School of Nursing and Midwifery, University of Queensland, Brisbane, Australia.
BMC Cancer. 2011 Jan 31;11:46. doi: 10.1186/1471-2407-11-46.
Cancer can be a distressing experience for cancer patients and carers, impacting on psychological, social, physical and spiritual functioning. However, health professionals often fail to detect distress in their patients due to time constraints and a lack of experience. Also, with the focus on the patient, carer needs are often overlooked. This study investigated the acceptability of brief distress screening with the Distress Thermometer (DT) and Problem List (PL) to operators of a community-based telephone helpline, as well as to cancer patients and carers calling the service.
Operators (n = 18) monitored usage of the DT and PL with callers (cancer patients/carers, >18 years, and English-speaking) from September-December 2006 (n = 666). The DT is a single item, 11-point scale to rate level of distress. The associated PL identifies the cause of distress.
The DT and PL were used on 90% of eligible callers, most providing valid responses. Benefits included having an objective, structured and consistent means for distress screening and triage to supportive care services. Reported challenges included apparent inappropriateness of the tools due to the nature of the call or level of caller distress, the DT numeric scale, and the level of operator training.
We observed positive outcomes to using the DT and PL, although operators reported some challenges. Overcoming these challenges may improve distress screening particularly by less experienced clinicians, and further development of the PL items and DT scale may assist with administration. The DT and PL allow clinicians to direct/prioritise interventions or referrals, although ongoing training and support is critical in distress screening.
癌症可能会给癌症患者及其护理人员带来困扰，影响他们的心理、社会、身体和精神功能。然而，由于时间限制和缺乏经验，卫生专业人员往往无法发现患者的痛苦。此外，由于关注的是患者，护理人员的需求往往被忽视。本研究调查了使用《 distress thermometer（DT）和 problem list（PL）》对社区电话热线操作人员以及拨打该服务电话的癌症患者和护理人员进行简短痛苦筛查的可接受性。
2006 年 9 月至 12 月，操作人员（n=18）监测了 DT 和 PL 在来电者（年龄>18 岁且讲英语的癌症患者/护理人员）中的使用情况（n=666）。DT 是一个 11 分制的单一项目，用于评估痛苦程度。相关的 PL 确定痛苦的原因。
DT 和 PL 用于 90%符合条件的来电者，大多数人提供了有效回复。好处包括有一个客观、结构化和一致的痛苦筛查和分诊到支持性护理服务的方法。报告的挑战包括由于来电的性质或来电者的痛苦程度、DT 的数字量表以及操作人员的培训水平，工具似乎不适用。
我们观察到使用 DT 和 PL 的积极结果，尽管操作人员报告了一些挑战。克服这些挑战可能会改善痛苦筛查，特别是对于经验较少的临床医生，并且进一步开发 PL 项目和 DT 量表可能有助于管理。DT 和 PL 允许临床医生指导/优先干预或转诊，尽管在痛苦筛查中持续的培训和支持至关重要。
