Haikel A Lim1, Rathi Mahendran2, Joanne Chua3, Chao-Xu Peh1, Siew-Eng Lim4, Ee-Heok Kua5. 1. Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore. 2. Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore; Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore. Electronic address: pcmrathi@nus.edu.sg. 3. Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore. 4. National University Cancer Institute, Singapore, National University Health System, NUHS Tower Block, Level 7, 1E Kent Ridge Road, 119228, Singapore. 5. Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore; Department of Psychological Medicine, National University Hospital, NUHS Tower Block, Level 9, 1E Kent Ridge Road, 119228 Singapore.
Abstract
INTRODUCTION: Research has shown that single-item tools, like the Distress Thermometer (DT), are comparable to longer ones, like the Hospital Anxiety and Depression Scale (HADS). In this study, we tested the validity of the DT in a population of Singapore cancer outpatients, and determined the cut-off scores on the DT for clinically relevant distress and an impaired quality of life (QOL). We also documented the prevalence of anxiety, depression, and QOL impairments in this population. METHODS: One hundred and five patients (Mdn age=51-60years, 64% female, and 71% Chinese) diagnosed with various cancers participated in this study. They completed a standard socio-demographic form, the DT and the Problem List, the HADS, and the EuroQOL Quality of Life Scale (EQ-5D). RESULTS: Almost a third of patients had clinically significant emotional distress, with 15%-16% having probable levels of anxiety and depression. Almost half (41%-55%) had an impaired QOL compared to Singapore population norms. Receiver operating characteristic curve analyses identified an area under the curve of 0.89 (SE=0.36, 95% CI [0.82, 0.96], p<.001) when compared to the HADS cut-off score of 15. A cut-off score of 5 on the DT had the best sensitivity (0.88) and specificity (0.81). Participants above the DT cut-off score of 5 reported significantly more emotional problems (worry, nervousness, depression, sadness), insurance/finance-related problems, and sleep problems. They also scored significantly lower on EQ-5D, with more QOL impairments in the domains of carrying out their usual activities and anxiety/depression. CONCLUSION: Levels of distress, anxiety, depression, and QOL impairments are high in this population. The DT was found to be a valid tool for distress screening in the Singapore cancer population, with a recommended cut-off score of 5.
INTRODUCTION: Research has shown that single-item tools, like the Distress Thermometer (DT), are comparable to longer ones, like the Hospital Anxiety and Depression Scale (HADS). In this study, we tested the validity of the DT in a population of Singapore cancer outpatients, and determined the cut-off scores on the DT for clinically relevant distress and an impaired quality of life (QOL). We also documented the prevalence of anxiety, depression, and QOL impairments in this population. METHODS: One hundred and five patients (Mdn age=51-60years, 64% female, and 71% Chinese) diagnosed with various cancers participated in this study. They completed a standard socio-demographic form, the DT and the Problem List, the HADS, and the EuroQOL Quality of Life Scale (EQ-5D). RESULTS: Almost a third of patients had clinically significant emotional distress, with 15%-16% having probable levels of anxiety and depression. Almost half (41%-55%) had an impaired QOL compared to Singapore population norms. Receiver operating characteristic curve analyses identified an area under the curve of 0.89 (SE=0.36, 95% CI [0.82, 0.96], p<.001) when compared to the HADS cut-off score of 15. A cut-off score of 5 on the DT had the best sensitivity (0.88) and specificity (0.81). Participants above the DT cut-off score of 5 reported significantly more emotional problems (worry, nervousness, depression, sadness), insurance/finance-related problems, and sleep problems. They also scored significantly lower on EQ-5D, with more QOL impairments in the domains of carrying out their usual activities and anxiety/depression. CONCLUSION: Levels of distress, anxiety, depression, and QOL impairments are high in this population. The DT was found to be a valid tool for distress screening in the Singapore cancer population, with a recommended cut-off score of 5.
Authors: Rathi Mahendran; Haikel A Lim; Joyce Y S Tan; Joanne Chua; Siew Eng Lim; Emily N K Ang; Ee Heok Kua Journal: Support Care Cancer Date: 2015-05-23 Impact factor: 3.603
Authors: Rathi Mahendran; Joanne Chua; Chao Xu Peh; Haikel A Lim; Emily N K Ang; Siew Eng Lim; Ee Heok Kua Journal: Support Care Cancer Date: 2014-03-11 Impact factor: 3.603
Authors: Michelle B Riba; Kristine A Donovan; Barbara Andersen; IIana Braun; William S Breitbart; Benjamin W Brewer; Luke O Buchmann; Matthew M Clark; Molly Collins; Cheyenne Corbett; Stewart Fleishman; Sofia Garcia; Donna B Greenberg; Rev George F Handzo; Laura Hoofring; Chao-Hui Huang; Robin Lally; Sara Martin; Lisa McGuffey; William Mitchell; Laura J Morrison; Megan Pailler; Oxana Palesh; Francine Parnes; Janice P Pazar; Laurel Ralston; Jaroslava Salman; Moreen M Shannon-Dudley; Alan D Valentine; Nicole R McMillian; Susan D Darlow Journal: J Natl Compr Canc Netw Date: 2019-10-01 Impact factor: 11.908
Authors: Lisa VanHoose; Lora L Black; Kimberly Doty; Dory Sabata; Philip Twumasi-Ankrah; Sarah Taylor; Rhonda Johnson Journal: Support Care Cancer Date: 2014-10-16 Impact factor: 3.603