The prevalence and related factors associated with psychosocial distress among 420 hospitalised lung cancer patients in China: A case study

Abstract

Previous studies have reported high prevalence of psychosocial distress among lung cancer patients in Western countries, but the prevalence of distress in Chinese patients is not established. The study objectives were to report the prevalence of and factors associated with psychosocial distress in a sample of hospitalised patients in China and to implement distress screening in one thoracic specialty department. In this cross‐sectional study, adult patients completed a self‐reported demographic and clinical questionnaire and the distress thermometer with the problem list. Distress was dichotomised (high vs. low) and compared. Regression analyses were used to determine which variables were associated with psychosocial distress. One hundred eighty‐six of 420 patients (38.6%) reported distress ≥4/10. They were unemployed, had New Rural Cooperative Medical System (NRCMS) insurance and Stage IV cancer. NRCMS insurance contributed to the likelihood of high distress and worry. Patients reported significant psychosocial distress during hospitalisation related to practical, emotional and physical problems. In this case study, staff reported they screened consecutive patients but there were no available referrals after discharge. We concluded it may be premature to screen patients for distress prior to instituting resources to establish services. To do otherwise is premature in ensuring patients' relief.

Lung cancer distress: screening thermometer meta-analysis

“…Of these, 15 studies were excluded after a full-text reading, including 5 studies without independent data on patients with lung cancer, 5 studies not involving DT, 2 studies reporting outcomes via DT scores as mean±SD and 1 review. At the end, a total of 10 studies were enrolled in the analysis 6 7 14 19–25…”

“…We also found the positive rate of distress in different regions featured significant differences. Despite having the largest lung cancer population, China only had one eligible publication 24. In the related study, the prevalence of distress in patients with lung cancer in China was 38.6%, and the most common causes were financial concerns and worry.…”

“…In the related study, the prevalence of distress in patients with lung cancer in China was 38.6%, and the most common causes were financial concerns and worry. Moreover, the populations in rural areas (54.7%–74.7%) have higher levels of distress than urban areas (25.3%–45.3%) due to poor education with limited access to healthcare and low income 24. Mou et al reported that the proportion of the distress in patients of Cancer Centre of West China Hospital of Sichuan University in Chengdu with lung cancer was 30% using the HADS,30 and the top five causes of distress were worry, disease treatment, breathing, pain and sleep.…”

Psychological Characteristics of Lung Cancer Patients During the 2019 Novel Coronavirus Outbreak: A Cross-Sectional and Longitudinal Study Based on a Propensity Score-Matched Population

“…The distress thermometer (DT) is a screening tool recommended by the National Comprehensive Cancer Network (NCCN) [21]. Since there are racial differences in responses to the DT [22], the validated Chinese version of the DT (CDT) was used to screen patients' levels of distress ranging from 0 (no distress) to 10 (extreme distress) [23]. Patients were instructed to circle the number (0-10) that best described how much distress they had been experiencing recently.…”

Re‐imagining Psycho‐oncology

“…In this approach, technology may have the potential to directly disrupt barriers to implementation. Again around the focus of distress screening, Tan et al () call for caution where distress screening may well be feasible, but an evidence‐based response to distress is not. Of particular note in this study is the exploration of how health insurance schemes, financial system constraints, and rurality influence the cancer experience in China.…”