title: Profile and predictors of global distress: can the DT guide nursing practice in prostate cancer?
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre.
authors.forename: Kerryann
authors.initials: K
authors.lastname: Lotfi-Jam
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre.
authors.forename: Karla
authors.initials: K
authors.lastname: Gough
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre.
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre.
authors.forename: Sanchia
authors.initials: S
authors.lastname: Aranda
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D001918:Brachytherapy / Q000451:nursing / Q000523:psychology; D057189:Checklist; D003866:Depressive Disorder / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D064946:Hospice and Palliative Care Nursing; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000451:nursing; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009730:Nursing Assessment / Q000379:methods*; D017063:Outcome Assessment, Health Care; D057184:Practice Patterns, Nurses'; D011471:Prostatic Neoplasms / Q000451:nursing* / Q000523:psychology* / Q000532:radiotherapy; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology