How much psychological distress is experienced at home by patients with palliative care needs in Germany? A cross-sectional study using the Distress Thermometer

Abstract

A significant proportion of patients treated at home reported symptoms of distress. The most oft-mentioned problems were physical and emotional in nature. The findings of our study highlight the importance of creating new concepts and structures in order to address the psychosocial needs of patients in home care with palliative needs.

Accuracy of the Distress Thermometer for home care patients with palliative care needs in Germany

“…Validation in a palliative care setting is important, because the properties of an instrument as a screening tool depend partly on the population in which it is investigated (Rouse, 2007). In a former study (Kü ttner et al, 2016), we demonstrated that the DT has a high degree of sensitivity and acceptability in persons at the end of life.…”

What defines the comprehensive assessment of needs in palliative care? An integrative systematic review

“…41 One of the tools was use to assessed the needs of home-based palliative care patients specifically. 64…”

Changes in Distress Measured by the Distress Thermometer as Reported by Patients in Home Palliative Care in Germany

“…All other sociodemographic and medical variables showed no statistically significant differences. 10 The response and dropout rate were relatively high. However, there are inherent difficulties in recruiting patients in palliative care due to frailty, deterioration, and death.…”

“…The problem list (PL) consists of 38 problems commonly experienced by patients with cancer grouped into 5 categories. 5,10,22 Respondents were instructed to indicate whether any of the items listed were a problem in the previous week by selecting “yes” or “no.” The PL may also suggest the appropriate professional support for each patient. We used the NCCN Guidelines version 2.2013, slightly modified by skipping the item “ability to conceive children” (accepted by the NCCN).…”

“…4 With the distress thermometer (DT), it is possible to screen for and monitor psychological distress throughout the course of disease. 9 A screening of 103 patients using the DT, cared for at home by a specialized palliative care team, revealed that 90% of the patients suffer from high levels of distress, 10 but little is known about the patterns of the distress over time. 9,11 Former studies have shown the utility of DT as screening instrument compared with Hospital Anxiety and Depression Scale (HADS) for palliative setting, 12 also for longitudinal data and suggested that it can be used to monitor change in psychological distress over time.…”