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Stevens JM, Montgomery K, Miller M, Saeidzadeh S, Kwekkeboom KL. Common patient-reported sources of cancer-related distress in adults with cancer: A systematic review. Cancer Med 2024; 13:e7450. [PMID: 38989923 PMCID: PMC11238242 DOI: 10.1002/cam4.7450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/14/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Cancer-related distress (CRD) is widely experienced by people with cancer and is associated with poor outcomes. CRD screening is a recommended practice; however, CRD remains under-treated due to limited resources targeting unique sources (problems) contributing to CRD. Understanding which sources of CRD are most commonly reported will allow allocation of resources including equipping healthcare providers for intervention. METHODS We conducted a systematic review to describe the frequency of patient-reported sources of CRD and to identify relationships with CRD severity, demographics, and clinical characteristics. We included empirical studies that screened adults with cancer using the NCCN or similar problem list. Most and least common sources of CRD were identified using weighted proportions computed across studies. Relationships between sources of CRD and CRD severity, demographics, and clinical characteristics were summarized narratively. RESULTS Forty-eight studies were included. The most frequent sources of CRD were worry (55%), fatigue (54%), fears (45%), sadness (44%), pain (41%), and sleep disturbance (40%). Having enough food (0%), substance abuse (3%), childbearing ability (5%), fevers (5%), and spiritual concerns (5%) were infrequently reported. Sources of CRD were related to CRD severity, sex, age, race, marital status, income, education, rurality, treatment type, cancer grade, performance status, and timing of screening. CONCLUSIONS Sources of CRD were most frequently emotional and physical, and resources should be targeted to these sources. Relationships between sources of CRD and demographic and clinical variables may suggest profiles of patient subgroups that share similar sources of CRD. Further investigation is necessary to direct intervention development and testing.
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Affiliation(s)
- Jennifer M Stevens
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Megan Miller
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Jan Ben S, Dörner M, Günther MP, von Känel R, Euler S. Proof of concept: Predicting distress in cancer patients using back propagation neural network (BPNN). Heliyon 2023; 9:e18328. [PMID: 37576295 PMCID: PMC10412887 DOI: 10.1016/j.heliyon.2023.e18328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Background Research findings suggest that a significant proportion of individuals diagnosed with cancer, ranging from 25% to 60%, experience distress and require access to psycho-oncological services. Until now, only contemporary approaches, such as logistic regression, have been used to determine predictors of distress in oncological patients. To improve individual prediction accuracy, novel approaches are required. We aimed to establish a prediction model for distress in cancer patients based on a back propagation neural network (BPNN). Methods Retrospective data was gathered from a cohort of 3063 oncological patients who received diagnoses and treatment spanning the years 2011-2019. The distress thermometer (DT) has been used as screening instrument. Potential predictors of distress were identified using logistic regression. Subsequently, a prediction model for distress was developed using BPNN. Results Logistic regression identified 13 significant independent variables as predictors of distress, including emotional, physical and practical problems. Through repetitive data simulation processes, it was determined that a 3-layer BPNN with 8 neurons in the hidden layer demonstrates the highest level of accuracy as a prediction model. This model exhibits a sensitivity of 79.0%, specificity of 71.8%, positive predictive value of 78.9%, negative predictive value of 71.9%, and an overall coincidence rate of 75.9%. Conclusion The final BPNN model serves as a compelling proof of concept for leveraging artificial intelligence in predicting distress and its associated risk factors in cancer patients. The final model exhibits a remarkable level of discrimination and feasibility, underscoring its potential for identifying patients vulnerable to distress.
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Affiliation(s)
- Schulze Jan Ben
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marc Dörner
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Kissane DW, Appleton J, Lennon J, Michael N, Chye R, King T, William L, Poon P, Kanathigoda S, Needham K, Bobevski I. Psycho-Existential Symptom Assessment Scale (PeSAS) Screening in Palliative Care. J Pain Symptom Manage 2022; 64:429-437. [PMID: 35961431 DOI: 10.1016/j.jpainsymman.2022.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT Psycho-existential symptoms are common yet often missed or neglected in palliative care. Screening can be an effective way to recognize and respond to this need. OBJECTIVES We aimed to implement routine use of the Psycho-existential Symptom Assessment Scale (PeSAS) as a screening tool in Australian palliative care services and discern the symptom prevalence identified. METHODS In a multi-site rolling design, we established implementation site committees and embarked on experiential workshops to train clinicians in the tool's efficient use. Patient symptom prevalence data were collected to compare uptake across sites. Descriptive statistics were applied. RESULTS Over one year, we trained 216 clinicians across six palliative care services in the use of the PeSAS as a screening tool and collected data from 1405 patients. Clinicians reported significant growth in their sense of efficacy in assessing psycho-existential wellness. Services using electronic records implemented most easily. Psycho-existential symptoms with clinically significant prevalence (scores ≥ 4/10) included anxiety 41.1%, discouragement 37.6%, hopelessness 35.8%, pointlessness 26.9%, depression 30.3%, and the wish to die 17%. The precision of measurement within 3% was found for severe ratings (score ≥ 8/10) including anxiety 10.6%, depression 10.2%, the wish to die 7.6%, and confusion 3.6%. CONCLUSION Clinicians can be trained to screen with the Psycho-existential Symptom Assessment Scale, which serves as a valuable measure to better recognize symptoms of psycho-existential distress among palliative care patients. Implementation barriers included the prior ethos of the service, confidence in talking about these themes, electronic data entry, and perceived time pressures.
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Affiliation(s)
- David W Kissane
- School of Medicine (D.W.K, J.A., J.L., N.M., K.N., I.B.), University of Notre Dame Australia; St. Vincent's Hospital (D.W.K., J.A., J.L., R.C., K.N.), Sydney, NSW; Cabrini Health (D.W.K., N.M., I.B.), Melbourne, Victoria; School of Clinical Sciences (D.W.K., N.M., L.W., P.P., I.B.), Monash University, Victoria; Monash Health (D.W.K., P.P.), Melbourne, Victoria.
| | - Jane Appleton
- School of Medicine (D.W.K, J.A., J.L., N.M., K.N., I.B.), University of Notre Dame Australia; St. Vincent's Hospital (D.W.K., J.A., J.L., R.C., K.N.), Sydney, NSW
| | - Jonathon Lennon
- School of Medicine (D.W.K, J.A., J.L., N.M., K.N., I.B.), University of Notre Dame Australia; St. Vincent's Hospital (D.W.K., J.A., J.L., R.C., K.N.), Sydney, NSW
| | - Natasha Michael
- School of Medicine (D.W.K, J.A., J.L., N.M., K.N., I.B.), University of Notre Dame Australia; Cabrini Health (D.W.K., N.M., I.B.), Melbourne, Victoria; School of Clinical Sciences (D.W.K., N.M., L.W., P.P., I.B.), Monash University, Victoria
| | - Richard Chye
- St. Vincent's Hospital (D.W.K., J.A., J.L., R.C., K.N.), Sydney, NSW
| | - Tania King
- Eastern Palliative Care (T.K.), Victoria
| | - Leeroy William
- School of Clinical Sciences (D.W.K., N.M., L.W., P.P., I.B.), Monash University, Victoria; Eastern Health (L.W.), Melbourne, Victoria
| | - Peter Poon
- School of Clinical Sciences (D.W.K., N.M., L.W., P.P., I.B.), Monash University, Victoria; Monash Health (D.W.K., P.P.), Melbourne, Victoria
| | | | - Katarina Needham
- School of Medicine (D.W.K, J.A., J.L., N.M., K.N., I.B.), University of Notre Dame Australia; St. Vincent's Hospital (D.W.K., J.A., J.L., R.C., K.N.), Sydney, NSW
| | - Irene Bobevski
- School of Medicine (D.W.K, J.A., J.L., N.M., K.N., I.B.), University of Notre Dame Australia; Cabrini Health (D.W.K., N.M., I.B.), Melbourne, Victoria; School of Clinical Sciences (D.W.K., N.M., L.W., P.P., I.B.), Monash University, Victoria
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Park SY, Kim Y, Hong H. Patient-reported distress and problems among elderly patients with hematological malignancy in Korea. Support Care Cancer 2022; 30:9019-9027. [PMID: 35948847 DOI: 10.1007/s00520-022-07315-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Treatment for hematological malignancies (HMs) and functional decline associated with age can cause distress in elderly patients with HMs. However, information about the nature and effects of distress in this population is scarce. Therefore, this study examined the level of distress, its source, and the practical/familial/physical/emotional problems among elderly patients with HMs. METHODS We conducted a cross-sectional study of patients with HMs aged ≥ 65 years who visited an outpatient clinic at a tertiary medical center in Korea between November 2019 and March 2020. Patient-reported distress and problems were measured using the distress thermometer (DT) and 39-item Problem List by the National Comprehensive Cancer Network. Descriptive statistics, χ2 test or Fisher's exact test, and multivariate logistic regression analyses were conducted (N = 132). RESULTS In total, 62.1% of patients had moderate to severe distress (DT score ≥ 4), experiencing an average of nine problems. Significant sources of distress on multivariate logistic analysis included problems with transportation, depression, and constipation, accounting for 47% of distress variance. Most patients had physical (97.0%) or emotional problems (79.5%). Among these, fatigue (60.6%), worry (59.8%), tingling (59.8%), difficulty with mobility (47.0%), and memory/concentration (40.2%) were the most frequently reported problems. CONCLUSIONS Elderly patients with HMs have a high burden of distress, which is affected by different sources, compared with younger patients with solid tumors. Thus, in this population, assessment and management of distress need to be conducted considering the unique features of their source and burden. Further research on distress should consider the cancer type and population age.
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Affiliation(s)
- Sun-Young Park
- Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.,Division of New Health Technology Assessment, National Evidence-Based Healthcare Collaborating Agency, 400 Neungdong-ro, Gwangjin-gu, Seoul, 04554, Korea
| | - Yoonjoo Kim
- Department of Nursing, College of Healthcare Sciences, Far East University, Eumseong-gun, Chungcheongbuk-do, Seoul, South Korea, 27601
| | - Hyunju Hong
- National Cancer Center, 323 Ilsan-ro, Goyang-si, Gyeonggi-do, 10408, Korea.
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Schulze JB, Günther MP, Riemenschnitter C, Wicki A, von Känel R, Euler S. Distinct psycho-oncological support inclinations and needs in patients with cancer: A large sample latent class analysis approach. Gen Hosp Psychiatry 2022; 75:17-22. [PMID: 35093622 DOI: 10.1016/j.genhosppsych.2021.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND In patients with cancer, the routine recording of distress symptoms has been widely established in recent years. Psycho-oncological support has proven to reduce distress and increase quality of life. Despite high levels of distress as well as physical and emotional challenges in patients with cancer, a significant proportion forgoes psycho-oncological services. METHODS A cross-sectional retrospective evaluation was carried out. Latent class analysis was used to examine the relationship between distress, physical and emotional challenges, and desire for psycho-oncological services in 2191 patients with cancer. RESULTS Latent class analysis revealed four homogeneous subgroups: a) patients with high distress, high physical and low emotional challenges and no desire for psycho-oncology, b) patients with high distress, low physical and high emotional challenges and no desire for psycho-oncology, c) patients with high distress, high physical and emotional challenges and a desire for psycho-oncology, d) patients with low distress, low physical and emotional challenges and no desire for psycho-oncology. CONCLUSION The identification of these subgroups of patients with cancer is useful for health care providers in order to focus their efforts in patients with cancer. It might contribute to a more tailored treatment offer for specific subgroups whose needs have so far been insufficiently met.
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Affiliation(s)
- Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Cosima Riemenschnitter
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas Wicki
- Department of Medical Oncology and Hematology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Seland M, Skrede K, Lindemann K, Skaali T, Blomhoff R, Bruheim K, Wisløff T, Thorsen L. Distress, problems and unmet rehabilitation needs after treatment for gynecological cancer. Acta Obstet Gynecol Scand 2021; 101:313-322. [PMID: 34964982 DOI: 10.1111/aogs.14310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/13/2021] [Accepted: 12/10/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The prevalence of distress, problems and need for rehabilitation among women treated for gynecological cancer is largely unknown. The aims of this study were to examine the prevalence of distress, problems and unmet rehabilitation needs in the first years after treatment for gynecological cancer. MATERIAL AND METHODS Women treated for gynecological cancer within the last 2 years were invited. Participants responded to the National Comprehensive Cancer Network Distress Thermometer and Problem List measuring distress and problems. They also answered a questionnaire regarding physical endurance, muscle strength, and need for rehabilitation services. RESULTS Of 114 eligible women, 92 (81%) agreed to participate. Mean time since last treatment was 7.6 months (range 0-24.5 months). A total of 57% of the participants reported distress. The four most common problems reported were fatigue (58%), tingling in hands/feet (54%), worry (53%), and problems with memory/concentration (50%). Problems associated with distress were: dealing with partner, all emotional problems (i.e. depression, fears, nervousness, sadness, worry, and loss of interest in usual activities), appearance, memory/concentration, pain, sex, sleep, and problems with physical endurance and muscle strength. Fifty-two per cent reported unmet needs for rehabilitation services. Women with distress reported more unmet rehabilitation needs than those in the non-distressed group. CONCLUSIONS The prevalence of distress in this population of women treated for gynecological cancer was high. Having a high number of problems and having unmet needs for rehabilitation services were both associated with distress. Hence, measurement of distress seems to be helpful when assessing the need for rehabilitation services.
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Affiliation(s)
- Mette Seland
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Katrine Skrede
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.,The Norwegian University of Life Sciences, Ås, Norway
| | - Kristina Lindemann
- Department of Gynecologic Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tone Skaali
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Rune Blomhoff
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Kjersti Bruheim
- Department of Cancer Treatment, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Wisløff
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Lene Thorsen
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.,National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Mendonça AB, Pereira ER, Magnago C, da Silva PG, Morett Leão DC, Costa Rosa Andrade Silva RM, Meira KC. Distress and Spiritual Well-Being in Brazilian Patients Initiating Chemotherapy during the COVID-19 Pandemic-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13200. [PMID: 34948809 PMCID: PMC8702099 DOI: 10.3390/ijerph182413200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/29/2021] [Accepted: 12/06/2021] [Indexed: 12/27/2022]
Abstract
Social distancing and the priority given to COVID-19 patients in health services, which caused postponement of appointments and cancer treatment, may have triggered unprecedented levels of distress in cancer patients. The aim of this study was to analyze the prevalence of distress and the levels of spiritual well-being of people initiating chemotherapy during the COVID-19 pandemic, identifying the factors associated with distress, and determining if there is a relationship between distress and spiritual well-being. A cross-sectional study was conducted with 91 Brazilians. Data were collected by applying the Spiritual Well-Being Scale (SWBS) and the Distress Thermometer and Problem List for Patients. The prevalence of distress was 59.5%, and the average score of spiritual well-being was 106.54 (±9.06). Emotional issues were the most reported by patients with distress. The Poisson regression showed that male sex (PR = 0.588; 95% CI 0.392-0.881), age (PR = 0.985; 95% CI 0.973-0.996), and spiritual well-being score were predictors of distress (PR = 0.971; 95% CI 0.946-0.996). These findings indicate that distress relief involves implementation of public health programs capable of integrating spiritual interventions into cancer care.
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Affiliation(s)
- Angelo Braga Mendonça
- Nursing School, Fluminense Federal University, Niterói 24020-091, Brazil; (E.R.P.); (D.C.M.L.); (R.M.C.R.A.S.)
| | - Eliane Ramos Pereira
- Nursing School, Fluminense Federal University, Niterói 24020-091, Brazil; (E.R.P.); (D.C.M.L.); (R.M.C.R.A.S.)
| | - Carinne Magnago
- School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
| | - Pedro Gilson da Silva
- School of Health, Federal University of Rio Grande do Norte, Natal 59075-000, Brazil; (P.G.d.S.); (K.C.M.)
| | - Diva Cristina Morett Leão
- Nursing School, Fluminense Federal University, Niterói 24020-091, Brazil; (E.R.P.); (D.C.M.L.); (R.M.C.R.A.S.)
| | | | - Karina Cardoso Meira
- School of Health, Federal University of Rio Grande do Norte, Natal 59075-000, Brazil; (P.G.d.S.); (K.C.M.)
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Kirk D, Kabdebo I, Whitehead L. Prevalence of distress, its associated factors and referral to support services in people with cancer. J Clin Nurs 2021; 30:2873-2885. [PMID: 33942939 PMCID: PMC8453497 DOI: 10.1111/jocn.15794] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/11/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022]
Abstract
AIMS AND OBJECTIVES To (i) characterise prevalence of distress amongst people diagnosed with cancer, (ii) determine factors associated with increasing distress, (iii) describe reported problems for those with clinically significant distress and (iv) investigate the factors associated with referral to support services. BACKGROUND International studies report a high prevalence of clinically significant distress in people with cancer. Australian studies are notably lacking. Additionally, clinicians still do not fully understand the factors associated with cancer-related distress. DESIGN Period prevalence study. METHODS Distress screening data were analysed for 1,071 people accessing the Cancer Council Western Australia information and support line between 01/01/2016-31/12/2018. These data included people's demographics, cancer diagnoses, level of distress, reported problems and the service to which they were referred. Distress and reported problems were measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List. A partial proportional logistic regression model was constructed to determine which factors were associated with increasing levels of distress. Standard binary logistic regression models were used to investigate factors associated with referral to support services. The STROBE checklist was followed. RESULTS Prevalence of clinically significant distress was high. Self-reported depression, sadness, worry and a lack of control over treatment decisions were significantly associated with increasing distress. Emotional problems were the most prevalent problems for people with clinically significant distress. Most people were referred to emotional health services, with depression, fatigue, living regionally and higher socioeconomic status associated with referral. CONCLUSIONS Emotional problems such as depression, sadness and worry are associated with increasing levels of distress. RELEVANCE TO CLINICAL PRACTICE Not all factors associated with referral to support services were those associated with increasing levels of distress. This suggests that other factors may be more influential to referral decisions.
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Affiliation(s)
- Deborah Kirk
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWAAustralia
| | - Istvan Kabdebo
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWAAustralia
| | - Lisa Whitehead
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWAAustralia
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Al-Shaaobi A, Alahdal M, Yu S, Pan H. The efficiency of distress thermometer in the determination of supporting needs for cancer inpatients. Libyan J Med 2021; 16:1957199. [PMID: 34347581 PMCID: PMC8344234 DOI: 10.1080/19932820.2021.1957199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Psychological distress scale is highly recommended for cancer patients’ care. Several psychological scales have been implemented in cancer outpatient clinics. However, the use of the psychological distress scale, particularly distress thermometer (DT), in the inpatient has not been reported. In this study, we report the efficacy of DT in the determination of cancer inpatients’ supporting needs. A total of 170 inpatients diagnosed with cancer have been enrolled in this study. Only 132 patients matched the inclusion criteria, while other cases were excluded because of other diseases associated with cancer. The standardized problem list (PL) and Hospital Anxiety and Depression Scale (HADS) were implemented in comparison with DT. Then, the cut-off score of DT was performed to identify clinically significant differences. The analysis of the receiver operating characteristic (ROC) curve revealed that a DT cut-off score of 4 displayed 0.76 under the ROC curve. Sensitivity showed 0.86 sensitivity for cut-off score 4 and a specificity of 0.56 relative to the HADS cut-off score (≥15). DT scores were found independent of medical variables such as cancer type and stage, recurrence, or metastasis. Clinical ECOG-SP showed a significant association with the DT cut-off score (P ≤ 0.05). Regarding PL, patients with scores above DT cut-off were suffering 21 of 40 problems in all categories. Furthermore, patients that scored above the DT cut-off significantly showed an association with high support needs. DT scale showed significant performance in the evaluation of psychological distress among cancer inpatients through the efficient determination of their support needs.
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Affiliation(s)
- Abdullah Al-Shaaobi
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, R. P. China
| | - Murad Alahdal
- Shenzhen Key Laboratory of Tissue Engineering, Shenzhen Laboratory of Digital Orthopedic Engineering, Guangdong Provincial Research Center for Artificial Intelligence and Digital Orthopedic Technology, Shenzhen Second People's Hospital (The First Hospital Affiliated to Shenzhen University, Health Science Center), Shenzhen, P. R. China.,Medical Laboratories Department, Faculty of Medicine and Health Sciences, Hodeidah University, Al Hudaydah, Yemen
| | - Shiying Yu
- Cancer Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, R. P. China
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Decker VB, Tofthagen C. Depression: Screening, Assessment, and Interventions in Oncology Nursing. Clin J Oncol Nurs 2021; 25:413-421. [PMID: 34269343 DOI: 10.1188/21.cjon.413-421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A high prevalence of depression exists among individuals with cancer, which negatively affects their health outcomes, quality of life, and adherence to cancer treatment. OBJECTIVES This article provides an overview and synthesis of depression screening, assessment, and nonpharmacologic treatments to help oncology nurses in their practices. METHODS Key insights are presented from a synthesized literature review regarding patients with cancer with depression. Resources for patient treatment and nurse training are also provided. FINDINGS To improve patient outcomes, nurses need to understand and follow a process that addresses the screening, assessment, and nonpharmacologic treatment of depression in patients with cancer.
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11
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Development of screening questions for doctor-patient consultation assessing the quality of life and psychosocial burden of glioma patients: an explorative study. Qual Life Res 2021; 30:1513-1522. [PMID: 33517524 PMCID: PMC8068662 DOI: 10.1007/s11136-021-02756-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 01/24/2023]
Abstract
PURPOSE Psychosocial screening for glioma patients is challenging because many patients suffer from neurocognitive deficits, which may impair assessment. This study's aim was to exploratively develop three screening questions for unmet needs to prospectively be applicable in patient-doctor consultation. METHODS Patient interviews, a survey for health-care professionals and a weighted scoring procedure were developed for this study. Six main areas were defined according to main areas of validated questionnaires (psyche, cognition, body, role functioning, social support, unmet needs). Patients and health-care professionals rated the importance of these areas and corresponding items, patients additionally stated whether the issues addressed affected them. RESULTS A total of 50 patients were included, and 36 health-care professionals participated in the online survey. The three areas (psyche, body and cognition) considered to be most relevant by both, health-care professionals and patients, generated three screening questions. If the patient was affected by the issue addressed with a screening question, a subordinate question from that area that our patient sample considered most important could additionally be asked. The elaborated screening questions are the following: (1) main area psyche: "Has your mood worsened?", (2) main area body: "Do physical changes put a strain on you?", and (3) main area cognition: "Has your memory capacity worsened?" CONCLUSION These questions represent a basis for further research regarding their application in neuro-oncological clinical routine.
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Moult A, Kingstone T, Chew-Graham CA. How do older adults understand and manage distress? A qualitative study. BMC FAMILY PRACTICE 2020; 21:77. [PMID: 32366270 PMCID: PMC7199345 DOI: 10.1186/s12875-020-01152-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Distress is an expected emotional response to a negative life event. Experiences common in later life may trigger distress such as bereavement or loss of physical mobility. Distress is considered to be distinct to anxiety and/or depression and is not diagnostically labelled as a mental health problem. Older adults will often manage their own distress. Previous literature has focused on how younger adults self-manage mental health problems, however little research has explored the self-management strategies used by older people. There is a need to clarify the role of primary care in the context of distressed older adults who may consult healthcare services. This study seeks to address these gaps through qualitative methods. METHODS Keele University's ethical review panel approved this study. We recruited older adults who self-identified as distressed from community groups in North Staffordshire, England. Data were generated through semi-structured interviews and analysed thematically using constant comparison methods. A patient and public involvement and engagement group contributed to development of the research questions and methods, and offered their perspectives on the findings. RESULTS After 18 interviews data saturation was achieved. Key themes were: experiences of distress, actions taken, help-seeking from healthcare services and perceptions of treatments offered in primary care. Various forms of loss contributed to participants' distress. Participants initiated their own self-management strategies which included: pursuing independent activities, seeking social support and attending community groups and church. Five participants reported having consulted a GP when distressed but described a lack of acceptable treatments offered. CONCLUSIONS To support older adults who are distressed, healthcare professionals in primary care should consider exploring how patients currently manage their mood problems, provide a broad range of information about potential management options and consider sign-posting older adults to community resources.
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Affiliation(s)
- Alice Moult
- Keele Medical School, Keele University, Staffordshire, ST5 5BG UK
| | - Tom Kingstone
- School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG UK
- Midlands Partnership NHS Foundation Trust, Stafford, ST16 3SR UK
| | - Carolyn A. Chew-Graham
- School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG UK
- Applied Research Collaboration (ARC) West Midlands, London, UK
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McFarland DC, Jutagir DR, Miller A, Nelson C. Physical problem list accompanying the distress thermometer: Its associations with psychological symptoms and survival in patients with metastatic lung cancer. Psychooncology 2020; 29:910-919. [PMID: 32096582 DOI: 10.1002/pon.5367] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/01/2020] [Accepted: 02/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The distress thermometer and problem list (DT&PL) is a recommended screening measure but the utility of the physical problem list (PPL) has not been evaluated in patients with metastatic lung cancer who typically have high rates of both physical and psychological symptoms. We hypothesized that the PPL will provide an accurate representation of lung cancer symptoms and be associated with concomitant distress, anxiety, depression, and worsened survival. METHODS Stage IV lung cancer patients (n = 116) reported physical symptoms from 22 PPL variables and completed the DT&PL for distress, general anxiety disorder-7 for anxiety, and Patient Health Questionnaire 9 for depression. Inferential analyses were controlled for demographic and clinical characteristics. RESULTS The average number of physical problems was 4.7 (SD = 3.8) while the median was 3.0. Fatigue, sleep, pain, and breathing problems were most common. Physical symptom burden was associated with nonmarried/partnered status (P = .003) and depression (P < .001) on multivariate analysis accounting for 43% of physical symptom burden variance. Greater number of physical symptoms and lower BMI were associated with worsened survival. Individual physical symptoms were most often associated with depression. CONCLUSION The PPL of the DT&PL appears to have clinical utility given its associations with the most common lung cancer symptoms, depression, and worsened survival. In addition to its potential role in clinics worldwide already using the DT&PL, physical symptom burden on the DT&PL should trigger a concomitant psychological assessment.
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Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Devika R Jutagir
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Andrew Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Jewett PI, Teoh D, Petzel S, Lee H, Messelt A, Kendall J, Hatsukami D, Everson-Rose SA, Blaes AH, Vogel RI. Cancer-Related Distress: Revisiting the Utility of the National Comprehensive Cancer Network Distress Thermometer Problem List in Women With Gynecologic Cancers. JCO Oncol Pract 2020; 16:e649-e659. [PMID: 32091952 DOI: 10.1200/jop.19.00471] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The Distress Thermometer (DT) includes a measure of cancer-related distress and a list of self-reported problems. This study evaluated the utility of the DT problem list in identifying concerns most associated with distress and poorer quality of life (QOL) in survivors of gynecologic cancer. METHODS Demographic, clinical, psychosocial functioning, and DT data were described among 355 women participating in a gynecologic cancer cohort. Problems from the DT list were ranked by prevalence, distress, and QOL. Logistic regression models explored factors associated with problems that were common (≥ 25% prevalence) and associated with distress and QOL. RESULTS The average age of participants was 59.9 years (standard deviation [SD], 10.8 years). Most participants were non-Hispanic white (97%) and had ovarian (44%) or uterine (42%) cancer. The mean DT score was 2.7 (SD, 2.7); participants reported a mean of 7.3 problems (SD, 5.9 problems). The most common problems were fatigue (53.6%), worry (49.9%), and tingling (46.3%); least common problems were childcare (2.1%), fevers (2.1%), and substance abuse (1.1%). Report of some common problems, including tingling, sleep, memory, skin issues, and appearance, was not associated with large differences in distress or QOL. In contrast, some rarer problems such as childcare, treatment decisions, eating, housing, nausea, and bathing/dressing were associated with worse distress or QOL. Younger age, lower income, and chemotherapy were risk factors across common problems that were associated with worse distress or QOL (fatigue, nervousness, sadness, fears, and pain). CONCLUSION The DT problem list did not easily identify concerns most associated with distress and low QOL in patients with gynecologic cancer. Adaptations that enable patients to report their most distressing concerns would enhance clinical utility of this commonly used tool.
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Affiliation(s)
- Patricia I Jewett
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN.,Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN
| | - Deanna Teoh
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Sue Petzel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Heewon Lee
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Audrey Messelt
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | | | | | - Susan A Everson-Rose
- Department of Medicine, Division of General Internal Medicine, and Program in Health Disparities Research, University of Minnesota, Minneapolis, MN
| | - Anne H Blaes
- Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
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Riba MB, Donovan KA, Andersen B, Braun II, Breitbart WS, Brewer BW, Buchmann LO, Clark MM, Collins M, Corbett C, Fleishman S, Garcia S, Greenberg DB, Handzo RGF, Hoofring L, Huang CH, Lally R, Martin S, McGuffey L, Mitchell W, Morrison LJ, Pailler M, Palesh O, Parnes F, Pazar JP, Ralston L, Salman J, Shannon-Dudley MM, Valentine AD, McMillian NR, Darlow SD. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 17:1229-1249. [PMID: 31590149 PMCID: PMC6907687 DOI: 10.6004/jnccn.2019.0048] [Citation(s) in RCA: 348] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Distress is defined in the NCCN Guidelines for Distress Management as a multifactorial, unpleasant experience of a psychologic (ie, cognitive, behavioral, emotional), social, spiritual, and/or physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Early evaluation and screening for distress leads to early and timely management of psychologic distress, which in turn improves medical management. The panel for the Distress Management Guidelines recently added a new principles section including guidance on implementation of standards of psychosocial care for patients with cancer.
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Affiliation(s)
| | | | - Barbara Andersen
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - IIana Braun
- Dana-Farber/Brigham and Women's Cancer Center
| | | | | | | | | | | | | | | | - Sofia Garcia
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Laura Hoofring
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | | | | | | | | | | | - Janice P Pazar
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Laurel Ralston
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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Abstract
PURPOSE OF REVIEW The current review provides an overview of recent research and other initiatives aimed at increasing and/or systematizing screening for distress in cancer survivors. It is timely given an increasing drive internationally to implement distress screening as part of routine cancer care. RECENT FINDINGS Screening using brief validated tools is recommended and the single-item distress thermometer continues to be the international screening tool of choice. Although debate continues regarding the most appropriate cut-off distress thermometer score to identify clinically distressed patients, review of checked items from the accompanying problem list can pinpoint sources of distress, to inform targeted intervention. An integrated approach should include screening, and if required, assessment/referral and intervention. However, whilst distress screening is associated with some impact on referral, especially its timeliness, delivery of evidence-based treatments to address identified distress may be limited by patients declining help and a lack of support services. SUMMARY Although screening for distress in routine care holds promise for reducing costs and enhancing health system efficiency, its implementation across cancer services is variable. Further research is required to evaluate screening implementation and sustainability in routine care, as well as the feasibility of distress screening in long-term cancer survivors who are no longer in regular contact with cancer centres.
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McFarland DC, Shaffer KM, Tiersten A, Holland J. Prevalence of physical problems detected by the distress thermometer and problem list in patients with breast cancer. Psychooncology 2018; 27:1394-1403. [PMID: 29315955 DOI: 10.1002/pon.4631] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Patients with breast cancer have high rates of physical symptoms that negatively impact their quality of life. The relationship between women's perceptions of these physical symptoms and patient demographic and breast cancer characteristics is less well known. This study describes physical symptoms of patients with breast cancer and their relationship with patient characteristics. METHODS Patients (n = 125) with breast cancer (stage 0-IV) completed questionnaires in a dedicated academic medical center breast cancer clinic. Patients reported demographics (age, race/ethnicity, marital status, and employment status) and disease characteristics (surgery type, receipt of chemotherapy, or antihormonal therapy). Patients reported whether they were bothered by any of the 22 physical problem list (PPL) variables from the distress thermometer and problem list. RESULTS The median number of physical problems endorsed by patients was 3.0 (M = 3.43, SD = 3.42). Approximately one-fourth endorsed no physical symptoms while three-fourths reported at least 1 problem, and three-fifths endorsed 2 or more problems. Fatigue (40.0%), sleep (34.7%), skin dry/itchy (22.9%), pain (19.5%), and feeling swollen (19.5%) were most commonly reported. Age, race/ethnicity, marital status, employment status, and receipt of chemotherapy were associated with certain physical problems. Problems with breathing, eating, memory/concentration, nausea, and total number of endorsed PPL variables were associated with distress. CONCLUSION The breast cancer population demonstrates heavy physical symptom burden with multiple physical problems that are related to overall functioning. Special attention should be given to the physical symptom burden of younger, nonwhite, unmarried, and unemployed patients. Future research should investigate the PPL of the distress thermometer and problem list with other measures of symptom burden.
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Affiliation(s)
- Daniel C McFarland
- Division of Network Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, West Harisson, NY, USA
| | - Kelly M Shaffer
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Amy Tiersten
- Department of Medicine, Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Jimmie Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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McFarland DC, Shaffer KM, Polizzi H, Mascarenhas J, Kremyanskaya M, Holland J, Hoffman R. Associations of Physical and Psychologic Symptom Burden in Patients With Philadelphia Chromosome-Negative Myeloproliferative Neoplasms. PSYCHOSOMATICS 2018; 59:472-480. [PMID: 29506868 DOI: 10.1016/j.psym.2018.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 01/14/2018] [Accepted: 01/16/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The physical symptom burden of patients with myeloproliferative neoplasms (MPNs) may last for extended periods during their disease trajectories and lead to psychologic distress, anxiety, or depression or all of these. OBJECTIVE This study evaluated the relationship between physical symptom burden captured by the Physical Problem List (PPL) on the Distress Thermometer and Problem List and psychologic outcomes (distress, anxiety, and depression) in the MPN setting. METHODS Patients (N = 117) with MPNs completed questionnaires containing the Distress Thermometer and Problem List and the Hospital Anxiety and Depression Scale in a dedicated MPN clinic within an academic medical center. They reported symptoms from any of 22 physical problems on the PPL. Items endorsed by more than 10% of participants were assessed for their associations with distress (Distress Thermometer and Problem List), anxiety (Hospital Anxiety and Depression Scale-Anxiety), and depression (Hospital Anxiety and Depression Scale-Depression). The total number of endorsed PPL items per participant was also evaluated. RESULTS Nine of 22 PPL items (fatigue, sleep, pain, dry skin/pruritus, memory/concentration, feeling swollen, breathing, and sexual) were reported by >10% of participants. In univariate analyses, all PPL items but one were associated with distress and depression, and all but 2 were associated with anxiety. In multivariate analyses, the total number of PPL items was associated with depression only (p < 0.001) when controlling for covariates. CONCLUSION Physical symptom burden in MPN patients was clearly associated with psychologic symptoms. Depression was uniquely associated with overall physical symptom burden. As such, the endorsement of multiple PPL items on the Distress Thermometer and Problem List should prompt an evaluation for psychologic symptoms to improve MPN patients' overall morbidity and quality of life.
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Affiliation(s)
- Daniel C McFarland
- Department of Medicine, Memorial Sloan Kettering Cancer Center, West Harrison, NY.
| | - Kelly M Shaffer
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Heather Polizzi
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
| | - John Mascarenhas
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
| | - Marina Kremyanskaya
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
| | - Jimmie Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ronald Hoffman
- Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY
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Li LR, Lin MG, Liang J, Hu QY, Chen D, Lan MY, Liang WQ, Zeng YT, Wang T, Fu GF. Effects of Intrinsic and Extrinsic Factors on the Level of Hope and Psychological Health Status of Patients with Cervical Cancer During Radiotherapy. Med Sci Monit 2017; 23:3508-3517. [PMID: 28720749 PMCID: PMC5531534 DOI: 10.12659/msm.901430] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background This study aimed to explore the factors affecting the level of hope and psychological health status of patients with cervical cancer (CC) during radiotherapy. Material/Methods A total of 480 CC patients were recruited. Psychological distress scale, Herth hope index, functional assessment cancer therapy-cervix, and Jolowiec coping scale were used to conduct surveys on psychological distress, level of hope, quality of life (QOL), and coping style to analyze the factors affecting the level of hope and psychological health status of CC patients. Results The morbidity of significant psychological distress in 480 CC patients during radiotherapy was 68%, and the main factors causing psychological distress were emotional problems and physical problems. During radiotherapy, most patients had middle and high levels of hope, and the psychological distress index of patients was negatively correlated with the level of hope. The QOL of CC patients during radiotherapy were at middle and high levels, and the QOL was positively correlated with confrontment, optimism, appeasement, and self-reliance, but it was negatively correlated with predestination and emotional expression. Conclusions For CC patients during radiotherapy, the morbidity of psychological distress was high, but they were at middle and high levels of hope.
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Affiliation(s)
- Li-Rong Li
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Mei-Guang Lin
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Juan Liang
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Qiong-Yan Hu
- Department of Nursing, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Dan Chen
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Meng-Ying Lan
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Wu-Qing Liang
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Yu-Ting Zeng
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Ting Wang
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Gui-Fen Fu
- Department of Nursing, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
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