Assessment of distress in patients visiting pain and palliative out patient department of a tertiary care hospital in Assam
DOI:
https://doi.org/10.18203/2320-6012.ijrms20223259Keywords:
Distress, DT, Palliative care, CancerAbstract
Background: Distress is a multifactorial entity seen in patients battling with cancer. It is under-reported and under-managed posing a hurdle in providing holistic patient care. It has a negative effect on the treatment and treatment adherence in cancer patients.
Methods: A cross- sectional study was done in the pain and palliative outpatient clinic of State Cancer Institute, Guwahati, Assam. About 250 patients were screened for distress using a questionnaire consisting of national comprehensive cancer network (NCCN) distress thermometer (DT) and problem list over a span of 4 months after obtaining due consent. They were asked to mark their level of distress and the contributing factors for distress as enlisted in the NCCN DT problem list. Chi square test and Mann Whitney test were used to analyze statistical significance.
Results: The distress levels were assessed based on the effects of the disease, treatment and other demographic variables and possible causes contributing to distress were determined. It was noted that out of 250 patients screened (n=250), 88 (35.2%) reported a distress score of 4 while 79 (31.6%) reported with a score of 6. Nature of the disease and current treatment received by the patient was significantly associated with distress while age, marital status and sex was not. Amongst physical, emotional and practical problems leading to distress, pain (45.2%), worry (49.2%) and transportation issues (45.1%) respectively were significantly reported as primary causes of distress.
Conclusions: NCCN DT in an effective tool for assessment of distress in cancer patients of Assam. It helps in identification of probable causes of distress which aids in holistic patient care.
References
Report of National Cancer Registry Programme (ICMR-NCDIR), Bangalore, India. 2020.
Shanker N, Mathur P, Das P, Sathish KK, Shalini AJ. Martina C et al. Cancer scenario in North-East India and need for an appropriate research agenda. Ind J Med Res. 2021;154(1):27-35.
O'Brien C. Drug addiction and drug abuse. In: Brunton LB, Lazo JS, Parker KL, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill. 2005;607-29.
National Cancer Institute. Fact sheet: targeted cancer therapies, 2012. Available at: http://www.cancer.gov/cancertopics/factsheet/Therapy/targeted#q1. Accessed on 9 June 2014.
Cutillo A, O'Hea E, Person S, Lessard D, Harralson T, Boudreaux E. The Distress Thermometer: Cutoff Points and Clinical Use. Oncol Nurs Forum. 2017;44(3):329-36.
Wei G, Michael IB, Daniel S, Scott M, Irene JH. Psychological distress in cancer from survivorship to end of life care: Prevalence, associated factors and clinical implications. Eur J Cancer. 2010;46(11):2036-44.
Bandiwadekar AS, Shanbhag N, Manjunath P. Evaluation of distress among cancer patients in Bengaluru City: A cross-sectional study. J Ind Asso Public Heal Dentistry. 2020;18(1):92-6.
Grassi L, Rossi E, Caruso R, Nanni MG, Pedrazzi S, Sofritti S et al. Educational intervention in cancer outpatient clinics on routine screening for emotional distress: An observational study. Psychooncology. 2011;20:669 74.
Gil F, Grassi L, Travado L, Tomamichel M, Gonzalez JR, Southern European Psycho Oncology Study Group. Use of distress and depression thermometers to measure psychosocial morbidity among southern European cancer patients. Support Care Cancer. 2005;13:600 6.
Mahanta LB, Nath DC, Rajbongshi N. On the study of risk factors of Ca. cervix and Ca. breast: A case study in Assam. Bonfring Int J Data Min. 2012;2:27 31.
Bauwens S, Baillon C, Distelmans W, Theuns P. The ‘Distress Barometer’: Validation of method of combining the Distress Thermometer with a rated complaint scale. Psychooncology. 2009;18:534 42.
Dolbeault S, Boistard B, Meuric J, Copel L, Brédart A. Screening for distress and supportive care needs during the initial phase of the care process: A qualitative description of a clinical pilot experiment in a French cancer center. Psychooncology. 2011;20:585 93.
Jacobsen PB, Donovan KA, Trask PC, Fleishman SB, Zabora J, Baker F et al. Screening for psychologic distress in ambulatory cancer patients. Cancer. 2005;103:1494 502.
Akizuki N, Yamawaki S, Akechi T, Nakano T, Uchitomi Y. Development of an Impact Thermometer for use in combination with the Distress Thermometer as a brief screening tool for adjustment disorders and/or major depression in cancer patients. J Pain Symptom Management. 2005;29(1):91-9.
Mathy M. Advancing geriatric nursing practice; A Specialized Home Care Intervention Improves Survival Among Older Post-Surgical Cancer Patients. J Am Geriatr Society. 2000;48(12):1707-13.
