Screening for distress in women with gynaecological cancer: Adaptation of the distress thermometer for gynaecological oncology patients

Abstract

Objective: Generic distress screening tools may not recognise the unique concerns reported in some cancer populations. The face and content validity of a screening tool derived from the National Cancer Comprehensive Network distress thermometer and problem list and adapted specifically for women with gynaecological cancer is presented.Methods: Building on existing work, panels of clinicians and researchers, and focus groups with women treated for gynaecological cancer, developed a nuanced distress screening tool. Results:The clinical reference group used an iterative process to reduce 54 items to 22 across four domains (practical/family/psychological/physical). These items were included in the draft tool, which was reviewed by two focus groups of long-term cancer survivors. Participants unanimously thought the tool was necessary though several changes were recommended. The final draft tool contained a global distress score and 25 items across the four domains. Conclusions:This measure provides a structured screening tool tailored to the concerns of women with gynaecological cancer, enhancing communication between clinicians and their patients about potentially identified and unrecognised sources of distress. Future research will focus on establishing sensitivity and specificity of this tool and further assessing its utility in clinical settings for all gynaecological cancers (including rare cancers like vulvar cancer).

Distress, problems and unmet rehabilitation needs after treatment for gynecological cancer

“…However, as some women who did not report distress also had unmet rehabilitation needs, the instrument should be used together with a clinical interview. A screening tool adapted for women with gynecological cancer and derived from the NCCN DTPL has been developed since this study 27 . The new instrument might be a relevant alternative communication tool for these patients because it is shorter and directed at problems specifically causing distress in women with gynecological cancer.…”

Vulvar Carcinoma: Standard of Care and Perspectives

“…10 VC and its treatment can cause several complications (urinary incontinence, lymphedema, psychosocial and sexual dysfunction) with impact on QoL. [91][92][93][94] Post-treatment rehabilitation cares should be offered to improve their QoL through comprehensive interventions by expert teams. 94,95 Psychological impact of treatments is also high.…”

“…[91][92][93][94] Post-treatment rehabilitation cares should be offered to improve their QoL through comprehensive interventions by expert teams. 94,95 Psychological impact of treatments is also high. Several tools may be used to identify supportive care needs in women treated for gynecologic cancers, but few data target VC specifically.…”

Establishing the sensitivity and specificity of the gynaecological cancer distress screen

“…18 For this reason, the DT-Gyn was developed. 17 This instrument was adapted from the National Comprehensive Cancer Network (NCCN) DT 19 and retained the single-item 11-point DT (higher scores denoting higher distress) and 11 of the original problem items. An additional 14 gynaecological cancer specific problem items and three open-ended follow-up questions (other sources of distress not currently listed, confirmation of the key sources of distress being experienced, and whether help for experienced distress is sought) were added (tool is provided in Appendix 1).…”

“…As such, a nuanced distress screening tool specifically for women with gynaecological cancer was developed 17 . However, while this tool, the Gynaecological Cancer Distress Screen or DT‐Gyn, has undergone an extensive process to establish face and content validity, sensitivity and specificity have yet to be determined.…”