ResumoA literatura especializada disponibiliza instrumentos de medida de estresse de aplicação geral, os quais vêm sendo empregados em diferentes contextos ocupacionais e em saúde. Mas, desde 1997, a National Comprehensive Cancer Network (NCCN) recomenda a adoção de uma medida específica para pacientes oncológicos. Considerando, portanto, o interesse clínico e científico de desenvolver futuros estudos de meta-análise em Oncologia, que incluam amostras brasileiras, realizaram-se a adaptação e a validação do Termômetro de Distress (TD). A eficácia de avaliação do TD foi verificada por meio da comparação com a Escala de Ansiedade e Depressão (HAD), um instrumento clinicamente estabelecido de avaliação de distress. Para tanto, avaliou-se uma amostra de 83 pacientes, que responderam ao TD e ao HAD. Os dados foram submetidos ao SPSS 15.0. Os resultados indicam uma sensibilidade de 82% e uma especificidade de 98%, o que indica que o TD é viável e eficiente para avaliar o distress psicológico.Palavras-chave: Termômetro de Distress; Validade; Estresse; Psico-oncologia. AbstractThe specialized literature provides instruments measuring stress for general application. Those instruments have been employed in occupational and health contexts. But since 1997, the National Comprehensive Cancer Network (NCCN) recommends the adoption of a specific measuring instrument for the assessment of cancer patients. Considering the existence of clinical and scientific interest to develop future meta-analysis studies in the field of Oncology, which will include Brazilian samples, the adaptation and validation of the Distress Thermometer (TD) was undertaken. The effectiveness of the TD in assessing distress was verified by comparison with the Anxiety and Depression Scale (HAD), a clinically established tool for evaluating distress. In order to that, a sample of 83 patients answered the TD and the HAD. The data were analyzed using SPSS 15.0. Results of the analysis indicated 82% for sensitivity and 98% for specificity. Using the TD appeared feasible and effective for psychological distress screening.Keywords: Distress thermometer; Validation; Stress; Psycho-oncology. INTRODUÇÃOAinda hoje, o câncer é uma doença cujo significado é ameaçador para a maioria das pessoas, pois está associado ao risco de morte e possibilidade de interrupção da trajetória existencial, que exige do indivíduo acometido força e criatividade para suportar mudanças, muitas vezes drásticas, em seu estilo de vida (Werebe, 2000). Segundo Coenson e Dimsdale (1994), a alta prevalência de transtornos psiquiátricos em oncologia pode ser compreendida em razão da intensidade com que os enfermos convivem com a angústia, a dor, o desfiguramento, a dependência, o isolamento, o luto, a separação, as perdas e a morte, além de terem de suportar os efeitos colaterais da quimioterapia e da radioterapia, as frequentes internações hospitalares, os altos gastos financeiros e as mudanças que atingem também suas famílias.

Distress is highest in these patients at the beginning of chemotherapy, suggesting that evaluation of patients for psychosocial needs is important. Screening with a simple rapid instrument such as the DT is feasible and useful.

e20686 Background: Distress is present in every phase of cancer. This high prevalence of distress showed the necessity of acting strategies that may favor the reduction or elimination of possible psychological and psychiatric disturbances. Facing this reality, the National Comprehensive Cancer Network suggested Distress Management in 1997. Today the oncological units need not only acting strategies, but also methods of evaluation of assistance quality. Methods: This study main goal was to evaluate the assistance offered in a private cancer treatment center in Brazil, using the distress prevalence during all the phases of the treatment as a quality indicator. Patients (N = 169) of both genders (37.9% male and 62.1% female), with age between 17 and 86 years (median = 53), with 18 types of cancer, took a part in this investigation. The research was authorized by an ethics committee. The procedure of gathering data included the consent of patients and the application of the Distress Thermometer (DT). The evaluation was made in three distinct stages of chemotherapy: beginning, middle and end of treatment. The data were analyzed according to the criteria defined in literature and with the software SPSS 15.0. Results: In the first stage of the evaluation, the major part of the patients showed a significative level of distress (69.8%), which is similar to literature data - In this phase the patients live with pain, losses and incertitude in relation to the prognoses. During the treatment, there was a progressive reduction in the second (32.4%) and in the last phase of evaluation (14.3%). Such fall was due to: 1) the routine of monitoring distress, the identification of the nature of distress and the intervention; 2) integration of the health team in a interdisciplinary work. Conclusions: The significative reduction of distress during the treatment points out to a good quality of cancer care. During the research it was possible to identify improvements and to reconsider some attitudes and conducts. There was a non automatization in the assistance, making it more human, individual and specific for each necessity. This result suggests the importance of DT as a quality indicator of cancer care. No significant financial relationships to disclose.