Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Riba, Michelle; Donovan, Kristine A.; Andersen, Barbara L.; Braun, IIana; Breitbart, William; Brewer, Benjamin W.; Buchmann, Luke; Clark, Matthew M.; Collins, Molly; Corbett, Cheyenne; Fleishman, Stewart B.; Garcia, Sofia F.; Greenberg, Donna; Handzo, Rev George F.; Hoofring, Laura; Huang, Chao-Hui; Lally, Robin M.; Martin, Sara; McGuffey, Lisa; Mitchell, William M.; Morrison, Laura; Pailler, Megan E.; Palesh, Oxana; Parnes, Francine; Pazar, Janice P.; Ralston, Laurel; Salman, Jaroslava; Shannon-Dudley, Moreen; Valentine, Alan D.; McMillian, Nicole R.; Darlow, Susan

doi:10.6004/jnccn.2019.0048

Cited by 505 publications

(475 citation statements)

References 184 publications

(182 reference statements)

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“…Almost half of our cohorts had a significant distress. This is in agreement with the world-wide reported prevalence rates of 20-52% of cancer patients [2,9,19] for distress among cancer patients.…”

Section: Discussionsupporting

confidence: 92%

“…By 2050, a 3-fold increase in incident cancer relative to 2013 was estimated [1]. Distress is defined by The National Comprehensive Cancer Network (NCCN) as an emotionally unpleasant psychological (cognitive, behavioral, emotional), social, and/or spiritual experience that might interfere with a patient's ability to effectively cope with cancer, its physical symptoms, and its treatment [2]. Unfortunately, distress is quiet common among cancer patients, with a reported overall level of clinically significant distress to be between 20-47% during the course of the disease [3].…”

Section: Introductionmentioning

confidence: 99%

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Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?

Aziz

Khallaf

Abozaid³

et al. 2020

Preprint

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Background The distress thermometer (DT) is an effective tool for identifying distress among cancer patients worldwide. However, DT has not been studied in Egyptian patients. We aimed to study the prevalence of distress among Egyptian patients with different types of cancers using DT. Methods A total of 550 patients with newly diagnosed hematological and solid cancers who followed at 3 Oncology Centers in Egypt were enrolled. They completed a sociodemographic and clinical status questionnaire, the DT and the Problem List (PL) scale. Results At a DT cut off score of ≥ 4, 46% of patients had significant distress, which was related to the tumor site and stage. The most frequent problems reported were treatment decision (64.4%), worry (47%), and fears (44.5%). Univariate analysis showed that participants who had significant distress described 26 out of 36 problems in the practical, family, emotional, spiritual/religious and physical areas. Multivariate analysis confirmed only advanced cancer stage, depression, fear, nervousness, sadness, worry, loss of interest in usual activity, appearance, fatigue, feeling swollen, fever, getting around, indigestion, nausea, pain, and sleep as independent factors associated with significant distress in cancer patients. Conclusions Almost half of Egyptian patients newly diagnosed with cancer suffered from significant distress. Patients who had significant distress described extra problems in the practical, family, emotional, spiritual and physical areas. We recommend the routine use of DT for screening Egyptian patients with cancer, as well as the involvement of the psycho-oncology service and palliative care for pain control, at the time of their initial diagnosis.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?

Aziz

Khallaf

Abozaid³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…[4][5][6][7][8] Follow-up care guidelines recommend psychological screening for all cancer survivors and YACS in particular, but offer limited practical guidance regarding how screening should be conducted or what measures are appropriate. Although a variety of self-report symptom checklist measures have been advocated for this purpose, [9][10][11] to our knowledge few studies to date have specifically examined the validity of self-report depression screening measures for YACS, and even fewer have compared these measures with the diagnostic interviews that are standard in psychiatric assessment research. [12][13][14] This is highly problematic because without comparisons to "gold-standard" diagnostic interviews, it is difficult to determine whether these measures accurately identify patients with clinically significant symptoms and diagnoses.…”

Section: Introductionmentioning

confidence: 99%

Screening young adult cancer survivors with the PROMIS Depression Short Form (PROMIS‐D‐SF): Comparison with a structured clinical diagnostic interview

Recklitis

Blackmon

Chang

2020

Cancer

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Background The current study was conducted to evaluate the Patient‐Reported Outcomes Measurement Information System Depression Short Form (PROMIS‐D‐SF) as a screening measure for young adult cancer survivors (YACS) compared with a structured diagnostic interview. Methods A total of 249 YACS (aged 18‐40 years) completed the PROMIS‐D‐SF and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID). Based on the SCID, participants were classified as having: 1) an SCID depression diagnosis; 2) depression symptoms without an SCID diagnosis; or 3) no depression symptoms. Receiver operating characteristic analyses evaluated PROMIS‐D‐SF and SCID concordance and the sensitivity and specificity of PROMIS‐D‐SF cutoff t ‐scores. Results The PROMIS‐D‐SF had overall good agreement with the SCID for both depression diagnosis (area under the curve, 0.89) and the presence of depressive symptoms (area under the curve, 0.83). A PROMIS‐D‐SF cutoff t‐score of ≥53.2 came closest to meeting study criteria for detecting a SCID depression diagnosis (sensitivity ≥0.85 and specificity ≥0.75), with a sensitivity of 0.81 and a specificity of 0.74. For identifying survivors with depression symptoms, a t‐score cutoff value of 49.4 was found to have slightly superior sensitivity (0.84) and inferior specificity (0.64). In hypothetical screening examples, these cutoff scores led to moderate levels of missed cases (15%‐19%) and a high percentage of clinical referrals that were unnecessary by SCID criteria (56%‐70%). Conclusions The PROMIS‐D‐SF demonstrated moderately strong concordance with depressive diagnoses and symptoms measured by the SCID, but cutoff t‐scores did not meet study criteria for clinical screening. The PROMIS‐D‐SF may be useful for assessing depression in YACS, but the limitations in its sensitivity and specificity identified in the current study are likely to limit its usefulness as a stand‐alone screening instrument in this population.

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“…The Psychological Distress Scale is a single item asking patients to rate their distress on a scale of 0 (none) to 10 (extreme distress) 16 . This tool is included as a measure recommended for clinical practice and research in the NCCN Psychological Distress Guidelines 16 …”

Section: Methodsmentioning

confidence: 99%

Spirituality in cancer patients on phase 1 clinical trials

et al. 2020

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Objectives Patients with cancer who are at a transition to Phase I investigational treatments have been identified as an underserved population with regard to palliative care. This disease transition is often accompanied by spiritual and existential concerns. The study objective was to conduct a secondary analysis of data from a larger study testing a palliative care intervention. This paper reports the findings of this secondary focus on the spiritual needs of this population. Methods Patients (n = 479) were accrued to this study prior to initiating a Phase I clinical trial with data collected at baseline, and 4, 12, and 24 week follow‐up. Results Qualitative data revealed that the transition to Phase 1 trial participation is a time of balancing hope for extended life with the reality of advancing disease. Quantitative results demonstrated increased spirituality over time in both religious‐ and non‐religious‐affiliated patients. Conclusions Patients entering Phase I trials have important spiritual needs as they face treatment decisions, advancing disease, and often mortality. Spiritual care should be provided to seriously ill patients as a component of quality care.

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Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Cited by 505 publications

References 184 publications

Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?

Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?

Screening young adult cancer survivors with the PROMIS Depression Short Form (PROMIS‐D‐SF): Comparison with a structured clinical diagnostic interview

Spirituality in cancer patients on phase 1 clinical trials

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