A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services
PurposeAlthough the distress thermometer (DT) scale has been widely validated and used in different cancer types and settings, an optimal cutoff score of DT is not defined to screen advanced cancer patients. The study aimed to define the optimal DT’s cutoff score among advanced cancer patients in re...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-03-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.970164/full |
| _version_ | 1827989939718979584 |
|---|---|
| author | Hammoda Abu-Odah Hammoda Abu-Odah Alex Molassiotis Alex Molassiotis Justina Yat Wa Liu |
| author_facet | Hammoda Abu-Odah Hammoda Abu-Odah Alex Molassiotis Alex Molassiotis Justina Yat Wa Liu |
| author_sort | Hammoda Abu-Odah |
| collection | DOAJ |
| description | PurposeAlthough the distress thermometer (DT) scale has been widely validated and used in different cancer types and settings, an optimal cutoff score of DT is not defined to screen advanced cancer patients. The study aimed to define the optimal DT’s cutoff score among advanced cancer patients in resource-limited countries without palliative care services and to assess the prevalence and factors associated with psychological distress among this population.MethodsA secondary analysis was performed. Three hundred seventy-nine patients were recruited from Palestine. Participants completed the DT and the Hospital Anxiety and Depression Scale (HADS). Receiver operating characteristic analysis (ROC) was used to define the optimal cutoff score for the DT against HADS-Total ≥15. Multiple logistic regression was utilized for identifying the factors associated with psychological distress of the DT.ResultsA DT cutoff score ≥ 6 correctly identified 74% of HADS distress cases and 77% of HADS non-distress cases, with a positive predictive value (PPV) and negative predictive value (NPV) of 97% and 18%, respectively. The prevalence of distress was found to be 70.7%, and the major sources of distress were related to physical (n = 373; 98.4%) and emotional problems (n = 359; 94.7%). Patients with colon (OR = 0.44, 95% CI: 0.31 – 0.62) and lymphoid cancers (OR = 0.41, 95% CI: 0.26 – 0.64) were less likely to have psychological distress than patients with other types of cancer, whereas patients with lung (OR = 1.80, 95% CI: 1.20 – 2.70) and bone cancers (OR = 1.75, 95% CI: 1.14 – 2.68) were more likely to experience it.ConclusionA cutoff DT score of 6 appeared acceptable and effective for screening distress in patients with advanced cancer stages. Palestinian patients exhibited a high level of distress, and the high prevalence supports the argument of using a DT within the standard delivery of cancer care to identify highly distressed patients. These highly distressed patients should then be involved in a psychological intervention programme. |
| first_indexed | 2024-04-10T00:29:17Z |
| format | Article |
| id | doaj.art-e1e043f2d06c43d981aed0ee7fe8eaec |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T00:29:17Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-e1e043f2d06c43d981aed0ee7fe8eaec2023-03-15T05:34:38ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-03-011310.3389/fonc.2023.970164970164A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care servicesHammoda Abu-Odah0Hammoda Abu-Odah1Alex Molassiotis2Alex Molassiotis3Justina Yat Wa Liu4School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, ChinaNursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, PalestineSchool of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, ChinaCollege of Arts, Humanities and Education, University of Derby, Derby, United KingdomSchool of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, ChinaPurposeAlthough the distress thermometer (DT) scale has been widely validated and used in different cancer types and settings, an optimal cutoff score of DT is not defined to screen advanced cancer patients. The study aimed to define the optimal DT’s cutoff score among advanced cancer patients in resource-limited countries without palliative care services and to assess the prevalence and factors associated with psychological distress among this population.MethodsA secondary analysis was performed. Three hundred seventy-nine patients were recruited from Palestine. Participants completed the DT and the Hospital Anxiety and Depression Scale (HADS). Receiver operating characteristic analysis (ROC) was used to define the optimal cutoff score for the DT against HADS-Total ≥15. Multiple logistic regression was utilized for identifying the factors associated with psychological distress of the DT.ResultsA DT cutoff score ≥ 6 correctly identified 74% of HADS distress cases and 77% of HADS non-distress cases, with a positive predictive value (PPV) and negative predictive value (NPV) of 97% and 18%, respectively. The prevalence of distress was found to be 70.7%, and the major sources of distress were related to physical (n = 373; 98.4%) and emotional problems (n = 359; 94.7%). Patients with colon (OR = 0.44, 95% CI: 0.31 – 0.62) and lymphoid cancers (OR = 0.41, 95% CI: 0.26 – 0.64) were less likely to have psychological distress than patients with other types of cancer, whereas patients with lung (OR = 1.80, 95% CI: 1.20 – 2.70) and bone cancers (OR = 1.75, 95% CI: 1.14 – 2.68) were more likely to experience it.ConclusionA cutoff DT score of 6 appeared acceptable and effective for screening distress in patients with advanced cancer stages. Palestinian patients exhibited a high level of distress, and the high prevalence supports the argument of using a DT within the standard delivery of cancer care to identify highly distressed patients. These highly distressed patients should then be involved in a psychological intervention programme.https://www.frontiersin.org/articles/10.3389/fonc.2023.970164/fulladvanced cancer patientsdistress thermometerhealthcare systempalliative carescreening |
| spellingShingle | Hammoda Abu-Odah Hammoda Abu-Odah Alex Molassiotis Alex Molassiotis Justina Yat Wa Liu A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services Frontiers in Oncology advanced cancer patients distress thermometer healthcare system palliative care screening |
| title | A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services |
| title_full | A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services |
| title_fullStr | A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services |
| title_full_unstemmed | A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services |
| title_short | A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services |
| title_sort | distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource limited countries without palliative care services |
| topic | advanced cancer patients distress thermometer healthcare system palliative care screening |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.970164/full |
| work_keys_str_mv | AT hammodaabuodah adistressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT hammodaabuodah adistressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT alexmolassiotis adistressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT alexmolassiotis adistressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT justinayatwaliu adistressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT hammodaabuodah distressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT hammodaabuodah distressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT alexmolassiotis distressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT alexmolassiotis distressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices AT justinayatwaliu distressthermometerwithacutoffscoreof6istheoptimalpointtoidentifyhighlydistressedpatientswithadvancedcancerstagesinresourcelimitedcountrieswithoutpalliativecareservices |