<p>Screening for Predictive Parameters Requiring Psycho-Oncological Intervention via the National Comprehensive Cancer Network Distress Thermometer in the Follow-Up of Uveal Melanoma Patients</p>

Abstract

Aim: To assess a profile of uveal melanoma patients at risk of requiring active psychooncological intervention by employing the National Comprehensive Cancer Network (NCCN) distress thermometer. Methods: Multivariate correlation and multiple linear regression analysis of data collected retrospectively from 106 consecutive patients suffering from uveal melanoma. Results: Distress levels correlated with practical (p = 0.01), emotional (p = 0.003) and physical problems (p = 0.001) as well as the total number of issues reported (p < 0.001; ANOVA, respectively). Emotional issues added up to 39% of influence on distress levels. Nervousness, worry and sadness as the most important emotional issues tested correlated significantly with anatomic stage, tumor T-category, metastatic status and time after primary diagnosis and were present more frequently in patients with higher distress levels (p < 0.001, p = 0.002, p = 0.004, respectively, Fisher's exact test). Pre-existing psycho-oncological support was more frequent in metastatic patients and patients with higher anatomic stage tumors (p = 0.008 and p = 0.003; Fisher's exact test). Conclusion: The distress thermometer proved to be useful for rapid assessment of patients requiring active intervention. A higher number of distress items recorded correlated with elevated distress levels. Emotional issues were responsible for the majority of problems. A typical patient profile at risk of developing distress requiring close attention of caregivers includes high anatomic stage, high T-category, presence of metastases and early follow-up. Correct diagnosis and interpretation of distress-levels should help improve the quality of life of uveal melanoma survivors. Trial Registration: Not applicable.

Distress among cancer patients: some considerations in identification and treatment

“…Of the original sample, 4% agreed to participate in an intervention study to ameliorate distress, leading the authors to conclude that 27 individuals needed to be screened to recruit one person into the study and that up to 17 hours were required to recruit each patient (van Scheppingen et al, 2014). Although some studies have suggested that the DT is useful for assessment of patients (e.g., Klingenstein et al, 2020), a systematic review found little evidence to support its validity, as well as uncertainty about what the tool indeed measures (Stewart-Knight et al, 2012). Stewart-Knight et al suggest that future research should compare the DT with qualitative interviews in which service users are asked how distressed they feel and to identify concerns that contribute to their distress.…”