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. 2012 Apr;19(2):e53-9.
doi: 10.3747/co.19.882.

Characterizing distress, the 6th vital sign, in an oncology pain clinic

A Waller  1 , S L Groff, N Hagen, B D Bultz, L E Carlson
Affiliations

Characterizing distress, the 6th vital sign, in an oncology pain clinic

A Waller et al. Curr Oncol. 2012 Apr.

Abstract

Context: The delineation of populations of cancer patients with complex symptoms can inform the planning and delivery of supportive care services.

Objectives: We explored the physical, psychosocial, and practical concerns experienced by patients attending an ambulatory oncology symptom control clinic.

Methods: Patients attending a Pain Clinic at a large tertiary cancer centre were invited to complete screening measures assessing distress, pain, fatigue, anxiety, depression, and practical and psychosocial problems. A matched sample of patients who did not attend the Pain Clinic were selected as a comparison group.

Results: Of all eligible Pain Clinic patients, 46 (77%) completed the measures; so did 46 comparison group patients. The percentages of patients reporting distress (78.3%), pain (93.5%), and fatigue (93.5%) were higher among Pain Clinic patients than among the comparison patients. A higher percentage of Pain Clinic patients also reported multiple, severe, concurrent symptoms: 87% scored 7 or higher in at least one of the pain, fatigue, or distress scales, and 30.4% of the patients scored 7 or higher on all three. The most common problem areas were feeling a burden to others, trouble talking with friends and family, spirituality, and sleep difficulties.

Conclusions: Higher levels of multiple, concurrent symptoms and psychosocial problems were found in Pain Clinic patients than in a group of patients who did not attend the Pain Clinic. Routine screening and triaging of cancer patients using a comprehensive and standardized panel of questions can facilitate symptom assessment and management, and can inform program planning.

Keywords: Screening for distress; common problems; fatigue; neoplasms; oncology; pain.

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Conflict of interest statement

6. CONFLICT OF INTEREST DISCLOSURES

There are no known financial conflicts of interest for the authors.

Figures

FIGURE 1
FIGURE 1
Percentage of patients experiencing symptoms and reporting scores above the clinical cut-off on the Distress Thermometer, the Pain Thermometer, the Fatigue Thermometer, and the Psychological Screen for Cancer anxiety and depression subscales. * p < 0.05.
FIGURE 2
FIGURE 2
Co-occurrence of symptoms (cut-off: ≥7): the overlap of severe distress [Distress Thermometer (dt)], pain [Pain Thermometer (pt)], and fatigue [Fatigue Thermometer (ft)]. * p < 0.05.
FIGURE 3
FIGURE 3
Concerns identified by patients: the percentage of patients endorsing each of the concerns in the Problem Checklist. * p < 0.07. ** p < 0.05.
See this image and copyright information in PMC

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