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Psychological Considerations

Assessment of psychological distress in prospective bone marrow transplant patients

Bone Marrow Transplantation volume 29, pages 917–925 (2002)Cite this article

Abstract

Patient psychological distress is associated with many aspects of the bone marrow transplantation (BMT) process and has been linked with poor treatment outcomes. We assessed psychological distress in potential BMT candidates, and compared patient and nurse coordinator ratings of emotional distress at the time of initial BMT consultation. Fifty patients self-reported psychological distress using both the NCCN Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS). Coordinators rated patient emotional distress using the DT and Coordinator Rating Scales that measure anxiety and depression. Fifty and 51% of patients self-reported clinically significant levels of emotional distress and anxiety, respectively, but only 20% self-reported clinically significant levels of depression. There was good correlation between ratings using the brief DT and the more comprehensive HADS. There was significant but only moderate agreement between patient and coordinator ratings of emotional distress and anxiety, with coordinators underestimating the number of patients with high levels of emotional distress. In addition, coordinator ratings of patient emotional distress primarily reflected anxiety, whereas anxiety and depression together only minimally accounted for patient self-reports of psychological distress. These findings suggest that: (1) the DT can be a useful screening device; (2) approximately half of patients at the time of initial consultation for BMT already experience significant levels of psychological distress; and (3) coordinators observe emotional distress primarily as anxiety, but patients experience psychological distress as something more than anxiety and depression.

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Acknowledgements

This study was funded by the University of Michigan Faculty Group Practice VIF No. 99–101 and NIH grant P30 CA46592.

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Authors and Affiliations

  1. Behavioral Medicine Program, University of Michigan Medical School and Comprehensive Cancer Center, Ann Arbor, MI, USA

    PC Trask & A Paterson

  2. Biostatistics Program, University of Michigan Medical School and Comprehensive Cancer Center, Ann Arbor, MI, USA

    K Griffith

  3. Department of Psychiatry, University of Michigan Medical School and Comprehensive Cancer Center, Ann Arbor, MI, USA

    M Riba

  4. Division of Hematology/Oncology, Departments of Internal Medicine and Pediatrics University of Michigan Medical School and Comprehensive Cancer Center, Ann Arbor, MI, USA

    B Brines, P Parker, J Weick, P Steele, K Kyro & J Ferrara

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  1. PC Trask
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Trask, P., Paterson, A., Riba, M. et al. Assessment of psychological distress in prospective bone marrow transplant patients. Bone Marrow Transplant 29, 917–925 (2002). https://doi.org/10.1038/sj.bmt.1703557

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