Shim Eun-Jung, Shin Yong-Wook, Jeon Hong Jin, Hahm Bong-Jin
Institute of Human Behavioral Medicine, Medical Research Institute, Seoul National University, Chongno-gu, Seoul, South Korea.
Psychooncology. 2008 Jun;17(6):548-55. doi: 10.1002/pon.1275.
The distress thermometer (DT), a one-item measure for distress, provides a means for rapidly and effectively screening psychological distress in cancer patients. In this pilot study, a screening efficacy of the DT was investigated in a mixed cohort of 108 Korean cancer patients. Participants completed the DT, the problem list (PL), and the Hospital Anxiety and Depression Scale (HADS), and answered questions regarding supportive needs and their degree of satisfaction with several aspects of care. Receiver operating characteristic (ROC) curve analyses indicated that a DT cutoff score of 4 yielded an area under the ROC curve of 0.75 with a sensitivity of 0.83 and a specificity of 0.59 for HADS-total score defined cases (> or =15). HADS--Anxiety and Depression subscale scores explained 27% of the variability in the DT scores, implying that 'distress' is a broader concept that includes anxiety and depressive symptoms but has a more comprehensive meaning that encompasses multiple contributory factors. Regarding the PL, distressed patients (DT> or =4) reported significantly more problems (23 of 35) in all categories, suggesting, although degrees differ, that a wide variety of problems contribute to distress in cancer patients. Distress as defined by DT and HADS subscale scores was also significantly associated with higher supportive needs, a poor ECOG performance status (both physician and patient-rated), and a reduced level of satisfaction with treatment, staff, and communications. In conclusion, the DT and the PL were found to be simple yet effective screening instruments for detecting psychosocial distress in Korean cancer patients, and for identifying problems that warrant intervention.
痛苦温度计（DT）是一种用于测量痛苦的单项工具，为快速有效地筛查癌症患者的心理痛苦提供了一种方法。在这项试点研究中，对108名韩国癌症患者的混合队列进行了DT筛查效能的调查。参与者完成了DT、问题清单（PL）和医院焦虑抑郁量表（HADS），并回答了关于支持需求以及他们对护理几个方面的满意度的问题。受试者工作特征（ROC）曲线分析表明，对于HADS总分界定的病例（≥15分），DT临界值为4时，ROC曲线下面积为0.75，灵敏度为0.83，特异性为0.59。HADS焦虑和抑郁子量表得分解释了DT得分中27%的变异性，这意味着“痛苦”是一个更宽泛的概念，它包括焦虑和抑郁症状，但具有更广泛的含义，涵盖多个促成因素。关于PL，痛苦患者（DT≥4）在所有类别中报告的问题显著更多（35个中的23个），这表明尽管程度不同，但各种各样的问题都会导致癌症患者的痛苦。DT和HADS子量表得分所定义的痛苦也与更高的支持需求、较差的ECOG表现状态（医生和患者评定）以及对治疗、医护人员和沟通的满意度降低显著相关。总之，DT和PL被发现是用于检测韩国癌症患者心理社会痛苦以及识别需要干预的问题的简单而有效的筛查工具。
