Associations of practical, emotional, and physical problems with psychosocial distress among cancer patients

Abstract

Objective

To better understand the relationship between cancer patient distress and psychosocial variables, including problem types, to improve ability to predict and address psychosocial need.

Methods

A variation of National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) was administered and collected at four sites from an Integrated Network Cancer Program (INCP). The presence of moderate/severe distress was examined relative to patient demographics, disease characteristics, and psychosocial problems.

Results

Distress scores were positively correlated with all problem counts. For every count increase of practical, emotional, and physical problems, and for every cancer stage increase the odds of reporting a moderate/severe distress score was significantly higher. Relative to patients with one cancer treatment type, patients with three cancer treatment types were significantly less likely to report moderate/severe distress.

Conclusion

Problem count could be a useful indicator for clinical intervention. Stage and number of treatment types may also be considered clinically relevant distress predictors.

Implications for Psychosocial Research

This study found that NCCN Distress Thermometer distress levels and problem counts are highly correlated in most cancer patients.

In addition to distress level, problem count on NCCN Distress Thermometer should be considered a potential trigger for psychosocial intervention.

NCCN Distress Thermometer problem count may be a more durable indicator of need for psychosocial intervention then distress level alone. Psychosocial problems are rarely transient, while distress level can fluctuate day-to-day.

Future research should examine the role of psychosocial problems on continuous distress scores and the relative contribution of each set of problem types on distress.

Keywords:

• Cancer
• distress
• patient assessment
• psychosocial
• quality of life
• symptom management

Acknowledgements

The authors would like to thank the Piedmont Healthcare oncology staff and leadership for their support of this study.

Conflict of interests

The authors have no conflicts of interests to disclose, financial or otherwise.

Ethical statement

This study was carried out in accordance with Good Clinical Practice (GCP) as required by the United States Code of Federal Regulations (CFR) applicable to clinical studies (45 CFR Part 46, 21 CFR Part 50, 21 CFR Part 56, and 21 CFR Part 312). The study was approved by Piedmont Healthcare Institutional Review Board on 8/17/2017 and assigned number 1084390-2. All participants provided informed consent. No serious or unexpected adverse events occurred during the study.