title: Screening for Psychological Distress in Adult Primary Brain Tumor Patients and Caregivers: Considerations for Cancer Care Coordination.
abstract: BACKGROUND
  This study aimed to assess psychological distress (PD) as scored by the Distress Thermometer (DT) in adult primary brain tumor patients and caregivers (CGs) in a clinic setting and ascertain if any high-risk subgroups for PD exist.
  
  
  METHODS
  From May 2012 to August 2013, n = 96 patients and n = 32 CG underwent DT screening at diagnosis, and a differing cohort of n = 12 patients and n = 14 CGs at first recurrence. Groups were described by diagnosis (high grade, low grade, and benign) and English versus non English speaking. Those with DT score ≥4 met caseness criteria for referral to psycho-oncology services. One-way ANOVA tests were conducted to test for between-group differences where appropriate.
  
  
  RESULTS
  At diagnosis and first recurrence, 37.5 and 75.0% (respectively) of patients had DT scores above the cutoff for distress. At diagnosis, 78.1% of CGs met caseness criteria for distress. All CGs at recurrence met distress criterion. Patients with high-grade glioma had significantly higher scores than those with a benign tumor. For patients at diagnosis, non English speaking participants did not report significantly higher DT scores than English speaking participants.
  
  
  CONCLUSIONS
  Psychological distress is particularly elevated in CGs and in patients with high-grade glioma at diagnosis. Effective PD screening, triage, and referral by skilled care coordinators are vital to enable timely needs assessment, psychological support, and effective intervention.
authors.affiliation: Liverpool Cancer Therapy Centre, Liverpool Hospital , Sydney, NSW , Australia.
authors.forename: Wafa
authors.initials: W
authors.lastname: Trad
authors.affiliation: Liverpool Cancer Therapy Centre, Liverpool Hospital , Sydney, NSW , Australia ; University of New South Wales , Sydney, NSW , Australia.
authors.forename: Eng-Siew
authors.initials: ES
authors.lastname: Koh
authors.affiliation: Ingham Institute for Applied Medical Research , Sydney, NSW , Australia ; Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital , Sydney, NSW , Australia.
authors.forename: Maysaa
authors.initials: M
authors.lastname: Daher
authors.affiliation: Prince of Wales Hospital , Sydney, NSW , Australia.
authors.forename: Alanah
authors.initials: A
authors.lastname: Bailey
authors.affiliation: Sydney Neuro-Oncology Group, North Shore Private Hospital , Sydney, NSW , Australia ; Northern Sydney Cancer Centre, Royal North Shore Hospital , Sydney, NSW , Australia.
authors.forename: Marina
authors.initials: M
authors.lastname: Kastelan
authors.affiliation: Olivia Newton-John Cancer & Wellness Centre, Austin Health , Heidelberg, VIC , Australia.
authors.forename: Dianne
authors.initials: D
authors.lastname: Legge
authors.affiliation: Department of Neurosurgery and Medical Oncology, Royal Melbourne Hospital , Parkville, VIC , Australia.
authors.forename: Marcia
authors.initials: M
authors.lastname: Fleet
authors.affiliation: Ingham Institute for Applied Medical Research , Sydney, NSW , Australia ; Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital , Sydney, NSW , Australia.
authors.forename: Grahame K
authors.initials: GK
authors.lastname: Simpson
authors.affiliation: University of New South Wales , Sydney, NSW , Australia ; Department of Medical Oncology, Prince of Wales Hospital , Sydney, NSW , Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hovey
keywords: care coordination; neuro-oncology; primary brain tumor; psychological distress; screening