PURPOSE: The purpose of this project was to implement routine distress screening as standard of care in a Lung Cancer Evaluation Center, evaluate scores to determine the prevalence of distress in this population and to identify associated risk factors that may contribute to high distress.
METHODS: Measurements of distress were obtained using National Comprehensive Cancer Network’s Distress Thermometer (DT). The DT is a visual analogue tool which measures distress on a scale of 0 through 10. Scores were linked to clinical variables including visit type, gender, age, co-morbidities, cancer stage, treatment history and support.
RESULTS: The distress readings of the 127 patients screened revealed stress levels of 4 or greater in 65 percent of the patients. The NCCN recommends that distress thermometer reading of 4 or higher warrants a minimum of further questioning related to patient distress. Referrals to psychosocial support are often indicated based on this score.There was a positive correlation between the following variables: gender and distress with woman being at greater risk for distress than men; age and distress with distress scores higher as age increased; distress and cancer treatments with higher distress amongst patients with history of chemotherapy or surgery. There was a 100% frequency of high distress in lung cancer patients staged 2A or higher.
CONCLUSION: Distress is a common occurrence in patients with lung cancer and those at risk for lung cancer. Distress screening must be the standard in all settings where cancer care is given. This is particularly important given today’s trend toward limited clinician/patient time. Distress monitoring is vital in recognizing the distressed patient for appropriate interventions and referrals. Further research is needed in this area to evaluate the relationship between distress and quality of life, morbidity and mortality rates and health care cost.
CLINICAL IMPLICATIONS: The data stresses the importance of routine distress monitoring in patients being evaluated or treated for lung cancer. The distress thermometer is a quick and easy to administer tool to evaluate patient distress in this setting.
DISCLOSURE: April Plank, No Financial Disclosure Information; No Product/Research Disclosure Information