Is it the time to implement the routine use of distress thermometer among Egyptian patients with newly diagnosed cancer?

Abstract

Background The distress thermometer (DT) is an effective tool for identifying distress among cancer patients worldwide. However, DT has not been studied in Egyptian patients. We aimed to study the prevalence of distress among Egyptian patients with different types of cancers using DT. Methods A total of 550 patients with newly diagnosed hematological and solid cancers who were followed up at 3 Oncology Centers in Egypt were enrolled. They completed a sociodemographic and clinical status questionnaire, the DT and the Problem List (PL) scale. Results At a DT cut-off score of ≥4, 46% of patients had significant distress, which was related to the tumor site and stage. The most frequent problems reported were treatment decision (64.4%), worry (47%), and fears (44.5%). In univariate logistic regression analysis, participants who had significant distress described 23 out of 36 problems in the practical, family, emotional, and physical areas. After adjustment to sociodemographic and clinical characteristics, multivariable analysis confirmed that insurance, depression, fear, sadness, worry, loss of interest in usual activity, and sleep were independent factors associated with significant distress in cancer patients. Conclusions Almost half of Egyptian patients newly diagnosed with cancer reported significant distress. Those who had significant distress described extra problems in the practical, family, emotional, and physical areas. We recommend the routine use of DT for screening Egyptian patients with cancer, as well as the involvement of the psycho-oncology and social services, at the time of their initial diagnosis.

Is the Modified Distress Thermometer Useful for Screening Pregnant Women With COVID-19 for Psychological Distress?

“…The originally adopted distress thermometer is a single-item tool that uses a point Likert scale resembling a thermometer, where the patient rates his/her level of distress over the past week [ 16 , 17 ], proved useful for screening cancer patients for psychological distress [ 12 , 13 ]. As an essential part of the assessment, a 39-item supplemental problem list (PL) of potential sources of distress was incorporated into DT to assist the provider in identifying distress [ 12 , 13 , 16 , 17 ].…”

“…Our experience in using that cut-off score confirms that it brings the needed combination of sensitivity and specificity [ 14 ]. This is optimally needed to avoid over-misdiagnoses due to false-positive results [ 12 - 14 ]. Notably, nondistressed patients can be burdened with unnecessary interventions with high false-positive screening results.…”

“…As shown in our recent publication [ 14 ], we have utilized the m-DT to screen the enrolled pregnant women for psychological distress, with the use of a cutoff score of ≥4 for significant distress [ 12 , 14 ]. The patients were screened at their first outpatient/emergency department visit or inpatient admission.…”

“…A p<0.05 was considered statistically significant. Binary logistic regression test was carried out to explore the association between the m-DT cutoff scores of 4 and the demographic and clinical variables, while binary and multivariable logistic regression tests were used to analyze the association between these scores and individual items in the PL [ 12 , 14 ]. We have used the Statistical Package for Social Science (SPSS) version 24 (Chicago, IL: SPSS Inc.) for data analysis.…”

“…The importance of screening cancer patients for psychological distress using valuable tools, like distress thermometer (DT) is well established [ 12 , 13 ]. This had led us to the idea of adopting a modified version of this DT (m-DT) to screen adults with suspected or confirmed COVID-19 for psychological distress [ 14 ].…”