The Distress Thermometer: Cutoff Points and Clinical Use
The Distress Thermometer: Cutoff Points and Clinical Use
复制标题
窘迫温度计： 临界点和临床应用
DOI：
10.1188/17.onf.329-336
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发表时间：
2017-05-01
影响因子：
1.9
通讯作者：
Boudreaux, Edwin
中科院分区：
文献类型：
--
作者：
Cutillo, Alexandra;O'Hea, Erin;Boudreaux, Edwin
目的/目标：为国家综合癌症网络的痛苦温度计(DT)建立一个最佳的临界点，作为一种筛查措施，以识别和解决癌症患者的心理痛苦，并检查DT测量的痛苦是否在治疗轨迹上发生显著变化。设计：对一项纵向父母研究的基线数据进行二次分析，以检验计算机化的心理社会评估。背景：美国三个不同的综合癌症中心。样本：836名目前或过去被诊断为癌症的患者。方法：研究参与者选自随机临床试验。癌症治疗轨迹的任何阶段的患者都是在化疗输液或常规肿瘤科预约期间被招募的。主要研究变量：行为健康状况指数和DT被使用接收器操作特征分析进行比较。结果：DT上的截止分数为3，指示患者的临床痛苦水平升高。此外，在评估前1-4周内接受诊断的患者表示的痛苦程度最高。结论：提供者可能希望使用3的分界点来最有效地识别大量、多样化的癌症患者的痛苦。此外，研究结果表明，与癌症的其他应对阶段相比，患者在确诊后的1-4周内可能会经历一种高度的痛苦状态。护理启示：使用简单的痛苦测量可以帮助简化心理社会痛苦的筛查过程。
Purpose/Objectives: To establish an optimal cutoff point for the National Comprehensive Cancer Network's Distress Thermometer (DT) as a screening measure to identify and address psychological distress in individuals with cancer, and to examine whether distress as measured by the DT significantly changes across the treatment trajectory.Design: Secondary analyses of baseline data from a longitudinal parent study examining a computerized psychosocial assessment.Setting: Three diverse comprehensive cancer centers across the United States.Sample: 836 patients with a current or past diagnosis of cancer.Methods: Study participants were selected from a randomized clinical trial. Patients during any stage of the cancer treatment trajectory were recruited during a chemotherapy infusion or routine oncology appointment.Main Research Variables: The Behavioral Health Status Index and the DT were administered and compared using receiver operating characteristic analyses.Findings: Results support a cutoff score of 3 on the DT to indicate patients with clinically elevated levels of distress. In addition, patients who received a diagnosis within the 1-4 weeks prior to the assessment indicated the highest levels of distress.Conclusions: Providers may wish to use a cutoff point of 3 to most efficiently identify distress in a large, diverse population of patients with cancer. In addition, results indicate that patients may experience a heightened state of distress within 1-4 weeks post-diagnosis compared to other stages of coping with cancer.Implications for Nursing: Using a brief measure of distress can help streamline the process of screening for psychosocial distress.