Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-21T10:39:38.784Z Has data issue: false hasContentIssue false
  • English
  • Français

Profile and predictors of global distress: Can the DT guide nursing practice in prostate cancer?

Published online by Cambridge University Press:  07 August 2013

Kerryann Lotfi-Jam ,
Karla Gough ,
Penelope Schofield  and
Sanchia Aranda
Kerryann Lotfi-Jam
Affiliation:
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre School of Health Sciences, The University of Melbourne
Karla Gough
Affiliation:
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre Sir Peter MacCallum Department of Oncology, The University of Melbourne
Penelope Schofield*
Affiliation:
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre School of Health Sciences, The University of Melbourne
Sanchia Aranda
Affiliation:
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre Cancer Institute NSW
*
Address correspondence and reprint requests to: Penelope Schofield, Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Locked bag 1, A'Beckett Street, Victoria 8006, Australia. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study examines the ability of the distress thermometer to accurately identify patients with higher symptoms, unmet needs and psychological morbidity.

Methods:

Baseline data collected as part of a randomized controlled trial evaluating a nurse-led supportive care intervention for men with prostate cancer commencing radiotherapy at a specialist cancer hospital in Melbourne, Australia. Measures assessed global distress (DT), anxious and depressive symptomatology (HADS), prostate-cancer specific quality of life (EPIC-26), unmet supportive care needs (SCNS-SF34R) and cancer treatment-related concerns (CATS). Following descriptive and correlational analysis, hierarchical multiple regression was employed to examine the contribution of variable sets to explaining variance in DT scores.

Results:

Less than 20% of men reported DT scores of 4 or higher, indicating overall low distress. The DT accurately identified almost all men reporting HADS score indicative of anxious or depressive symptomatology, suggesting it accurately identifies psychological morbidity. Importantly, the DT identified a further group of distressed men, not identified by HADS, whose distress related to unmet needs and prostate cancer-specific issues, indicating the DT is superior in identifying other forms of distress. While the hierarchical multiple regression confirmed anxious and depressive symptomatology as the best predictor of distress score, many other scales are also good predictors of DT scores, supporting the argument that distress is multi-determined.

Significance of results:

Nurses can be confident that the DT accurately identifies patients with psychological morbidity and importantly identifies other patients with distress who may require intervention. A distress score of 4 or higher identified participants with higher physical symptomatology, higher unmet needs, more concerns about treatment and poorer quality of life. The low prevalence of distress reaching cut off scores suggests nurses would not be overwhelmed by the outcomes of screening and could use the score to prioritise the patients who need greater attention at entry to radiotherapy services.

Keywords

Distressunmet needssupportive careprostate cancernursingscreening
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 1 , February 2014 , pp. 5 - 14
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Absolom, K., Holch, P., Pini, S., et al. (2011). The detection and management of emotional distress in cancer patients: The views of health-care professionals. Psycho-Oncology, 20, 601–608.Google Scholar
Balderson, N. & Towell, T. (2003). The prevalence and predictors of psychological distress in men with prostate cancer who are seeking support. British Journal of Health Psychology, 8, 125–34.CrossRefGoogle ScholarPubMed
Bonevski, B., Sanson-Fisher, R., Hersey, P., et al. (2000). Assessing the perceived needs of patients attending an outpatient melanoma clinic. Journal of Psychosocial Oncology, 17, 101–118.Google Scholar
Carey, M., Noble, N., Sanson-Fisher, R., et al. (2012). Identifying psychological morbidity among people with cancer using the hospital anxiety and depression scale: Time to revisit first principles. Psycho-Oncology, 21, 229–239.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences. Mahwah: Lawrence Erlbaum Associates Inc.Google Scholar
Cohen, J., Cohen, P., West, S., et al. (2003). Applied Multiple Regression/Correlation Analysis For The Behavioral Sciences. Mahwah: Lawrence Erlbaum Associates Inc.Google Scholar
Courville, T. & Thompson, B. (2001). Use of structure coefficients in published multiple regression articles: β is not enough. Educational & Psychological Measurement, 61, 229–248.CrossRefGoogle Scholar
Fayers, P.M., Curran, D. & Machin, D. (1998). Incomplete quality of life data in randomised trials: Missing items. Statistics in Medicine, 17, 679–696.Google Scholar
Hair, J.F., Black, W.C., Babin, B.J., et al. (2006). Multivariate Data Analysis. Upper Saddle River: Pearson Education.Google Scholar
Holland, J. & Bultz, B. (2007). The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network, 5, 3–7.CrossRefGoogle ScholarPubMed
Howell, D. & Olsen, K. (2011). Distress —The 6th Vital Sign. Current Oncology, 18, 208–210.CrossRefGoogle ScholarPubMed
Jacobsen, P.B., Donovan, K.A., Trask, P.C., et al. (2005). Screening for psychologic distress in ambulatory cancer patients. Cancer, 103, 1494–1502.Google Scholar
Lintz, K., Moynihan, C., Steginga, S., et al. (2003). Prostate cancer patients' support and psychological care needs: Survey from a non-surgical oncology clinic. Psychooncology, 12, 769–783.Google Scholar
Luckett, T., King, M. P., Butow, P., et al. (2010). Assessing Health-related Quality of Life in Gynaecological Oncology: A systematic review of questionnaires and their ability to detect clinically important differences and change. International Journal of Gynaecological Cancer, 20, 664–684.Google Scholar
Ream, E., Quennell, A., Fincham, L., et al. (2008). Supportive care needs of men living with prostate cancer in England: a survey. British Journal of Cancer, 98, 1903–1909.CrossRefGoogle ScholarPubMed
Ridner, S.H. (2004). Psychological distress: Concept analysis. Journal of Advanced Nursing, 45, 536–545.CrossRefGoogle ScholarPubMed
Rosenfeld, B., Roth, A.J., Gandhi, S., et al. (2004). Differences in health-related quality of life in prostate cancer patients based on stage of disease. Psycho-Oncology, 13, 800–807.CrossRefGoogle Scholar
Roth, A.J., Kornblith, A.B., Batel-Copel, L., et al. (1998). Rapid screening for psychologic distress in men with prostate carcinoma. Cancer, 82, 1904–1908.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Schofield, P., Gough, K., Lotfi-Jam, K., et al. (2012). Validation ofthe supportive care needs survey-short form 34 with a simplifiedresponse format in men with prostate cancer. Psycho-Oncology, 21, 1107–1112.CrossRefGoogle Scholar
Schofield, P., Gough, K., Ugalde, A., et al. (2012). Cancer treatment survey (CaTS): Development and validation of a new instrument to measure patients' preparation for chemotherapy and radiotherapy. Psychooncology, 21, 307–315.CrossRefGoogle ScholarPubMed
Smith, A.B., Selby, P.J., Velikova, G., et al. (2002). Factor analysis of the hospital anxiety and depression scale from a large cancer population. Psychology & Psychotherapy: Theory, Research & Practice, 75, 165–176.Google Scholar
Steginga, S.K., Occhipinti, S., Dunn, J., et al. (2001). The supportive care needs of men with prostate cancer (2000). Psychooncology, 10, 66–75.Google Scholar
Szymanski, K.M., Wei, J.T., Dunn, R.L., et al. (2010). Development and validation of an abbreviated version of the expanded prostate cancer index composite instrument for measuring health-related quality of life among prostate cancer survivors. Urology, 76, 1245–1250.Google Scholar
van Scheppingen, C., Schroever, M.J., Smink, A., et al. (2011). Does screening for distress efficiently uncover unmet needs in cancer patients? Psycho-Oncology, 20, 665–663.Google Scholar
Wei, J.T., Dunn, R.L., Litwin, M.S., et al. (2000). Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology, 56, 899–905.Google Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The hospital anxiety and depression scale. Acta Psychiatry Scandinavia, 67, 361–370Google Scholar