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The Distress Thermometer (DT) is a well validated screening tool, demonstrably sensitive and reasonably specific to the construct of distress in cancer. Its brevity makes it ideal to incorporate into a system of distress management. To ascertain how far this idea has been developed in practice, and to support future research, a literature review wa...
Contexts in source publication
Context 1
... authors of the present article suggest that these quality criteria should extend to include all research. These quality criteria were therefore applied to the literature searching process, regardless of paradigm, in order to justify inclusion in the first instance ( Table 2). Articles that did not meet these criteria were excluded. ...
Context 2
... ease of reporting, the results were categorized according to the purpose of the original study. Those studies categorized within Table 2 as 'Comparative Analysis' (CA) referred to any study in which the primary purpose was to compare the DT or an amendment of the DT with another scale for the purpose of ascertaining its validity. 'Implementation Study' (IS) referred to any examination of the utility of the DT or a distress management programme in clinical practice. ...
Context 3
... Study' (IS) referred to any examination of the utility of the DT or a distress management programme in clinical practice. Table 2 shows summaries of 30 comparative analyses and 10 implementation studies. It is interesting to note that of these 40 studies, only 11 recommended further comparative analyses. ...
Citations
... Perceived short-term stress was measured using the Distress Thermometer (DT) [37], a single-item screening tool known for its high sensitivity and specificity in capturing short-term stress [38]. This instrument has previously been validated for use in the Italian context [33,35]. ...
Background: Recent advances in psychophysiology have underscored the importance of autonomic nervous system modulation in managing short-term stress. While several interventions have demonstrated efficacy in reducing short-term stress and anxiety symptoms, there remains a gap in understanding how different short-term techniques compare in terms of both psychological and physiological outcomes. This study investigated the effects of a single session of the Brain Wave Modulation Technique (BWM-T) compared with a psychoeducational session on short-term stress management. Methods: A total of 72 university students participated in this study (mean age = 27.5 years, 79% female). They were randomly assigned to either an experimental group (n = 36) receiving BWM-T or a control group (n = 36) receiving a standard psychoeducational short-term stress management session. Pre- and post-intervention measures included HRV parameters, perceived stress (using the Distress Thermometer, DT), and anxiety (using the STAI-Y State Anxiety Scale, S-ANX). Results: Both groups experienced significant reductions in perceived stress (DT: MD = 1.42, p < 0.001) and anxiety (S-ANX: MD = 6.93, p < 0.001). However, only the experimental group demonstrated physiological changes indicative of improved autonomic function: decreased low-frequency (LF) power (MD = −0.369, p < 0.05) and a lower LF/HF ratio (MD = −1.09, p < 0.05). These findings highlight the unique physiological benefits of BWM-T, beyond the general psychological improvements seen in both interventions. Conclusions: BWM-T appears to be a promising, effective short-term intervention for reducing short-term stress and enhancing autonomic regulation. Further studies are needed to evaluate its long-term effects and potential for broader implementation.
... The thermometer allows patients to indicate their psychological burden on a numerical scale from 0 to 10." 0 "represents" "no burden" and "10" represents "very burdened." Over the years, the thermometer has been validated through numerous studies [9]. ...
... In addition, 70.3% of patients had a high-risk HPV subtype. Patients' overall psychological distress was assessed using the Distress Thermometer [9]. For analysis, responses from 1 to 5 were grouped as "not distressed" and responses from 6 to 10 were grouped as "distressed". ...
Purpose
This study aims to investigate the psychological distress experienced by patients with an initial diagnosis of abnormal Pap smears or dysplastic changes of the cervix uteri. It investigated whether patients’ age, education, information level and approach to information acquisition have an impact on their psychological distress.
Methods
A total of 364 female patients, aged 20–80 years, referred to the special dysplasia consultation hour at the Department of Obstetrics and Gynecology, Wuerzburg, completed a questionnaire containing validated items to assess information level, information acquisition, information needs and psychological distress, including a distress thermometer. Data from questionnaires and medical reports were used for analysis.
Results
The study found that 56.9% of patients experienced psychological distress before their first visit. Patients under 44 years of age, especially those with concerns about fertility and sexuality, and those with lower levels of education showed higher levels of distress (p-value = 0.018 and p-value = 0.037). 40.9% of patients felt poorly informed and 53.7% of patients wanted more information before their visit. Correlational analysis showed that the method of obtaining information correlated with the desire for more information (p-value < 0.001). Those who received information via the Internet felt less informed, wanted more information and experienced more anxiety.
Conclusion
These findings highlight the need for improved patient education strategies and effective doctor-patient communication to address the knowledge gap and reduce patient distress. In addition, healthcare providers should ensure that patients have access to reliable online resources for accurate information.
... The ePROM comprise five validated, multidimensional assessment questionnaires for symptoms and needs: the Personal Health Questionnaire-8 (PHQ8) (Kroenke et al. 2009;Kroenke et al. 2010), Generalized Anxiety Disorder-7 (GAD-7) (Plummer et al. 2016), Minimal Documentation System (MIDOS2) (Stiel et al. 2010), Hornheider Screening Instrument (HSI) (Buchhold et al. 2020), and the Distress Thermometer (Ownby et al. 2019;Snowden et al. 2011). In addition, it also assesses the patient's subjective need for palliative or psycho-oncological support (for a detailed sample of all ePROM questions and possible answers, refer to our supplements). ...
Purpose
The Minimal Documentation System (MIDOS2) is recommended as a systematic screening tool for assessing symptom burden and patient needs in advanced cancer patients. Given the absence of an optimal weighting of individual symptoms and a corresponding cut-off value, this study aims to determine a threshold based on inpatient’s subjective need for palliative support. Additionally, we investigate the correlation between symptom burden and subjective need for palliative support collected through a patient-reported outcome measure (PROM) with survival duration of less or more than one year.
Methods
Inpatients diagnosed with advanced solid cancer completed an electronic PROM, which included the MIDOS2 questionnaire among other tools. Differences in symptom burden were analysed between patients expressing subjective need for palliative support and those with survival of less or more than one year using ANOVA, Mann–Whitney-U Test, logistic regression, Pearson and Spearman correlation tests. Cut-off analyses were performed using a ROC curve. Youden-Index, sensitivity, and specificity measures were used as well.
Results
Between April 2020 and March 2021, 265 inpatients were included in the study. Using a ROC curve, the MIDOS2 analysis resulted in an Area under the curve (AUC) of 0.732, a corresponding cut-off value of eight points, a sensitivity of 76.36% and a specificity of 62.98% in assessing the subjective need for palliative support. The MIDOS2, with double weighting of the significant symptoms, showed a cut-off value of 14 points, achieving a sensitivity of 78.18% and a specificity of 72.38%. A total of 55 patients (20.8%) expressed a need for support from the palliative care team. This need was independent of the oncological tumour entity and increased among patients with a survival of less than one year. These patients reported significantly poorer physical (p < 0.001) or mental (p < 0.001) condition. Additionally, they reported higher intensities of pain (p = 0.002), depressive symptoms (p < 0.001), weakness (p < 0.001), anxiety (p < 0.001), and tiredness (p < 0.001).
Conclusion
Using the established MIDOS2 cut-off value with an adjusted double weighting in our study, a large proportion of inpatients may be accurately referred to SPC based on their subjective need for palliative support. Additionally, subjective reports of poor general, mental, and physical condition, as well as pain, depressive symptoms, weakness, anxiety, and tiredness, increase the subjective need for palliative support, particularly in patients with a survival prognosis of less than one year.
... If the respondent can describe their perception of stress in the first part, they can indicate in the second part which problems this perception relates to. The first part is a quick screening instrument in which participants rate their level of stress in the past week on an analogue visual scale (a single item) from 0 (not stressed) to 10 (extremely stressed), and it is considered a reliable measure of stress perception (Snowden et al., 2011). As stated by the National Cancer Institute, most studies use a cut-off score of 4 or 5 to indicate the presence of stress that could affect health. ...
Police job, because of its inherent characteristics, predisposes to work in stressful contexts on a daily basis. The features of the work environment, such as a good organizational climate, could play an important role in maintaining a good level of job satisfaction. The aim of the present study is to investigate, using OLS regressions, which climate dimensions predict job satisfaction and stress in a sample of police workers (N = 665) in Northern Italy. In addition, the differences between groups in terms of organizational climate and stress are examined, especially in relation to role (police officers vs. other roles) and gender. Results showed that all dimensions of workplace climate (except fairness, autonomy and communication) were positively and significantly associated with job satisfaction, while job description, job involvement, team and leadership were negatively and significantly associated with stress. Compared to the differences between groups, police officers showed significantly more critical scores on most of the variables included in the analyses (workplace climate and stress); in terms of gender, women showed more negative scores on stress symptoms (relational problems, emotional distress and physical problems) and more positive perceptions of organizational fairness. This study offers new insights into the critical role of police officers and gender differences in the police force. The importance of supporting and maintaining a good organizational climate in such a critical profession is also confirmed.
... The thermometer allows patients to indicate their psychological burden on a numerical scale from 0 to 10. "0" represents "no burden" and "10" represents "very burdened." Over the years, the thermometer has been validated through numerous studies [9]. ...
... In addition, 70.3% of patients had a high-risk HPV subtype. Patients' overall psychological distress was assessed using the Distress Thermometer [9]. For analysis, responses from 1 to 5 were grouped as "not distressed" and responses from 6 to 10 were grouped as "distressed". ...
Purpose: This study aims to investigate the psychological distress experienced by patients with initial diagnosis of abnormal Pap smears or dysplastic changes of the cervix uteri. It is investigated whether patients' age, education, information level and approach to information acquisition have an impact on their psychological distress.
Methods: A total of 364 female patients, aged 20-80 years, referred to the special dysplasia consultation hour at the Department of Obstetrics and Gynecology, Wuerzburg, completed a questionnaire containing validated items to assess information level, information acquisition, information needs and psychological distress, including a distress thermometer. Data from questionnaires and medical reports were used for analysis.
Results: The study found that 56.9% of patients experienced psychological distress before their first visit. Patients under 44 years of age, especially those with concerns about fertility and sexuality, and those with lower levels of education showed higher levels of distress (p-value=0.018 and p-value=0.037). 40.9% of patients felt poorly informed and 53.7% of patients wanted more information before their visit. Correlational analysis showed that the method of obtaining information correlated with the desire for more information (p-value <0.001). Those who received information via the Internet felt less informed, wanted more information and experienced more anxiety.
Conclusion: These findings highlight the need for improved patient education strategies and effective doctor-patient communication to address the knowledge gap and reduce patient distress. In addition, healthcare providers should ensure that patients have access to reliable online resources for accurate information.
... A simplified version of the Distress Thermometer (DT without the problem list) for pre-and post-treatment scores was used for the hospitalized patients who were treated occasionally. (12) At the request of the Trust, the service was extended to St Bartholomew's Hospital (Barts), first in 2016 for outpatients who have an appointment to receive chemotherapy, and later in 2017 to hospitalized patients in the cancer wards. During the time the data were collected, the service was offered two days per week with CITs being offered on Mondays for outpatients and on Mondays and Thursdays for hospitalized patients. ...
Background:
The paper sets out the development, validity, and responsiveness of the Integrative Medicine Treatment Evaluation Form (IMTEF), which has been designed to measure the effects of complementary and integrative therapy (CIT) interventions in cancer and palliative care (PC) patients in a National Health Service (NHS) hospital setting. Treatment evaluation is essential for ensuring safety and quality of services, for meeting NHS governance requirements. It also helps to add to the evidence base for complementary and integrative therapies through collecting data about treatments.
Methods:
A number of different Patient Reported Outcome Measures (PROMs) tools were reviewed in order to design the IMTEF, which details questions that captures both quantitative and qualitative data. The IMTEF was reviewed by patients and a range of health care practitioners.
Results:
IMTEF's validity is supported by feedback from health care practitioners and patients, by its ability to detect different degrees of change in relation to change scores, and by its correlations with Visual Analog Scale (VAS) scores.
Conclusion:
The IMTEF can be used to assess the effects of therapeutic bodywork and CITs when many of the patients do not have the capacity or the time to answer many questions, and when therapists do not know in advance the number of treatments that patients will be able to receive. Because of the way it is structured, it can also assess the effects after a number of sessions.
... 0 is no distress and 10 is extreme distress." 11 Moral distress was measured using a visual representation of a thermometer with ratings from "none" to "worst possible," and included a prompt with a definition of moral distress: "Moral distress occurs when you believe you know the ethically correct thing to do, but something or someone restricts your ability to pursue the right course of action." 12 Psychological outcomes included anxiety and depression as measured by the PHQ-4 utilizing the prompt, "Since the day the code occurred, how often have you been bothered by the following problems?" ...
Background
In-hospital resuscitation events have complex and enduring effects on clinicians, with implications for job satisfaction, performance, and burnout. Ethically ambiguous cases are associated with increased moral distress. We aim to quantitatively describe the multidisciplinary resuscitation experience.
Methods
Multidisciplinary in-hospital healthcare professionals at an adult academic health center in the Midwestern United States completed surveys one and six weeks after a resuscitation event. Surveys included demographic data, task load (NASA-TLX), overall and moral distress, anxiety, depression, and spiritual peace. Spearman’s rank correlation was computed to assess task load and distress.
Results
During the 5-month study period, the study included 12 resuscitation events across six inpatient units. Of 82 in-hospital healthcare professionals eligible for recruitment, 44 (53.7%) completed the one-week post-resuscitation event survey. Of those, 37 (84.1%) completed the six-week survey. Highest median task load burden at one week was seen for temporal demand, effort, and mental demand. Median moral distress scores were low, while “at peace” median scores tended to be high. There were no significant non-zero changes in task load or distress scores from weeks 1–6. Mental demand (r = 0.545, p < 0.001), physical demand (r = 0.464, p = 0.005), performance (r = −0.539, p < 0.001), and frustration (r = 0.545, p < 0.001) significantly correlated with overall distress. Performance (r = −0.371, p = 0.028) and frustration (r = 0.480, p = 0.004) also significantly correlated with moral distress.
Conclusions
In-hospital healthcare professionals’ experiences of resuscitation events are varied and complex. Aspects of task load burden including mental and physical demand, performance, and frustration contribute to overall and moral distress, deserving greater attention in clinical contexts.
... Adolescents were asked, "What is your overall stress level about your diabetes right now?" on a Likert scale ranging from "1" I'm not at all stressed to "5" I'm moderately stressed, to "10" I'm extremely stressed. Stress-o-meters have been validated in populations experiencing chronic illness (Keegan et al., 2015;Linehan et al., 2017;Snowden et al., 2011). Acute diabetes-specific stress was assessed at baseline. ...
Objective:
Youth and adolescents with type 1 diabetes (T1D) are at risk for poor health outcomes. Understanding if psychological factors shortly following diagnosis, such as diabetes distress and resilience, predict glycated hemoglobin (A1C) trajectories may help inform both optimal timing and content of psychosocial interventions for youth with T1D.
Methods:
Youth and adolescents (N = 34) with newly diagnosed T1D completed distress and resilience measures at baseline and 3 months following diagnosis. Using multilevel modeling, we predicted A1C trajectories up to 3 years following diagnosis.
Results:
We found that in separate models, higher 3-month diabetes distress and lower 3-month resilience predicted larger increases in A1C years 1-3 following diagnosis.
Conclusions:
Our findings suggest that targeting resilience and diabetes distress within 3 months following diagnosis has implications for the yearly rate of A1C increase up to 3 years later.
... Research into the clinical utility of the DT and PCL in adult populations has thus far focused on its ability to accurately identify patients experiencing clinically significant levels of distress and, to a lesser extent, its acceptability; relatively little work has explored its accessibility, practicability or service responsiveness (Snowden et al., 2011). It is unclear whether use of the DT/PCL improves patient outcomes, perhaps because screening has not consistently led to increased referrals for support in these implementation studies (Snowden et al., 2011). ...
... Research into the clinical utility of the DT and PCL in adult populations has thus far focused on its ability to accurately identify patients experiencing clinically significant levels of distress and, to a lesser extent, its acceptability; relatively little work has explored its accessibility, practicability or service responsiveness (Snowden et al., 2011). It is unclear whether use of the DT/PCL improves patient outcomes, perhaps because screening has not consistently led to increased referrals for support in these implementation studies (Snowden et al., 2011). More recent research has largely replicated these findings (e.g. ...
Objective
Routine psychosocial screening and assessment of people diagnosed with cancer are crucial to the timely detection of distress and provision of tailored supportive care; however, appropriate screening tools have been lacking for adolescents and young adults (AYAs), who have unique needs and experiences. One exception is the recently validated AYA Psycho-Oncology Screening Tool (AYA-POST) for use with young people aged 15–29 years, which comprises a distress thermometer and age-specific needs assessment. This study investigates the clinical utility of this measure, as well as the subsequent service responsiveness within the Australian Youth Cancer Services.
Method
In total, 118 AYAs and 29 healthcare professionals: (HCPs) completed surveys about the clinical utility of the AYA-POST; a subset of 30 AYAs completed a 3-month follow-up survey assessing service responsiveness. Descriptive statistics (frequencies/means) were computed for all items, with chi-square analyses used to explore whether perceived clinical utility varied with AYA age, AYA sex, HCP discipline or HCP length of time using the AYA-POST.
Results
Participants’ responses demonstrate high levels of satisfaction with the tool, evidencing its appropriateness, practicability and acceptability. Moreover, the AYA-POST was reported to facilitate communication about psychosocial needs and prompt referrals, indicating good service responsiveness. Ratings of clinical utility did not differ significantly between AYA and HCP groups.
Conclusion
This study demonstrates that the AYA-POST is an appropriate tool in the psychosocial screening of AYAs with cancer, facilitating the identification of distress and unique concerns in this population and valuable in triaging and tailoring care for young cancer patients.
... This instrument has been developed for patients with cancer with the aim of identifying personal needs and problem areas that may require help. The DT has been shown to be a valid and useful screening instrument [7][8][9]. The DT has also been validated in parents of children with a chronic disease [10]. ...
... The DT and PL have been validated in Dutch [7]. The DT showed to be valid to measure distress in a population of patients with cancer [8]. A widely used cut-off point for clinically significant distress is ≥5. ...
Burn survivors may benefit from screening for a broad area of problems to improve communication and inform referral needs. Therefore, the aim of this study was to investigate clinical utility aspects such as appropriateness and acceptability to clinicians and completers of an existing, frequently used screening instrument in oncological populations, the Distress Thermometer and Problem List (DT and PL). Methods: Paediatric and adult patients visiting the outpatient clinic after admission to the burn centre were invited to complete the instrument. The DT and (problem domains of) the PL were related and compared to the need to discuss the reported problems. Results: A total of 160 patients were invited to complete the DT and PL, of which 139 agreed. The study shows evidence for appropriateness and high acceptability to clinicians and completers, although the effectiveness of the PL may be lower compared to the DT and needs adaptation to better meet the burn survivors’ situation. Discussion: The use of a screening instrument in the outpatient clinic environment has shown to be appropriate and acceptable and informs clinical practice to identify supportive needs in patients with burns. However, the PL needs to be adapted to the situation of the burn survivors.
