Skip to main content
SpringerLink
Log in

Validation and reliability of distress thermometer in Chinese cancer patients

  • Original Article
  • Published:
Chinese Journal of Cancer Research

Abstract

Objective

To examine the validation and reliability of the distress thermometer (DT) recommended by National Comprehensive Cancer Network (NCCN) in Chinese cancer patients.

Methods

A total of 574 Chinese cancer patients from Beijing Cancer Hospital completed the detection of DT, the Hospital Anxiety and Depression Scale (HADS) and Symptom Checklist 90 (SCL-90), Receiver Operating Characteristic (ROC) curve and Area Under the Curve (AUC) were used to analyze the validation relative to HADS and SCL-90. The patients with DT≥4 and whose distress caused by emotional problems were interviewed with the MiNi International Neuro-psychiatric Interview (MINI) (Chinese Version 5.0). This version was used to analyze cancer patients’ psychological and Psychiatric symptoms during the cancer process; 3. Another 106 cancer patients in rehabilitation stage and stable condition were asked to fill in DT two times, at the base time and after 7–10 days.

Results

Data of ROC indicates that a DT cutoff score of 4 yielded AUC of 0.80 with a optimal sensitivity (0.80) and specificity (0.70) relative to HADS, and AUC of 0.83 with the greatest sensitivity (0.87) and specificity (0.72) against SCL-90. The DT also has acceptable test-retest reliability (r=0.800, P=0.000); According to the interview results, the most common psychiatric problems cancer patients have adjustment disorder, depression, and anxiety.

Conclusion

The data suggest that DT has acceptable overall accuracy and reliability as a screening tool for testing distress severity and specific problems causing distress in Chinese cancer patients. It is worth being used in oncology clinic, the rapid screening and interview could help caregivers to identify psychological and psychiatric problems of cancer patients and provide useful information for further treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Cancer Society & National Comprehensive Cancer Network. (2005). Distress Treatment guidelines for patients-Version II/July 2005. Retrieved October 3, 2005, Available from http://www.nccn.org/patients_gls/_english/_distress/contents.aps

  2. Maguire P. Improving the detection of psychiatric problems in cancer patients. Soc Sci Med 1985; 20:819–823.

    Article  PubMed  CAS  Google Scholar 

  3. Zabora J, Brintzenhofeszoc K, Curbow B, et al. The prevalence of psychological distress by cancer site. Psychooncology 2001; 10:19–28.

    Article  PubMed  CAS  Google Scholar 

  4. Stark D, Kiely M, Smith A, et al. Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life. J Clin Oncol 2002; 20:3137–3148.

    Article  PubMed  CAS  Google Scholar 

  5. Söllner W, DeVries A, Steixner E, et al. How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 2001; 84:179–185.

    Article  PubMed  Google Scholar 

  6. McDonald MV, Passik SD, Dugan W, et al. Nurses’ recognition of depression in their patients with cance. Oncol Nurs Forum 1999; 26:593–599.

    PubMed  CAS  Google Scholar 

  7. Bultz BD, Carlson LE. Emotional distress: the sixth vital sign in cancer care. J Clin Oncol 2005; 23:6440–6441.

    Article  PubMed  Google Scholar 

  8. Zhang YN, Zhang HW, Tang LL. Application of the NCCN Distress Thermometer in Chinese cancer Patients. Chin Ment Health J (in Chinese) 2010; 12:897–902.

    Google Scholar 

  9. Roth AJ, Kornblith AB, Batel-Copel L, et al. Rapid screening for psychological distress in men with prostate carcinoma: a pilot study. Cancer 1998; 82:1904–1908.

    Article  PubMed  CAS  Google Scholar 

  10. Jacobsen PB, Donovan KA, Trask PC, et al. Screening for psychological distress in ambulatory cancer patients. Cancer 2005; 103:1494–1502.

    Article  PubMed  Google Scholar 

  11. Shim EJ, Shi YW, Jeon HJ, et al Distress and its correlates in Korean cancer patients: pilot use of the distress thermometer and the problem list. Psychooncology 2008. 17:548–555.

    Article  PubMed  Google Scholar 

  12. Gessle S, Low J, Daniells E, et al. Screening for distress in cancer patients: is the distress thermometer a valid measure in the UK and does it measure change over time? A prospective validation study. Psychooncology 2008; 17:538–547.

    Article  Google Scholar 

  13. Recklitis CJ, Licht I, Ford J, et al. Screenning adult survivors of childhood cancer with the distress thermometer: a comparison with the SCL-90-R. Psychooncology 2007; 16:1046–1049.

    Article  PubMed  Google Scholar 

  14. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Distress management, version 1. 2008. Available from: http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf

  15. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983 67:361–370.

    Article  PubMed  CAS  Google Scholar 

  16. Barczak P, Kane N, Andrews S, et al. Patterns of psychiatric morbidity in a genitor-urinary clinic. A validation of the Hospital Anxiety Depression scale (HAD). Br J Psychiatry 1988; 152:698–700.

    Article  PubMed  CAS  Google Scholar 

  17. Bjelland I, Dahl AA, Haug TT, et al. The validity of the Hospital Anxiety and Depression Scale. An update literature review. J Psychosom Res 2002; 52:69–77.

    Article  PubMed  Google Scholar 

  18. Ye WF, Xu JM. Application and evaluation of hospital anxiety and depression scale in general hospital patients. Chin Behav Med J (in Chinese) 1993; 2:17–19.

    Google Scholar 

  19. Derogatis LR. How to use the Symptom Distress Checklist (SCL-90) in clinical evaluations, Psychiatric Rating Scale, Vol II. Self-Report Rating Scale, Hoffmann-La Roche Inc.

  20. Jin H, Wu WY, Zhang MY. Preliminary analysis of SCL-90 results in normal Chinese. Chin J Nerv Ment Dis (in Chinese) 1986; 12:260–263.

    Google Scholar 

  21. Karnofsky DA. The use of nitrogen mustards in the palliative treatment of carcinoma. Cancer 1948; 1:634–656.

    Article  Google Scholar 

  22. Yates JW, Chalmer B, McKegney FP. Evaluation of patients with advanced cancer using karnofsky performance status. Cancer 1980; 45:2220–2224.

    Article  PubMed  CAS  Google Scholar 

  23. Lecrubier Y, Sheehan DV, Weiller E, et al. The mini international neuropsychiatric interview (MINI). A short diagnostic structured interview: reliability and validity according to CIDI [J]. Eur Psychiatry 1997; 12:224–231.

    Article  Google Scholar 

  24. Spitzer RL, Williams JB, Gibbon M, et al. The structured clinical interview for DSM-III-R (SCID). I. History, rationale, and description. Arch Gen Psychiatry 1992; 49:624–629.

    PubMed  CAS  Google Scholar 

  25. World Health Organization. The Composite International Diagnostic Interview (CIDI), Authorized Core, Version 1.0. Geneva: WHO Press; 1990.

    Google Scholar 

  26. Si TM, Shu L, Dang WM, et al. Evaluation of the reliability and validity of Chinese version of the mini international neuropsychiatric interview in patients with mental disorders. Chin Mental Health J (in Chinese) 2009; 23:439–503.

    Google Scholar 

  27. Derogatis LR, Morrow GR, Fetting J, et al. The prevalence of psychiatric disorders among cancer patients. J Am Med Assoc 1983; 249:751–757.

    Article  CAS  Google Scholar 

  28. Glover J, Dibble SL, Dodd MJ, et al. Mood states of oncology outpatients: does pain make a difference? J Pain Symptom Manage 1995; 10:120–128.

    Article  PubMed  CAS  Google Scholar 

  29. Ayres A, Hoon PW, Franzoni JB, et al. Influence of mood and adjustment to cancer on compliance with chemotherapy among breast cancer patients. J Psychosom Res 1994; 38:393–402.

    Article  PubMed  CAS  Google Scholar 

  30. Lee MS, Love SB, Mitchell JB, et al. Mastectomy or conservation for early breast cancer: psychological morbidity. Eur J Cancer 1992; 28A:1340–1344.

    Article  PubMed  CAS  Google Scholar 

  31. Passik SD, Dugan W, McDonald MV, et al. Oncologists’ recognition of depression in their patients with cancer. J Clin Oncol 1998; 16:1594–1600.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, 100142, China

    Li-li Tang, Ye-ning Zhang, Ying Pang, Hai-wei Zhang & Li-li Song

Authors
  1. Li-li Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ye-ning Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ying Pang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hai-wei Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Li-li Song
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Li-li Tang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tang, Ll., Zhang, Yn., Pang, Y. et al. Validation and reliability of distress thermometer in Chinese cancer patients. Chin. J. Cancer Res. 23, 54–58 (2011). https://doi.org/10.1007/s11670-011-0054-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11670-011-0054-y

Key words

Search

Navigation