Prevalence of distress in cancer patients undergoing chemotherapy

Abstract

Aim: Feeling distressed is often a normal reaction to the diagnosis of cancer and cancer treatment. However, if excessive, distress may lead to more disabling conditions such as depression and anxiety. The aims of the study were to determine the prevalence and level of distress in patients with cancer who were undergoing chemotherapy and to examine the associated factors related to psychological distress in these patients. Methods: Adult patients with confirmed cancer who were undergoing out-patient chemotherapy at the Clinical Oncology Unit, Universiti Malaya Medical Centre were invited to participate in the study. They were assessed on their sociodemographic profiles, clinical history, distress level as measured using the 'Distress Thermometer', and problems checklist on practical, family, emotional and physical symptoms. The Hospital Anxiety Depression Scale (HADS) was used by patients to report anxiety and depression. Results: One hundred and sixty-eight patients with mean age of 50 years participated in the study. The prevalence of psychological distress determined by the 'Distress Thermometer' was 51%. HADS found the prevalence of depression/anxiety to be 32%. There was no significant association between distress and the primary site of cancer, the phase of chemotherapy and the sociodemographic profiles except for age (r = -0.21, P = 0.007). Distress was significantly associated with practical, family and emotional problems. Some of the physical problems such as appearance, breathing, changes in urination, constipation, eating, fatigue, getting around, memory/concentration, nausea, pain and sleep were also significantly associated with distress. Conclusion: Cancer patients undergoing chemotherapy experienced high level of distress. This finding should alert oncologists that some patients exhibiting these signs of distress may need referral to the mental health team.

Validation of the emotion thermometers and hospital anxiety and depression scales in Singapore: Screening cancer patients for distress, anxiety and depression

“…Lim observed that cancer patients might present with adjustment disorder, which is still a clinically significant response to cancer. Zainal et al . and Koo et al .…”

“…The distress thermometer has been validated, against the hospital and anxiety depression scale (HADS), General Health Questionnaire‐12 and Brief Symptom Inventory‐18 in America, in Japan and in Italy, Portugal, Spain and Switzerland . A previous study in Malaysia did use the distress thermometer as a screening tool, but did not validate the instrument . Mitchell et al .…”

Reliability and Validity of the Malay Version of the Breast-Impact of Treatment Scale (MVBITS) in Breast Cancer Women undergoing Chemotherapy

“…Both post-surgery and chemotherapy are known to precipitate psychological distress, anxiety or depression. Postsurgery breast cancer may lead to body image distress and chemotherapy agents may cause toxic side effects such as vomiting, fatigue, hair loss, etc (Zainal, 2012). Breast-Impact Treatment Scale (BITS) is a self-report questionnaire to measure the body image distress experienced by breast cancer patients after breast surgery.…”

Validity and Reliability Study of James Supportive Care Screening for Cancer Patients

“…[11] As seen in different researches conducted, distress, which is a multidimensional symptom, is seen in individuals diagnosed with cancer at varying rates. [9][10][11][12][13] Furthermore, there are many researches made proving that there are problems that exist causing individuals to experience distress in physical, social, and spiritual areas of life. [14][15][16][17][18][19][20][21][22] Thus, the problems experienced by individuals diagnosed with cancer and distress that occur as a result of these problems should be handled together.…”

“…[9] In a research made by Liao and his friends (2015) over 97 individuals diagnosed with cancer, it was stated that all of the patients experienced distress at intermediate level and that the level of distress had increased dur-…”