Department of Population Sciences, City of Hope Medical Center, Duarte, California 91010, USA.
Psychooncology. 2011 Dec;20(12):1324-33. doi: 10.1002/pon.1859. Epub 2010 Oct 5.
Empirically based data support the validity of the distress thermometer recommended by the National Comprehensive Cancer Network as a standard screen for patient distress. However, the feasibility and utility of the distress thermometer has not been studied in the pediatric oncology setting. We conducted a study to: (1) investigate the validity of an adapted distress thermometer with pediatric oncology patients, (2) assess the degree of agreement among different respondents, including physician and psychosocial staff, with respect to (a) the pediatric cancer patient's distress and (b) the caregiver/parent's distress, and (3) to evaluate the relationship between distress levels and the psychosocial services provided to patients and families.
Ninety-one patients and their English and Spanish-speaking caregivers were prospectively assessed at 3-month intervals for 1 year. The quantity of psychosocial services provided to each family was logged for a 12-month period.
Convergent validity was demonstrated by reasonable agreement between the pediatric distress rating tool and standardized measures. Additionally, the demographic and medical predictors of distress were consistent with previously reported findings using more extensive assessment. There was reasonable agreement among multiple raters of the child's distress; however, there was discrepancy between self-ratings of caregiver distress and psychosocial staff ratings of caregiver distress. This difference in perception impacted the quantity of psychosocial services provided following the baseline assessment.
The single-item distress thermometer is a viable option as a rapid screening tool of patient and caregiver distress to help efficiently identify those who should be evaluated further.
基于实证数据的支持，美国国家综合癌症网络推荐的痛苦温度计作为患者痛苦的标准筛查工具具有有效性。然而，该痛苦温度计在儿科肿瘤学环境中的可行性和实用性尚未得到研究。我们进行了一项研究，以：（1）调查适用于儿科肿瘤患者的改良痛苦温度计的有效性，（2）评估不同受访者（包括医生和心理社会工作人员）对（a）儿科癌症患者的痛苦和（b）照顾者/父母的痛苦的认同程度，以及（3）评估痛苦程度与向患者和家庭提供的心理社会服务之间的关系。
91 名患者及其讲英语和西班牙语的照顾者在 1 年内每 3 个月进行一次前瞻性评估。为 12 个月的时间段记录向每个家庭提供的心理社会服务数量。
儿童痛苦评估工具与标准化测量之间的合理一致性表明具有收敛有效性。此外，痛苦的人口统计学和医学预测因素与使用更广泛评估报告的发现一致。多名儿童痛苦评估者之间存在合理的一致性；然而，照顾者自我评估的痛苦与心理社会工作人员对照顾者痛苦的评估存在差异。这种感知上的差异影响了基线评估后的心理社会服务提供量。
单项痛苦温度计是一种可行的选择，可作为患者和照顾者痛苦的快速筛查工具，有助于有效地识别需要进一步评估的患者。
