Performance of Distress Thermometer and Associated Factors of Psychological Distress among Chinese Cancer Patients

Abstract

Objective. We aimed to examine the performance of the distress thermometer (DT) and identify the prevalence and risk factors associated with psychological distress (PD) in heterogeneous cancer patients. Methods. This cross-sectional study enrolled 1496 heterogeneous cancer patients from the inpatient and outpatient departments. Receiver operating characteristic analysis (ROC) of DT was evaluated against the Hospital Anxiety and Depression Scale-Total (HADS-T ≥15). An area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and clinical utility index were calculated. Multiple binary logistic regression was used to identify the factors associated with PD. Results. Referring to ROC analysis, DT showed good discriminating accuracy (AUC = 0.88). A cutoff score of 4 was established, and it yielded sensitivity (0.81), specificity (0.88), PPV (0.87), NPV (0.82), and clinical utility indexes (screening utility = 0.71 and case-finding utility = 0.73). 46.5% of our participants was distressed. Lower education levels (odd ratio (OR) = 1.39), advanced stage (OR = 1.85), active disease status (OR = 1.82), lack of exercise (OR = 3.03), diagnosis known (OR = 0.64), emotional problems (OR = 3.54), and physical problems (OR = 8.62) were the predictive factors for PD. Conclusion. DT with a cutoff score (≥4) is a comprehensive, appropriate, and practical initial screener for PD in cancer patients. Predicting factors should be considered together for effective management of PD in such population.

Screening for Psychological Distress in Vietnamese Cancer Patients: An Evaluation of the Distress Thermometer

“…To meet the need of rapid screening of distress in cancer patients, the single-item Distress Thermometer (DT) was developed by Roth and colleagues for patients to rate distress from 0 ("no distress") to 10 ("extreme distress"). The DT cutoff point has changed slightly in different research [14][15][16][17] . Holland identified 4 as the best cutoff to identify clinical distress in a cancer patient, 14 and the NCCN Clinical Practice Guidelines for Distress Management recommends using a DT cutoff score of 4 followed by a Problem List (PL) to investigate any unmet psychological needs in the prior week.…”

Suffering experiences of people with cancer undergoing chemotherapy: A meta‐ethnographic study

“…Observational studies have shown that people with cancer experience intense suffering resulting from chemotherapy (Brandl et al, 2019; Thapa et al, 2020). Evaluating this phenomenon is important, not only in epidemiological studies, but also for the clinical practice of professionals who daily witness the pain experienced by these patients.…”

“…While some studies have addressed this phenomenon by means of specific screening instruments, conjecturing that suffering is a complex human response that encompasses physical, psychological, social, and spiritual aspects (Mendonça, Pereira, Magnago, Silva, et al, 2020b; Rajeshwari et al, 2020; Thapa et al, 2020), others have treated it analytically by using measures of anxiety and depression, interpreting it in terms of psychiatric morbidity (El Kheir & Ibrahim, 2019; Lu et al, 2019; McMullen et al, 2018; Wen et al, 2017).…”

“…The applied instruments, whether specific for assessing suffering or not, were designed to track its occurrence and intensity, following previously established concepts of what suffering is considered to consist (Chambers et al, 2014; Cutillo et al, 2017; Thapa et al, 2020). Therefore, a view of the meaning of this experience and of how patients perceive and cope with treatment is not provided, and the consequence can be the creation of a distorted picture, especially if patients’ understanding of suffering differs substantially from that of the professionals assessing them.…”

Corrigendum to “Performance of Distress Thermometer and Associated Factors of Psychological Distress among Chinese Cancer Patients”

“…In the article titled “Performance of Distress Thermometer and Associated Factors of Psychological Distress among Chinese Cancer Patients” [ 1 ], Dr. Ahmad Khalid Aalemi was missing from the authors' list. Dr. Aalemi shared his knowledge and experience during the study design, data cleaning, data analysis, and report writing.…”