Objective: Screening for distress is important for identifying those who might benefit from support and allocating limited resources. A common screening tool is the Distress Thermometer (DT) but other thermometers such as the Impact Thermometer (IT) have also been suggested. The objective of this study was to investigate the accuracy in identifying distress of these two screening thermometers individually and two possible methods of combining the responses.Methods: A random selection of 400 patients from a regional cancer treatment service data base was selected and 50% responded to a mailed questionnaire. The accuracy of these screening options individually and of two methods of combining the responses was investigated by comparison with responses to the Hospital Anxiety and Depression Scale.Results: The results supported the cut off suggested in the literature for the DT. The IT individually was found to perform at least as well as the DT individually. However, the combinations of the two generally proved to be more accurate than either used alone.Conclusions: These results suggest that the accuracy of the DT in identifying distress can be increased by combining it with the IT. This increase in accuracy must be weighed against the possible increase in complexity. However, one method of combining the responses from the two thermometers simply involves summing the two scores and this should not be enough to deter busy clinicians from screening patients and family members.

These results suggest that exercise exhibits a different physiological response in MS and CFS/ME, demonstrating repeated cardiovascular exercise testing as a valid measure for differentiating between fatigue conditions.

Objective This qualitative meta‐synthesis explored the subjective experiences of patients and their family members when receiving bad news about cancer, with a focus on what was important to them during this process and making future recommendations. Methods A search of five electronic databases yielded 587 different records that resulted in 88 articles assessed against the inclusion/exclusion criteria. With the supplement of four additional records, 29 articles were analysed using thematic synthesis. A quality appraisal checklist was used to provide further information about the included articles. Results Patients and family members experienced receiving bad news as a process that involved three phases, labelled as follows: “preparation”, “delivery”, and “adjusting and coping”. The “preparation” phase had four themes: the setting, developing a relationship, knowing the patient, and forewarning. Four themes were identified during the “delivery” phase: emotional reactions, empathy not sympathy, active participation, and understanding. “Adjusting and coping” comprised four themes: hope, holistic support, being a protector, and ongoing relationships. Conclusions Receiving bad news is a significant experience for patients and family members. They want bad news delivered in an appropriate setting, in a manner consistent with their personal preferences, and have their psychological needs attended to within the context of an established relationship. Healthcare professionals can be assisted to deliver bad news in the best way possible by additional training and their workplace institutions providing quiet, private rooms, and sufficient time. Future research is needed to better understand family members' experiences and needs.

As part of a larger meta-analysis seeking moderators of the effectiveness of psycho-oncological interventions, this report focuses on intervention types and characteristics, including protocol components, means of delivery (mode, dose, and therapist variables), and mechanisms of effectiveness. The data set comprised 146 published and unpublished prospective controlled trials with outcomes of anxiety, depression, and distress. Analyses took into account two moderators from analysis of study design features. The authors conclude that each of the four main professional therapy types (education, relaxation, cognitive behavior therapy (CBT), and expressive-support) has effect and that it is more important to focus on participant variables, notably, elevated baseline distress. Therapy components delivered by nonprofessionals and interventions that affect the patient indirectly show potential. Recommendations for practice and research are made.

The Multidimensional Health Locus of Control (MHLC) Scale was a significant contribution to the development of the locus of control construct in establishing the importance of multiple sources of control. This article suggests that further development of the construct should include two distinct aspects of control beliefs: strategy and capacity beliefs. A confirmatory factor analysis that tested six competing models supported the use of multidimensional measurements of control. Correlations with existing measures of health-related control constructs, including the MHLC, supported the validity of the strategy and capacity dimensions.