Predictors of distress among individuals with cancer reporting physical problems

Abstract

Purpose: Psychological distress among cancer patients is linked to adverse outcomes. The enhanced Distress Thermometer (eDT) allows patients to self-report distress levels on a Likert scale (0-10) and select from a list of physical, emotional, family, and psychological problems contributing to their distress. The physical problem list includes symptoms and functional impairments. Little is known about the predictive validity of the eDT physical problem list. This study aims to evaluate predictors of risk associated with distress scores measured by the eDT among patients with physical problems.

Methods: Patient medical records with significant distress were reviewed, defined by eDT scores ≥ 6 with any physical problems or scores < 6 with > 3 problems selected. Patients were categorized into three groups based on eDT score: mild (1-3), moderate (4-6), and severe (7-10). The chi-square test assessed differences in demographic and clinical variables across distress categories. Linear regression evaluated associations between distress scores and significant predictive variables.

Results: Data from 549 patients showed severe distress was common among head and neck, breast, skin, and colorectal cancers. Significant predictors of distress included age, gender, geography, and number of physical problems (NPP) reported. Higher distress was associated with individuals younger, female, urban, and reporting more physical problems. The regression model explained 15% of the variance in distress scores.

Conclusions: Age, geography, gender, and NPP were factors influencing distress in cancer patients. Future research is recommended to develop more comprehensive clinical and demographic profiles to better identify cancer patients at risk for high distress and unmet supportive care needs.

Keywords: Cancer survivorship; Distress screening; Distress thermometer; Rehabilitation navigator; Supportive care.