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Associated factors of distress in patients with advanced cancer: A retrospective study

Published online by Cambridge University Press:  23 November 2020

Leticia Ascencio-Huertas Open the ORCID record for Leticia Ascencio-Huertas [Opens in a new window] ,
Silvia Rosa Allende-Pérez  and
Tania Pastrana Open the ORCID record for Tania Pastrana [Opens in a new window]
Leticia Ascencio-Huertas*
Affiliation:
Servicio de Cuidados Paliativos, Instituto Nacional de Cancerologia, Mexico City, Mexico
Silvia Rosa Allende-Pérez
Affiliation:
Servicio de Cuidados Paliativos, Instituto Nacional de Cancerologia, Mexico City, Mexico
Tania Pastrana
Affiliation:
Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
*
Author for correspondence: Leticia Ascencio-Huertas, Cuidados Paliativos, Instituto Nacional de Cancerologia, Av San Fernando Núm 22 Col Sección XVI, Mexico City, Ciudad de México, Mexico. E-mail: [email protected]
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Abstract

Objective

The objective of this study was to assess the psychosocial distress and associated factors in advanced cancer patients consulting at the outpatient Palliative Care Unit at the National Cancer Institute in Mexico City.

Design

A retrospective study was conducted using electronic records (June 2015 to December 2016).

Sample

A total of 646 patients with advanced cancer during their first visit to the outpatient palliative care unit at the National Cancer Institute in Mexico were evaluated using the Distress Thermometer (DT) and ECOG performance status scores.

Findings

Overall, 62% were women, with a median age of 57 years, and married (54.8%). The most frequent diagnosis was gastrointestinal cancer (28.6%), and 38.9% had a functional performance status of ECOG 2. The median DT score was 4.0 (IQR = 2–6), with 56% reporting DT scores ≥4. The three most frequent problems ≥4 were sadness (82.6%), feeling weak (81.2%), worry (79.6%), and <4 were feeling weak (57.7%), fatigue (55.6%), and financial security (52.1%). The variables associated with distress according to the multiple logistic regression analysis were problems with housing (OR = 2.661, 95% CI = 1.538–4.602), sadness (OR = 2.533, 95% CI = 1.615–3.973), transportation (OR = 1.732, 95% CI = 1.157–2.591), eating (OR = 1.626, 95% CI = 1.093–2.417), nervousness (OR = 1.547, 95% CI = 1.014–2.360), and sleep (OR = 1.469, 95% CI = 1.980–2.203).

Conclusion

The principal factors were related to distress levels, housing problems, transportation issues, and emotional problems such as sadness, nervousness, lower functionality, and younger age. Therefore, psychosocial support is of considerable relevance in palliative care. These findings will help clinicians understand the distress of patients with advanced cancer in palliative care in Latin American countries.

Keywords

Advanced cancerDistressDistress thermometerPalliative carePsychosocial support
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 4 , August 2021 , pp. 447 - 456
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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