Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN.
Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN.
JCO Oncol Pract. 2020 Aug;16(8):e649-e659. doi: 10.1200/JOP.19.00471. Epub 2020 Feb 24.
The Distress Thermometer (DT) includes a measure of cancer-related distress and a list of self-reported problems. This study evaluated the utility of the DT problem list in identifying concerns most associated with distress and poorer quality of life (QOL) in survivors of gynecologic cancer.
Demographic, clinical, psychosocial functioning, and DT data were described among 355 women participating in a gynecologic cancer cohort. Problems from the DT list were ranked by prevalence, distress, and QOL. Logistic regression models explored factors associated with problems that were common (≥ 25% prevalence) and associated with distress and QOL.
The average age of participants was 59.9 years (standard deviation [SD], 10.8 years). Most participants were non-Hispanic white (97%) and had ovarian (44%) or uterine (42%) cancer. The mean DT score was 2.7 (SD, 2.7); participants reported a mean of 7.3 problems (SD, 5.9 problems). The most common problems were fatigue (53.6%), worry (49.9%), and tingling (46.3%); least common problems were childcare (2.1%), fevers (2.1%), and substance abuse (1.1%). Report of some common problems, including tingling, sleep, memory, skin issues, and appearance, was not associated with large differences in distress or QOL. In contrast, some rarer problems such as childcare, treatment decisions, eating, housing, nausea, and bathing/dressing were associated with worse distress or QOL. Younger age, lower income, and chemotherapy were risk factors across common problems that were associated with worse distress or QOL (fatigue, nervousness, sadness, fears, and pain).
The DT problem list did not easily identify concerns most associated with distress and low QOL in patients with gynecologic cancer. Adaptations that enable patients to report their most distressing concerns would enhance clinical utility of this commonly used tool.
《苦恼温度计》（DT）包含了癌症相关苦恼的衡量标准以及一系列自我报告的问题。本研究评估了 DT 问题清单在识别与妇科癌症幸存者的苦恼和较差生活质量（QOL）最相关的问题方面的效用。
在参与妇科癌症队列的 355 名女性中，描述了人口统计学、临床、心理社会功能以及 DT 数据。根据流行程度、苦恼和 QOL 对 DT 清单中的问题进行排名。逻辑回归模型探讨了与常见（患病率≥25%）以及与苦恼和 QOL 相关的问题相关的因素。
参与者的平均年龄为 59.9 岁（标准差 [SD]，10.8 岁）。大多数参与者是非西班牙裔白人（97%），患有卵巢癌（44%）或子宫癌（42%）。DT 平均得分为 2.7（SD，2.7）；参与者报告了 7.3 个问题（SD，5.9 个问题）。最常见的问题是疲劳（53.6%）、担忧（49.9%）和刺痛（46.3%）；最不常见的问题是儿童保育（2.1%）、发烧（2.1%）和药物滥用（1.1%）。一些常见问题的报告，包括刺痛、睡眠、记忆、皮肤问题和外貌，与苦恼或 QOL 没有显著差异。相比之下，一些罕见的问题，如儿童保育、治疗决策、饮食、住房、恶心和洗澡/穿衣，与更严重的苦恼或 QOL 相关。年轻、低收入和化疗是与苦恼或 QOL 较差相关的常见问题的共同风险因素（疲劳、紧张、悲伤、恐惧和疼痛）。
DT 问题清单并不能轻易识别与妇科癌症患者苦恼和低 QOL 最相关的问题。使患者能够报告他们最苦恼的问题的调整将增强这种常用工具的临床实用性。
