title: Distress in patients with acute leukemia: a concept analysis.
abstract: BACKGROUND
  Patients with acute leukemia (AL) require immediate and aggressive inpatient treatment that results in many weeks to months of hospitalization. Thus, it is not surprising that distress has been found in as many as 45.5% of patients. Although distress is a regularly reported outcome measure in clinical research, currently, there is a lack of a clear, consistent, and universal definition of this concept.
  
  
  OBJECTIVE
  The purposes of this article were to examine the current state of the science surrounding the concept of distress and to propose a model of distress for patients with AL.
  
  
  METHODS
  The Walker and Avant framework was used to guide the analysis of the concept of distress in patients with AL. The findings from this analysis were then used to generate a model guided by the current science.
  
  
  RESULTS
  Distress in AL is generally accepted as multidimensional, quantifiable, subjective, and temporal. Antecedents to distress include demographics, intrinsic factors, social support, disease progression, treatment, and communication. Consequences to distress include decreased quality of life, patient outcomes, as well as the severity of physical and psychological symptoms.
  
  
  CONCLUSIONS
  Distress is an outcome measure that is frequently assessed and reported within the literature. The operationalization of distress varies by investigator, limiting its generalizability.
  
  
  CONCLUSIONS
  The proposed conceptual model may be used to guide further research on distress in patients with AL at high risk for negative outcomes. Improved understanding of patient distress may guide interventions aimed at managing the psychosocial needs for patients receiving treatment for AL.
authors: Author Affiliation: School of Nursing, University of Pittsburgh, Pennsylvania.
authors: Tara A
authors: TA
authors: Albrecht
authors: Margaret
authors: M
authors: Rosenzweig
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006760:Hospitalization; D006801:Humans; D007938:Leukemia / Q000451:nursing* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D015399:Nursing Research; D017063:Outcome Assessment, Health Care; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000451:nursing*
references: J Psychosom Res. 2003 Apr;54(4):289-92
references: 12670604
references: Oncology (Williston Park). 2002 Sep;16(9 Suppl 10):64-70
references: 12380956
references: J Psychosom Res. 2003 Nov;55(5):403-9
references: 14581094
references: Psychooncology. 2001 Jan-Feb;10(1):19-28
references: 11180574
references: Eur J Cancer Care (Engl). 2011 May;20(3):345-53
references: 21414052
references: Blood. 2010 Jan 21;115(3):453-74
references: 19880497
references: Semin Oncol Nurs. 1987 Nov;3(4):242-7
references: 3321273
references: Lancet. 2006 Nov 25;368(9550):1894-907
references: 17126723
references: Leuk Res. 2010 Feb;34(2):e67-8
references: 19733395
references: J Pain Symptom Manage. 2011 Sep;42(3):432-42
references: 21477979
references: Psychooncology. 2013 Feb;22(2):299-307
references: 22081505
references: Palliat Support Care. 2006 Dec;4(4):357-63
references: 17133895
references: Leuk Res. 2005 Mar;29(3):293-300
references: 15661265
references: Cancer. 2009 Jan 15;115(2):437-45
references: 19107768
references: J Nurs Scholarsh. 2005;37(4):336-42
references: 16396406
references: J Support Oncol. 2007 Nov-Dec;5(10):499-504
references: 18240673
references: J Adv Nurs. 2004 Mar;45(5):536-45
references: 15009358
references: Cancer. 1997 Nov 15;80(10):1936-44
references: 9366296
references: Eur J Cancer Care (Engl). 2011 May;20(3):403-11
references: 20597956
references: Br J Cancer. 2004 Jun 14;90(12):2297-304
references: 15162149
references: J Hosp Palliat Nurs. 2012 Oct 1;14(7):462-468
references: 23002383
references: Genes Cancer. 2011 Feb;2(2):95-107
references: 21779483
references: Semin Oncol Nurs. 2010 Feb;26(1):2-11
references: 20152573