Validation And Reliability of Distress Thermometer in Chinese Cancer Patients

Objective：To examine the validation and reliability of the distress thermometer（DT） recommended by National Comprehensive Cancer Network（NCCN） in Chinese cancer patients.Methods：A total of 574 Chinese cancer patients from Beijing Cancer Hospital completed the detection of DT,the Hospital Anxiety and Depression Scale（HADS） and Symptom Checklist 90（SCL-90）,Receiver Operating Characteristic（ROC） curve and Area Under the Curve（AUC） were used to analyze the validation relative to HADS and SCL-90.The patients with DT≥4 and whose distress caused by emotional problems were interviewed with the MiNi International Neuro-psychiatric Interview（MINI）（Chinese Version 5.0）.This version was used to analyze cancer patients＇ psychological and Psychiatric symptoms during the cancer process;3.Another 106 cancer patients in rehabilitation stage and stable condition were asked to fill in DT two times,at the base time and after 7-10 days.Results：Data of ROC indicates that a DT cutoff score of 4 yielded AUC of 0.80 with a optimal sensitivity（0.80） and specificity（0.70） relative to HADS,and AUC of 0.83 with the greatest sensitivity（0.87） and specificity（0.72） against SCL-90.The DT also has acceptable test-retest reliability（r=0.800,P=0.000）;According to the interview results,the most common psychiatric problems cancer patients have adjustment disorder,depression,and anxiety.Conclusion：The data suggest that DT has acceptable overall accuracy and reliability as a screening tool for testing distress severity and specific problems causing distress in Chinese cancer patients.It is worth being used in oncology clinic,the rapid screening and interview could help caregivers to identify psychological and psychiatric problems of cancer patients and provide useful information for further treatment.

Validity of distress thermometer for screening of anxiety and depression in family caregivers of Chinese breast cancer patients receiving postoperative chemotherapy

Objective:Family caregivers(FCs)of breast cancer patients play a vital role throughout the treatment process.Psychological distress of FCs is common and often ignored.A simple and effective instrument for screening psychological distress would help in selecting those FCs requiring special attention and intervention.Here,the validity of distress thermometer(DT)in FCs of Chinese breast cancer patients receiving postoperative chemotherapy was assessed,and the prevalence of anxiety and depression was evaluated.Methods:We recruited 200 FCs of hospitalized breast cancer patients in this cross-sectional descriptive study.Before the first cycle of adjuvant chemotherapy,the levels of anxiety and depression among FCs were assessed using DT and Hospital Anxiety and Depression Scale(HADS).In total,191 valid cases were analyzed.HADS was used as the diagnostic standard to assess the effectiveness of DT as a screening tool for anxiety and depression as well as to analyze the diagnostic efficiency of DT at various cutoff points.Results:The definitive prevalence of both anxiety and depression was 8.90%.The mean level of anxiety and depression among FCs was 5.64±3.69 and 5.09±3.85,respectively,both of which were significantly higher than corresponding Chinese norms(P<0.01).The areas under receiver operating characteristic curves of DT for the diagnoses of FCs'anxiety and depression were 0.904 and 0.885,respectively.A cutoff value of 5 produced the best diagnostic effects of DT for anxiety and depression.Conclusions:The levels of both anxiety and depression were higher in the FCs of Chinese breast cancer patients receiving postoperative chemotherapy than the national norm.DT might be an effective tool to initially screen psychological distress among FCs.This process could be integrated into the palliative care of breast cancer patients and warrant further research.

Research on the Intervention of Internet+ Health Education Model on Hemodialysis Patients with Psychological Distress

Objective:To observe the status quo of patients’psychological distress,and to explore the effect of Internet+health education model(IHEM)on patients who experienced psychological distress during their first hemodialysis treatment,with the goal of reducing their psychological distress and improving their quality of life.Methods:IHEM was conducted on 120 first-time hemodialysis patients for 3 months while a distress thermometer and a list of questionnaires were used to screen patients and provide corresponding psychological intervention.The incidence rate of psychological distress was analyzed statistically to explore the difference in psychological distress at various periods.Results:The incidence rate(score≥4)of psychological distress in first-time hemodialysis patients was 46.67%,and their distress was mainly rooted in physical,emotional,practical problems(economy,time,and energy),etc.Through IHEM,the psychological distress scores of the patients decreased to 3.29±1.02 at one month after their discharge,and the incidence rate was 32.14%;the psychological distress scores of the patients were 2.29±1.02 at 3 months after their discharge,and the incidence rate was 21.14%.The difference before and after the intervention was statistically significant(P<0.05).Conclusion:A psychological distress thermometer can timely detect the degree and causes of psychological distress among first-time hemodialysis patients,and the use of IHEM may significantly alleviate the psychological distress among hemodialysis patients.

Assessment of the psychological distress difficulties in patients with cancer using the national comprehensive cancer network rapid screening measure

Objective Clinical guidelines like National Comprehensive Cancer Network Disease recommend routine psychological distress screening as a common problem among patients with cancer. The purpose of this study was to assess the prevalence of clinically significant emotional distress related to demographic and clinical association by standard distress thermometer (DT) within the patients lived in different regions of Gilan state, Iran.