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Review
. 2025 Aug 12;13(16):1976.
doi: 10.3390/healthcare13161976.

Defining and Assessing Distress in Oncology Patients: A Systematic Review of the Literature

Tiago Lima  1 , Ana Torres  1   2   3 , Paula Carvalho  1   2   3 , Ricardo João Teixeira  4   5
Affiliations
Review

Defining and Assessing Distress in Oncology Patients: A Systematic Review of the Literature

Tiago Lima et al. Healthcare (Basel). .

Abstract

Psychological distress is an extremely relevant phenomenon in cancer patients due to its high prevalence, especially when cancer diagnoses are increasingly frequent. It is estimated that only one-third of patients with clinically significant levels of distress are referred to mental health services. To reinforce this point, most health centers lack the resources for distress screening.

Background/objectives: This study aims to systematically gather and critique information relevant to the operationalization of distress, as well as the instruments used to assess it.

Methods: The data included in this systematic review were published after 2014 and collected through the meta-database EBSCO and the following databases: PsycArticles, PubMED, and SCOPUS.

Results: A total of 1028 references were imported, and 54 duplicate articles were excluded. Of the 974 references, 934 were excluded because they had titles, keywords, or abstracts that were incompatible with the research objectives. Finally, of the 40 articles obtained, 3 were excluded due to the inclusion of cancer survivors, 1 for including a non-oncological sample, and 9 for not expressing a focus on distress, resulting in a total of 27 articles included in this systematic review.

Conclusions: The field of psycho-oncology needs to improve the understanding and assessment of distress in cancer patients. The lack of a holistic and homogeneous vision, as well as the use of reductionist instruments are common problems. A more complete understanding of distress, especially its effective evaluation, and better communication with other health professionals and their patients concerning this health issue are needed.

Keywords: assessment; cancer survivor; mental health; psycho-oncology; psychological distress; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure A1
Figure A1
Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA) study selection flow diagram outlining the literature review process when searching for articles across the meta-database and databases.
See this image and copyright information in PMC

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