Calderón Jorge, Campla Cristóbal, D'Aguzan Nicole, Barraza Soledad, Padilla Oslando, Sánchez Cesar, Palma Silvia, González Matías
Psychiatry Department, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
Cancer Center, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
Ecancermedicalscience. 2014 Jun 16;8:437. doi: 10.3332/ecancer.2014.437. eCollection 2014.
Emotional distress (ED) is greater for oncology patients in comparison with the general population, and this has implications for the quality of life of the patient and his/her family, adherence to the treatment, and eventually, survivorship. In general, the detection of these symptoms is low, which explains the need for detection systems appropriate to the clinical reality of the oncology team. The objective of this study is to evaluate for the first time the usefulness of an ultra-brief screening instrument [distress thermometer (DT)], in a group of Chilean oncology patients. A total of 166 outpatients were evaluated at the Cancer Center of the Pontificia Universidad Católica de Chile, before starting chemotherapy. Two screening instruments were applied: Hospital Anxiety and Depression Scale (HADS) and DT. The application of HADS resulted in a prevalence of 32.7% of anxiety symptoms (HADS-A ≥ 8), 15.7% of depression symptoms (HADS-D ≥ 8), and 39.8% had a total score of HADS-T ≥ 11. The DT resulted in the prevalence of 32.5% of distress or ED (DT ≥ 5). The validity of the DT was evaluated as a screening tool in comparison with HADS, observing, in relation to the anxiety scale (HADS-A), a sensitivity of 88.9% and specificity of 78.4% (DT ≥ 4); depression (HADS-D), a sensitivity of 69.2% and specificity of 74.3% (DT ≥ 5); and in relation to the total scale (HADS-T), a sensitivity of 68.2% and specificity of 73.0% (DT ≥ 4). This study demonstrates the elevated prevalence of emotional symptoms in Chilean oncology patients, before the start of chemotherapy, and confirms the potential of the DT as a brief screening instrument with easy application. The DT will allow the clinician to increase the detection threshold in the Chilean oncology population, intervene in a timely manner, and contribute to the comprehensive handling of the oncology patient without affecting the time needed for assistance.
与普通人群相比，肿瘤患者的情绪困扰更为严重，这对患者及其家人的生活质量、治疗依从性以及最终的生存情况都有影响。总体而言，这些症状的检出率较低，这说明了需要有适合肿瘤团队临床实际情况的检测系统。本研究的目的是首次评估一种超简短筛查工具[苦恼温度计（DT）]在一组智利肿瘤患者中的实用性。共有166名门诊患者在智利天主教大学癌症中心开始化疗前接受了评估。应用了两种筛查工具：医院焦虑抑郁量表（HADS）和DT。HADS的应用结果显示，焦虑症状（HADS - A≥8）的患病率为32.7%，抑郁症状（HADS - D≥8）的患病率为15.7%，HADS总分≥11的患病率为39.8%。DT显示苦恼或情绪困扰（DT≥5）的患病率为32.5%。与HADS相比，评估了DT作为筛查工具的有效性，观察到在焦虑量表（HADS - A）方面，敏感性为88.9%，特异性为78.4%（DT≥4）；抑郁量表（HADS - D）方面，敏感性为69.2%，特异性为74.3%（DT≥5）；在总分量表（HADS - T）方面，敏感性为68.2%，特异性为73.0%（DT≥4）。本研究表明，智利肿瘤患者在开始化疗前情绪症状的患病率较高，并证实了DT作为一种易于应用的简短筛查工具的潜力。DT将使临床医生提高对智利肿瘤人群的检测阈值，及时进行干预，并有助于在不影响诊疗所需时间的情况下对肿瘤患者进行全面管理。
