title: The measure of psychological distress in cancer patients: the use of Distress Thermometer in the Oncological Rehabilitation Center of Florence.
abstract: OBJECTIVE
  Distress in cancer patients is common. In the last years, several studies have used the single-item Distress Thermometer (DT) as a screening tool for psychological distress in cancer patients. The primary objective of this study was to determine the optimal cutoff score on the DT for detecting psychological distress in cancer patients attending a rehabilitation center, by comparing the DT's scores with those of the Psychological Distress Inventory (PDI). The second aim was to explore the effectiveness of the DT as a screening tool for psychological distress in rehabilitative oncological setting.
  
  
  METHODS
  The sample study totaled 290 patients who were recruited from patients attending the Oncological Rehabilitation Center of Florence for the first time between January and December 2007. Patients were administered the DT along with the Problem List (PL) and the PDI as the gold standard against which the DT was compared.
  
  
  RESULTS
  The area under the receiver operating characteristics curve was 0.84 [95%CI 0.80-0.89]. The optimal DT cutoff score for identifying distressed cancer patients would be at or above 7 (sensitivity = 0.73; specificity = 0.82). Patients whose DT score was 7 or above were more likely to report problems in all issues on the PL.
  
  
  CONCLUSIONS
  The combination of DT and PL could be a practicable screening instrument for assessing the extent and the kind of distress also in rehabilitative oncological patients. On the other hand, the choice of the DT should be evaluated by clinicians.
authors.affiliation: Clinical and Descriptive Epidemiology Unit ISPO, Cancer Prevention and Research Institute, Epidemiologia Clinica e Descrittiva, ISPO, Istituto Scientifico della Regione Toscana, Via S. Salvi 12, 50135, Florence, Italy. f.bulli@ispo.toscana.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Bulli
authors.forename: Guido
authors.initials: G
authors.lastname: Miccinesi
authors.forename: Alice
authors.initials: A
authors.lastname: Maruelli
authors.forename: Manuel
authors.initials: M
authors.lastname: Katz
authors.forename: Eugenio
authors.initials: E
authors.lastname: Paci
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000534:rehabilitation; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology