Validation of the Distress Thermometer in patients with advanced cancer receiving specialist palliative care in a hospice setting

Graham‐Wisener, Lisa; Dempster, Martin; Sadler, Aaroon; McCann, Laura; McCorry, Noleen

doi:10.1177/0269216320954339

Cited by 22 publications

(17 citation statements)

References 43 publications

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“…This study utilised IPA to provide the rst examination of the lived experience of CAs among individuals living in the community with a life-limiting condition. Evidence suggests that individuals living with advanced cancer experience a range of psychological sequalae, such as loneliness, low mood and worry for the future [13,14]. Our ndings indicate that CAs mitigate against these negative psychological experiences by providing a range of supports to the individual managing advanced cancer, which encompass emotional, practical, and social supports.…”

Section: Discussionmentioning

confidence: 76%

“…The same understanding does not exist of the bene ts and mechanisms through which companion animals may provide support to individuals with advanced cancer and other life-limiting diagnoses [5]. Individuals with advanced cancer can experience heightened complexity in relation to psychological distress [13] and social support need [14,15], and therefore may bene t from consideration of how a CA may be integrated into care planning to facilitate improved psychological wellbeing. Research indicates that although individuals receiving palliative care cite 'animals and nature' as a meaningful aspect of their life [16], they are likely to be unsatis ed with this aspect of their life.…”

Section: Introductionmentioning

confidence: 99%

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The Role of Companion Animals in Advanced Cancer: An Interpretative Phenomenological Analysis

McGhee

Dempster

Graham‐Wisener

2022

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Background:There is evidence that a companion animal (CA) or ‘pet’ can be helpful during the management of chronic illness. However, the psychological effects of CAs and the mechanism by which they can be beneficial to individuals managing life-limiting conditions is unknown. This study addresses this gap and provides the first examination of the lived experience of CAs among community-dwelling adults with advanced cancer. Methods:Semi-structured interview study consisting of a homogenous sample of 6 individuals with an advanced cancer diagnosis, who either self-selected to the study or were recruited through a regional charity that supports palliative and end-of-life care patients in maintaining a connection with their CA. Data were transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Results: Four superordinate themes occurred in the data: a protective relationship, positive behavioural change, facilitating meaningful social connections and increased loss-orientated cognitions. The findings suggest that CAs offer de-arousing and stress-buffering supports that mitigate physical and psychological sequalae experienced by people with advanced cancer. However, as their illness progresses, individuals may also experience negative effects associated with their CA and increased loss-orientated cognitions. Conclusions:CAs provide emotional, practical and social supports to individuals diagnosed with advanced cancer that can improve individual psychological wellbeing. Consequently, it is important that CAs are considered in advance care planning processes and that services are available to mitigate any negative effects of CA ownership, in order to maximise the benefits CAs confer to individuals managing advanced cancer.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

The Role of Companion Animals in Advanced Cancer: An Interpretative Phenomenological Analysis

McGhee

Dempster

Graham‐Wisener

2022

Preprint

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“…The distress thermometer, a simple one item tool, has been validated for screening for psychological morbidity within palliative care [ 17 , 18 ]. In addition, the Integrated Palliative care Outcome Scale (IPOS) contains items for emotional concerns such as patient anxiety, depression, feeling at peace and communication issues and has been validated for use in advanced disease [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Conceptualising effective symptom management in palliative care: a novel model derived from qualitative data

et al. 2022

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Background Pain, breathlessness and fatigue are some of the most challenging symptoms to manage in patients with advanced disease. Specialist palliative care leads to better symptom management, but factors contributing to successful symptom management in this context have not been explored. Our aim was to understand what facilitates effective symptom management in specialist palliative care within UK hospices and investigate what barriers are experienced. Methods This was a grounded theory study using qualitative semi-structured focus groups and interviews. Participants were recruited from multidisciplinary specialist palliative care teams (doctors, nurses, healthcare assistants, physiotherapists, occupational therapists, complementary therapists, social workers and chaplains) working in inpatient, outpatient and community services provided by five hospices in the United Kingdom. Results We present a novel qualitative data-derived model of effective symptom management in specialist palliative care. We describe a co-ordinated, multi-faceted, sequential approach involving a process of engagement, partnership, decision-making, and delivery. Interventions to manage symptoms are less effective in psychologically distressed patients. Our data highlights that families of patients have a key role in determining effectiveness of symptom management interventions A holistic approach by a co-ordinated, multi-disciplinary team, including support to recognise and minimise psychological distress might facilitate more effective symptom management. Barriers to symptom management include team discordance and lack of understanding about symptom management by patient and families. Conclusions Shared decision-making between patients and professionals and co-ordination of care by a multi-disciplinary team are key components of effective symptom management. Actions to address psychological distress and evaluate the understanding and expectations of patients and their families would enable more effective symptom management. A more effective multi-disciplinary approach would be facilitated by discussion within teams about role competencies and boundaries.

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“…The Distress Thermometer (DT) [ 9 ] is a self-report visual analogue scale resembling a thermometer, with values ranging from 0 (no distress) to 10 (extreme distress). A score of 4 on the DT was found to offer the best sensitivity and specificity for identifying potentially high distress [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

RELIEF: A Digital Health Tool for the Remote Self-Reporting of Symptoms in Patients with Cancer to Address Palliative Care Needs and Minimize Emergency Department Visits

et al. 2021

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The lack of timely symptom reporting remains a barrier to effective symptom management and comfort for patients with cancer-related palliative care needs. Poor symptom management at home can lead to unwanted outcomes, such as emergency department visits and death in hospital. We developed and evaluated RELIEF, a remote symptom self-reporting app for community patients with palliative care needs. A pilot feasibility study was conducted at a large, community hospital in Ontario, Canada. Patients self-reported their symptoms each morning using validated clinical symptom measures and RELIEF would alert for worsening or severe symptoms. RELIEF alerts were monitored by palliative care nurses who would then contact patients to determine if appropriate clinical intervention could be initiated to avoid unnecessary emergency department visits. A total of 20 patients were recruited to use RELIEF for two months. Patients completed 80% of daily self-report assessments; 133 alerts were trigged, half of which required clinical intervention. No patient visited the emergency department for symptom management during the study. Clinical staff estimated five emergency department visits were avoided because of RELIEF—saving an estimated cost of over CAD 60,000. RELIEF is a feasible and acceptable method for the remote monitoring of patients with palliative care needs through regular symptom self-reporting.

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Validation of the Distress Thermometer in patients with advanced cancer receiving specialist palliative care in a hospice setting

Cited by 22 publications

References 43 publications

The Role of Companion Animals in Advanced Cancer: An Interpretative Phenomenological Analysis

The Role of Companion Animals in Advanced Cancer: An Interpretative Phenomenological Analysis

Conceptualising effective symptom management in palliative care: a novel model derived from qualitative data

RELIEF: A Digital Health Tool for the Remote Self-Reporting of Symptoms in Patients with Cancer to Address Palliative Care Needs and Minimize Emergency Department Visits

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