pain, anxiety, sleep problems, physical activity, work/ school, restricted travel, numbness, fatigue, constipation, economic problems. Multiple linear regression analysis showed that the hospitalization, duration of illness, family care and family burden of the disease affected the scores of psychological pain in different seasons (P＜0.05). Conclusions The patients with lower extremity arteriosclerosis obliterans have severe psychological pain, so the targeted measures should be taken to prevent and treat the risk factors.
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Distress thermometer (DT) and problem list (PL) are rapid screening tools recommended by National Comprehensive Cancer Network for cancer patients' levels of distress. DT has good validation and reliability and widely used around the world. In this paper, we reviewed the cutoff score of DT, grading disputes of PL, and application situations of them to provide a reference for the tools selection and applying of psychological distress screening of cancer patients in China.
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Objective To understand the degree of psychological distress of breast cancer patients beford chemotherapy, and to analyze the causes and influencing factors. Methods A cross-sectional study was conducted on 95 patients with prechemotherapy for breast cancer from September 2017 to December 2017 using a general data questionnaire and distress management screening measure. Results The score of psychological pain before chemotherapy of breast cancer was (4.92 ±2.23), among which 69 cases with significant psychological pain accounted for 72.63％ (DT score was greater than 4). The main causes of breast cancer patients' psychological distress ranking on the top 10 are: surgical scar, recurrence worry, arm activities difficulty, daily life was disrupted, anxiety, memory loss, housekeeping difficulties, poor communication with her husband, fatigue, change the appearance. Single factor analysis showed that age, family harmony had an effect on psychological pain scores (P＜0.05).It is found that family harmony is the protective factor of paychological pain when age and family relationship are included in multifactor analysis (OR＞1, P＜0.05). Conclusion There is an obvious psychological distress in breast cancer patients before chemotherapy; The age, family harmony of the patient were independent factors related to psychological distress; body symptoms, emotions and family problems are the key issues to focus on before chemotherapy.
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Objective@#To explore the psychological distress status of HIV-infected pregnant women and analyze the possible influencing factors.@*Methods@#A total of 483 HIV-infected pregnant women were enrolled for this study by a cluster random sampling method from Sept. 2014 to Apr. 2017. Participants completed questionnaires including Distress Thermometer (DT), Berger HIV Stigma Scale (BHSS), HIV/AIDS Stress Scale (SS-HIV), Social Support Rating Scale (SSRS) and general questionnaire.@*Results@#The detection rate of psychological distress was 68.1%, the detection rates of moderate, severe and extreme psychological pain were 49.7%, 17.6% and 0.8% respectively. The detection rate of continuing pregnancy (75.2%) was higher than the termination pregnancy (56.4%), the difference was statistically significant (χ2=18.44, P<0.01). There were significant differences in the detection rates between continuing pregnancies at different gestational ages (χ2=15.41, P<0.01), and the termination pregnancy varies little with pregnancy (χ2=0.03, P>0.05). The mean DT score was 4.85 ± 1.82. The score of continuing pregnancy (5.94 ± 1.73) was higher than the termination pregnancy (4.20 ±1.96), the difference was statistically significant (t=4.57, P<0.01). Logistic regression analysis showed that CD4+ T lymphocyte count, infection route, perceived discrimination, related stress and social support were the common influencing factors of all pregnant women, factors affecting continuing pregnancy also include high risk pregnancy and gestational age.@*Conclusions@#HIV-infected pregnant women have higher incidence of psychological distress. The influencing factors are mainly related to the infection characteristics, pregnancy characteristics, BHSS, SS-HIV and SSRS, and has nothing to do with the general social demographic characteristics. The DT can be used as a screening tool to quickly identify psychological distress of the group.
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OBJECTIVES: The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. METHODS: 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. RESULTS: Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. CONCLUSIONS: This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.
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Humans , Anxiety , Comorbidity , Compliance , Depression , Education , Logistic Models , Mass Screening , National Health Programs , Quality of Life , Sleep Initiation and Maintenance DisordersABSTRACT
Objective To investigate the prevalence of psychological distress and analyze the relevant factors among patients with bladder tumor so as to provide evidence for future clinical practice. Methods Totally 128 patients were recruited from a urological surgery ward of a comprehensive hospital in Beijing in the study by using self-design questionnaire and the psychological distress thermometer (DT) recommended by the U.S. national comprehensive cancer network (NCCN). The acquired data were analyzed by SPSS17.0. Results The average score of the patients was 4.00(1.00~5.00). The identification rate of psychological stress was 55.47%( 71/128 ) , higher than the Chinese normal ( U = 8 . 28 , P < 0 . 05 ) . The relevant factors of psychological stress based on the rank from high to low scores included emotion problems ( 1 . 63 ± 0 . 67 ) , practical problems ( 1 . 42 ± 0 . 64 ) , communication problems (1.29 ± 0.65), physical problems (1.28 ± 0.33) and religion problems (1.00 ± 0.08). Conclusions The prevalence of psychological distress is higher among patients with bladder tumor and the influence factors mainly include emotional problems , practical problems and communication problems. Nurses should pay attention to the psychological distress of patients with bladder tumors and develop targeted interventions so as to relieve their distress.
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Objective To understand the levels of psychological distress in patients with lung cancer,and analyze the reason and influential factors. Methods The general information of the patients and the distress thermometer(DT) were used to carry out the cross-sectional study in 117 patients with lung cancer received treatments from September 2013 to January 2014. Results The score of psychological distress in patients with lung cancer was (3.10±1.70) points,and 56 patients (47.9%) had the significant psychological distress (DT score≥4 points). The main cause of lung cancer psychological distress ranking in the top 10, in turn, was fear, pain, fatigue, sleep problems, fear, tension, economic problems, eating, breathing, constipation. Mutiple linear regression analysis showed that the number of chemotherapy, age, vocation could affect the total score of distress. Conclusions The patients with lung cancer have obvious psychological distress. Emotional and physical problems of the patients are the main reason of psychological distress of patients with lung cancer.The number of chemotherapy,age,vocation of the patients are related to the psychological distress of patients with lung cancer.
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JUSTIFICATIVA E OBJETIVOS: Evidências apontam que cerca de metade dos pacientes com câncer apresentam altos níveis de estresse, condição que ainda permanece pouco diagnosticada e tratada. Este estudo piloto visou investigar a utilização do instrumento Termômetro de Estresse (TE) aplicando-o a pacientes idosos em vigência de tratamento quimioterápico, de forma a identificar possíveis fatores preditivos de estresse nessa população. MÉTODO: Foram selecionados aleatoriamente 40 pacientes com idade igual ou superior a 65 anos, portadores de neoplasia sólida ou hematológica, em tratamento quimioterápico nos serviços vinculados à Faculdade de Medicina do ABC. Estes responderam ao TE e a questionários para avaliação de qualidade de vida, atividades da vida diária, escala de sintomas relacionados à quimioterapia, escala de depressão geriátrica, mini-exame do estado mental e mini-avaliação nutricional. RESULTADOS: A pontuação média do TE foi de 4,20, sendo que 65% dos pacientes apresentaram alto nível de estresse (pontuação de corte maior ou igual a 4). Verificou-se a correlação do TE ao Questionário de Atividades Instrumentais de Lawton (p = 0,035), à Escala de Sintomas de Edmonton (p = 0,043) e à Escala de Depressão Geriátrica (p = 0,030). CONCLUSÃO: Pacientes idosos em tratamento quimioterápico sofrem de estresse, que pode estar relacionado à diminuição da capacidade de desenvolver atividades instrumentais da vida diária, aos próprios sintomas do regime quimioterápico e à manifestação de sintomas de depressão.
BACKGROUND AND OBJECTIVES: Up to half of all cancer patients experience clinically significant levels of stress and much of this stress goes unrecognized and untreated. This pilot study aimed to evaluate the Distress Thermometer (DT) in elderly patients undergoing chemotherapy in oncology services related to the School of Medicine of ABC and to identify possible predictors. METHOD: We randomly selected 40 patients aged over 65 years with hematologic or solid tumors undergoing chemotherapy treatment. They were asked to respond to the DT and questionnaires for assessing quality of life, activities of daily living, symptoms related to chemotherapy, geriatric depression scale, mini-mental state and mini-nutritional assessment. RESULTS : Regarding the DT, the average score was 4.20 and 26 patients (65% of total) had scores above 4 (the optimal DT cutoff score). In the correlation analysis, we obtained a correlation of TD to the questionnaires of Instrumental Activities of Daily Living (p= 0.035), Edmonton Symptom Assessment Scale (p =0.043) and Geriatric Depression Scale (p=0.030). CONCLUSION: Elderly patients undergoing chemotherapy suffer from stress that can be related to the decline in their ability to develop instrumental daily activities, to the symptoms related to the chemotherapy and to the development of depression symptoms.