Distress among cancer patients attending rehabilitation in the community

Abstract

Purpose The aim of this study is to identify sources of distress among cancer patients attending rehabilitation in the community. Methods Participants were 430 patients recruited from a cancer rehabilitation center in Singapore between 2017 and 2018, who had rated their distress using the distress thermometer (DT) and indicated associated problems on the problem list. Chi-square tests were used to detect differences in the reported symptoms among three age groups. Exploratory factor analysis was used to identify symptom clusters. Partial correlational analysis was then performed to examine the relationship between distress, symptom clusters, and age controlling for gender and cancer type. Results About 30% of the participants reported distress ≥ 5 on the DT (mean 3.3 ± 2.5), and the mean number of problems endorsed was 8 ± 6. A higher total number of reported problems (r = .63) and younger age (r = − .21) were associated with increased distress. The younger age group also reported more problems surrounding emotions, finance, work/school, children-related issues, and physical symptoms such as sleep and nausea. Of the 12 factors identified, 9 psychosocial and physical symptom clusters correlated with distress (r ranging from .12 to .41). All results were statistically significant after adjustment (p ≤ 0.05). Conclusion Younger survivors are more at risk of distress and report greater role functioning concerns related to childcare, partner relationship, and work participation. Age-tailored and multimodal interventions may be necessary to adequately address age-related differences and help coordinate management of multiple symptom clusters across physical and psychosocial concerns.

Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program

“…We also report a mean distress level of 3.51, which is similar to an earlier study in Singapore, which reported a mean distress level of 3.3 [ 20 ]. Nearly 2/3 of our study population experiencing significant distress, which is in line with a reported worldwide prevalence rate of 20–52% of cancer patients [ 43 , 44 ].…”

“…Unsurprisingly, distress has been shown to be strongly associated with mood disturbances including stress, anxiety, and depression which may not reach the criteria for clinical diagnosis, but still interfere with HRQOL [ 45 , 46 ]. Our findings emphasize the need to consistently screen for social and emotional issues in cancer survivors, even while many of these patients are undergoing physical therapy-based rehabilitation [ 20 ].…”

“…For example, a large Chinese cohort of cancer patients reported a prevalence rate of 20% using the DT [ 17 ]. In Korea, nearly a third of cancer patients were found to suffer from distress [ 18 ], with substantial proportions of cancer survivors in Southeast Asian countries also reporting psychological distress [ 19 , 20 ]. Consequently, this had led to the increasing awareness of cancer rehabilitation, which aims to address causes of psychological distress such as physical disability, pain, emotional distress, fatigue, or social functioning.…”

Caring for dependent children impacts practical and emotional problems and need for support, but not perceived distress among cancer patients

“…In the literature, a correlation between the domains or items of the Problem List and the distress score on the DT has often been found, although not equally for every patient group and every item. 27,28 Despite the fact that we found no significant between-group differences in terms of distress, the finding that more than half of the parents report increased distress is highly relevant because it can result in negative consequences for the children. In a U.S. national survey, Amrock et al found a correlation between parental distress and children's mental health.…”

Distress among cancer patients: some considerations in identification and treatment

“…Among Chinese persons with cancer, 20% reported elevated psychological distress (Rao et al, 2019). Among individuals attending a cancer rehabilitation facility in Singapore, approximately 30% reported distress in the elevated range (Kuo, 2022). Among South African persons with cancer, more than 33% of study participants had high scores on the Center for Epidemiological Studies – Depression Scale (CESD) and the Hopkins Symptom Checklist, which correlated with perceived social support and body change stress (Kagee et al, 2018).…”