The distress thermometer provides a simple screening tool for selecting distressed childhood cancer survivors

Geest, Ivana M.M. van der; Dorp, Wendy van; Pluijm, Saskia M F; Heuvel‐Eibrink, Marry M. van den

doi:10.1111/apa.14251

Cited by 14 publications

(10 citation statements)

References 22 publications

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“…Psychosocial and environmental factors include parenting stress, measured with the NOSI-K (Nijmeegse Ouderlijke Stress Index [ 33 ]), i.e. the adapted and shortened Dutch version of the Parental Stress Index (PSI)[ 34 ] and the Distress Thermometer (DT)[ 35 , 36 ].…”

Section: Methodsmentioning

confidence: 99%

Study protocol: DexaDays-2, hydrocortisone for treatment of dexamethasone-induced neurobehavioral side effects in pediatric leukemia patients: a double-blind placebo controlled randomized intervention study with cross-over design

et al. 2021

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Background Dexamethasone, a highly effective drug in treating pediatric acute lymphoblastic leukemia (ALL), can induce serious neurobehavioral side effects. These side effects are experienced by patients and parents as detrimental with respect to health related quality of life (HRQoL). Based on previous studies, it has been suggested that neurobehavioral side effects are associated to cortisol depletion of the mineralocorticoid receptor in the brain. Our previously reported randomized controlled trial, the Dexadagen study (NTR3280), suggests that physiological hydrocortisone addition during dexamethasone treatment may overcome clinically relevant neurobehavioral problems in patients who experience these problems during dexamethasone treatment. With our current study, we aim to replicate these results in a targeted larger sample before further implementing this intervention into standard of care. Methods In a national center setting, pediatric ALL patients between 3 and 18 years are enrolled in an Identification study, which identifies patients with clinically relevant dexamethasone-induced neurobehavioral side effects using the Strengths and Difficulties Questionnaire (SDQ). Contributing factors, such as genetic susceptibility, dexamethasone pharmacokinetics as well as psychosocial and family factors are studied to determine their influence in the inter-patient variability for developing dexamethasone-induced neurobehavioral side effects. Patients with clinically relevant problems (i.e. a rise of ≥ 5 points on the SDQ Total Difficulties Score after 5 days of dexamethasone) are subsequently included in a randomized double-blind placebo-controlled trial with a cross-over design. They receive two courses placebo followed by two courses hydrocortisone during dexamethasone treatment, or vice versa, each time at least 16 days without study medication in between. The primary endpoint is change in SDQ score. The secondary endpoints are sleep (measured with actigraphy and the Sleep Disturbance Scale for Children) and HRQoL (Pediatric Quality of Life Questionnaire). Discussion The results of our current study may contribute to the management of future ALL patients who experience dexamethasone-induced neuropsychological problems as it may improve HRQoL for patients who suffer most from dexamethasone-induced neurobehavioral side effects. Furthermore, by investigating multiple risk factors that could be related to inter-patient variability in developing these side effects, we might be able to identify and treat patients who are at risk earlier during treatment. Trial registration Medical Ethical Committee approval number: NL62388.078.17. Affiliation: Erasmus Medical Centre. Netherlands Trial Register: NL6507 (NTR6695). Registered 5 September 2017

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Section: Methodsmentioning

confidence: 99%

Study protocol: DexaDays-2, hydrocortisone for treatment of dexamethasone-induced neurobehavioral side effects in pediatric leukemia patients: a double-blind placebo controlled randomized intervention study with cross-over design

et al. 2021

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“…Participants completed the well‐validated Distress Thermometer 5,6 immediately before the interview, immediately after the interview, and 1 week later (via phone call or text message, range = 6–15 days after the interview). Participants provided verbal ratings of current distress using the visual image of the thermometer, with anchors ranging from 0 (no distress) to 10 (extreme distress).…”

Section: Methodsmentioning

confidence: 99%

“…Participants completed the well-validated Distress Thermometer 5,6 immediately before the interview, immediately after the interview,…”

Section: Distress Screeningmentioning

confidence: 99%

Do qualitative interviews cause distress in adolescents and young adults asked to discuss fears of cancer recurrence?

et al. 2020

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“…Their results showed that a threshold score of 4 provided good sensitivity (87.5%) and moderate specificity (56.9%), and they reported that potentially raising the cutoff to 5 or 6 improved specificity without substantial loss in sensitivity. In contrast, van der Geest et al 17 identified a threshold score of 3 as yielding the best sensitivity (92%) and specificity (79%) among survivors of childhood cancer, 17–44 years old, in an outpatient clinic in the Netherlands.…”

Section: Introductionmentioning

confidence: 91%

Threshold score for the self‐report Pediatric Distress Thermometer Rating Scale in childhood cancer patients

et al. 2020

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Objective Although there is enthusiasm for identifying and treating psychosocial problems in childhood cancer patients, there are few validated instruments to help providers identify at‐risk children for further assessment. The study objective was to evaluate the sensitivity and specificity of the self‐report pediatric Distress Thermometer Rating Scale (Peds DTRS) in childhood cancer survivors and identify a threshold score to help providers classify pediatric patients. Methods We evaluated 54 children 7–17 years old using 178 Peds DTRS longitudinal data points from the cohort that was used for the original pediatric adaptation of the DTRS. We compared Peds DTRS scores against two established standardized measures using a generalized linear mixed model to deal with the dependency in the longitudinal data to estimate ROC curves and related statistics. Results Results indicate that a score of 3 is a reasonable cutoff to identify distress with children 7–17 years old. This cutoff yielded high sensitivity (87.0%) and specificity (79.7%) using the PedsQL Emotional Domain score as the standard. Similar results were obtained using the CDI as the standard, but we are cautious as very few CDI scores reached the cutoff criterion. Exploratory analysis highlighted clinical factors that correlate with increased distress measured using the Peds DTRS. Conclusions The Peds DTRS is a very brief, convenient, and rapid screening tool for global distress in children. Further investigation of the Peds DTRS and other tools can improve the ability of providers to prevent and treat the negative emotional consequences of cancer and improve the quality of survivorship.

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The distress thermometer provides a simple screening tool for selecting distressed childhood cancer survivors

Abstract: The distress thermometer provided a rapid screening tool for identifying distressed childhood cancer survivors who needed further psychological support.

Cited by 14 publications

References 22 publications

Study protocol: DexaDays-2, hydrocortisone for treatment of dexamethasone-induced neurobehavioral side effects in pediatric leukemia patients: a double-blind placebo controlled randomized intervention study with cross-over design

Study protocol: DexaDays-2, hydrocortisone for treatment of dexamethasone-induced neurobehavioral side effects in pediatric leukemia patients: a double-blind placebo controlled randomized intervention study with cross-over design

Do qualitative interviews cause distress in adolescents and young adults asked to discuss fears of cancer recurrence?

Threshold score for the self‐report Pediatric Distress Thermometer Rating Scale in childhood cancer patients

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