Department of Pain Relief, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy (Tianjin), Tianjin's Clinical Research Center for Cancer, Tianjin.
Psychooncology. 2019 May;28(5):1004-1010. doi: 10.1002/pon.5032. Epub 2019 Mar 18.
This study aimed to provide support for the extensive application of Distress Thermometer (DT) in advanced cancer inpatients with pain and explored factors associated with high DT scores among this population.
Advanced cancer patients with pain were recruited from Department of Pain Relief in Tianjin Cancer Hospital and Institute, China. They completed the DT with problems list and HADS within 48 h after admission. The cutoff score of DT was evaluated against Hospital Anxiety and Depression Scale (HADS) for its sensitivity and specificity by using receiver operating characteristic (ROC) curves. Multiple logistic regression model analysis was performed to investigate correlates of DT scores.
Four hundred forty one inpatients with mixed diagnoses were recruited. Referring to the cutoff of 15 on HADS, DT cutoff score of 5 yielded AUC of 0.757, with an optimal sensitivity of 0.861 and specificity of 0.531. Using the cutoff scores of greater than or equal to 5, 70.5% of the patients were distressed. Logistic regression analysis of DT found that the breakthrough pain, poorer KPS, higher pain degree, and emotional problems were the predictive factor for current distress.
DT is efficacious in screening for psychological distress in advanced cancer inpatients with pain. Psychological distress is prevalent with a cutoff score of greater than or equal to five. To better identify the distressed cancer patients with pain, pain degree, performance status, and emotional problems should be considered together.
本研究旨在为广泛应用于伴有疼痛的晚期癌症住院患者的痛苦温度计（DT）提供支持，并探讨该人群中与 DT 高分相关的因素。
从中国天津肿瘤医院和研究所的止痛科招募伴有疼痛的晚期癌症患者。他们在入院后 48 小时内完成了 DT 与问题清单和 HADS 的测试。通过使用接收器工作特征（ROC）曲线，评估 DT 截止值对医院焦虑和抑郁量表（HADS）的敏感性和特异性。采用多因素逻辑回归模型分析 DT 评分的相关因素。
共招募了 441 名混合诊断的住院患者。参照 HADS 的 15 分截止值，DT 的截止值为 5 时 AUC 为 0.757，最佳灵敏度为 0.861，特异性为 0.531。使用大于或等于 5 的截止值，70.5%的患者感到痛苦。DT 的逻辑回归分析发现，爆发性疼痛、较差的 KPS、较高的疼痛程度和情绪问题是当前痛苦的预测因素。
DT 在筛查伴有疼痛的晚期癌症住院患者的心理痛苦方面是有效的。心理痛苦很普遍，截止值大于或等于 5。为了更好地识别伴有疼痛的痛苦癌症患者，应综合考虑疼痛程度、表现状态和情绪问题。
