title: Distress and its correlates in Korean cancer patients: pilot use of the distress thermometer and the problem list.
abstract: The distress thermometer (DT), a one-item measure for distress, provides a means for rapidly and effectively screening psychological distress in cancer patients. In this pilot study, a screening efficacy of the DT was investigated in a mixed cohort of 108 Korean cancer patients. Participants completed the DT, the problem list (PL), and the Hospital Anxiety and Depression Scale (HADS), and answered questions regarding supportive needs and their degree of satisfaction with several aspects of care. Receiver operating characteristic (ROC) curve analyses indicated that a DT cutoff score of 4 yielded an area under the ROC curve of 0.75 with a sensitivity of 0.83 and a specificity of 0.59 for HADS-total score defined cases (> or =15). HADS--Anxiety and Depression subscale scores explained 27% of the variability in the DT scores, implying that 'distress' is a broader concept that includes anxiety and depressive symptoms but has a more comprehensive meaning that encompasses multiple contributory factors. Regarding the PL, distressed patients (DT> or =4) reported significantly more problems (23 of 35) in all categories, suggesting, although degrees differ, that a wide variety of problems contribute to distress in cancer patients. Distress as defined by DT and HADS subscale scores was also significantly associated with higher supportive needs, a poor ECOG performance status (both physician and patient-rated), and a reduced level of satisfaction with treatment, staff, and communications. In conclusion, the DT and the PL were found to be simple yet effective screening instruments for detecting psychosocial distress in Korean cancer patients, and for identifying problems that warrant intervention.
authors.affiliation: Institute of Human Behavioral Medicine, Medical Research Institute, Seoul National University, Chongno-gu, Seoul, South Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Shim
authors.forename: Yong-Wook
authors.initials: YW
authors.lastname: Shin
authors.forename: Hong Jin
authors.initials: HJ
authors.lastname: Jeon
authors.forename: Bong-Jin
authors.initials: BJ
authors.lastname: Hahm
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D010147:Pain Measurement / Q000706:statistics & numerical data*; D010348:Patient Care Team; D017060:Patient Satisfaction; D010555:Personality Inventory / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D012372:ROC Curve; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012803:Sick Role; D012944:Social Support