Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

Kristi D. Graves, Susanne M. Arnold, Celia L. Love, Kenneth L. Kirsh, Pamela G. Moore, Steven D. Passik

Research output: Contribution to journalArticlepeer-review

279 Scopus citations

Abstract

Screening for distress in cancer patients is recommended by the National Comprehensive Cancer Network, and a Distress Thermometer has previously been developed and empirically validated for this purpose. The present study sought to determine the rates and predictors of distress in a sample of patients being seen in a multidisciplinary lung cancer clinic. Consecutive patients (N = 333) were recruited from an outpatient multidisciplinary lung cancer clinic to complete the Distress Thermometer, an associated Problem Symptom List, and two questions about interest in receiving help for symptoms. Over half (61.6%) of patients reported distress at a clinically significant level, and 22.5% of patients indicated interest in receiving help with their distress and/or symptoms. Problems in the areas of family relationships, emotional functioning, lack of information about diagnosis/treatment, physical functioning, and cognitive functioning were associated with higher reports of distress. Specific symptoms of depression, anxiety, pain and fatigue were most predictive of distress. Younger age was also associated with higher levels of distress. Distress was not associated with other clinical variables, including stage of illness or medical treatment approach. Similar results were obtained when individuals who had not yet received a definitive diagnosis of lung cancer (n = 134) were excluded from analyses; however, family problems and anxiety were no longer predictive of distress. Screening for distress in a multidisciplinary lung cancer clinic is feasible and a significant number of patients can be expected to meet clinical criteria for distress. Results also highlight younger age and specific physical and psychosocial symptoms as predictive of clinically significant distress. Identification of the presence and predictors of distress are the first steps toward appropriate referral and treatment of symptoms and problems that contribute to cancer patients' distress.

Original languageEnglish
Pages (from-to)215-224
Number of pages10
JournalLung Cancer
Volume55
Issue number2
DOIs
StatePublished - Feb 2007

Bibliographical note

Funding Information:
Supported by a Ruth L. Kirschstein National Research Service Award F32CA97760 from the National Cancer Institute (K.D. Graves). We thank Timothy Mullett, MD and Eric Bensadoun, MD, for support of the distress screening process and access to patients. We also thank Susan Revo and Stephen Erena, MS, for assistance with distress screening, and Mike Poynter for assistance with data extraction from the MLCP database.

Keywords

  • Distress Thermometer
  • Lung cancer
  • Predictors
  • Psychological distress
  • Screening

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

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