Abstract
Emotional distress (ED) is greater for oncology patients in comparison with the general population, and this has implications for the quality of life of the patient and his/her family, adherence to the treatment, and eventually, survivorship. In general, the detection of these symptoms is low, which explains the need for detection systems appropriate to the clinical reality of the oncology team. The objective of this study is to evaluate for the first time the usefulness of an ultra-brief screening instrument [distress thermometer (DT)], in a group of Chilean oncology patients. A total of 166 outpatients were evaluated at the Cancer Center of the Pontificia Universidad Católica de Chile, before starting chemotherapy. Two screening instruments were applied: Hospital Anxiety and Depression Scale (HADS) and DT. The application of HADS resulted in a prevalence of 32.7% of anxiety symptoms (HADS-A ≥ 8), 15.7% of depression symptoms (HADS-D ≥ 8), and 39.8% had a total score of HADS-T ≥ 11. The DT resulted in the prevalence of 32.5% of distress or ED (DT ≥ 5). The validity of the DT was evaluated as a screening tool in comparison with HADS, observing, in relation to the anxiety scale (HADS-A), a sensitivity of 88.9% and specificity of 78.4% (DT ≥ 4); depression (HADS-D), a sensitivity of 69.2% and specificity of 74.3% (DT ≥ 5); and in relation to the total scale (HADS-T), a sensitivity of 68.2% and specificity of 73.0% (DT ≥ 4). This study demonstrates the elevated prevalence of emotional symptoms in Chilean oncology patients, before the start of chemotherapy, and confirms the potential of the DT as a brief screening instrument with easy application. The DT will allow the clinician to increase the detection threshold in the Chilean oncology population, intervene in a timely manner, and contribute to the comprehensive handling of the oncology patient without affecting the time needed for assistance.
Highlights
In 2012, around 14.1 million new cancer cases were diagnosed worldwide, reaching a mortality rate of around 8.2 million
The prevalence of emotional distress (ED) in oncology patients is of about 35% in the course of the illness [3, 4], and it is greater for young people, depending on the location of the tumour and the oncology illness of worst prognosis, with a greater risk for patients with a survival prognosis of less than one year [5]
Psychiatric co-morbidity in cancer patients increases the number of days of hospitalisation, the demand for medical attention, and the risk of suicide [6, 7]; it delays adaptation to the cancer diagnosis for at least a month, and it is associated with lower adherence to anti-neoplastic treatments [8]
Summary
In 2012, around 14.1 million new cancer cases were diagnosed worldwide, reaching a mortality rate of around 8.2 million. Psychiatric co-morbidity in cancer patients increases the number of days of hospitalisation, the demand for medical attention, and the risk of suicide [6, 7]; it delays adaptation to the cancer diagnosis for at least a month, and it is associated with lower adherence to anti-neoplastic treatments [8]. Depression symptoms increase sensitivity to pain and affect the rank and intensity of the side effects of the treatment, with a negative impact on the physical well-being and the social functioning of the patient [9]
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