The nccn distress management panel developed the dt, a now wellknown tool for initial screening, using 0 no distress to 10 extreme distress, which is similar to the successful rating scale used to measure pain. Analysis of the distress thermometers psychometric properties and applicability to subgroups by lora l. Screening for distress suggests that 40% to 50% of. Distress is defined in the nccn guidelines for distress management as a multifactorial, unpleasant experience of a psychologic ie, cognitive. Thank you for your interest in the nccn distress thermometer and problem list, figure disa, from the nccn clinical practice guidelines in oncology nccn. Measurement of psychological distress in patients with. Several panel members noted that their institutions are using the dt to screen for distress in survivors at this time. Use of the distress thermometer in clinical practice ncbi. Distress thermometer assesses psychosocial distress. Diffusion of distress management guideline into practice. Using a visual distress thermometer see the collection methods section below for an example, ask the person to indicate the level of distress that they have experienced in the past week on a scale from 010, where 0 indicates no distress and 10 indicates extreme distress. Only three institutions screened every patient, and the other five screened certain groups of cancer patients. New nccn distress guidelines and tools encourage patients.
Use of the distress thermometer in clinical practice. The nccn clinical practice guidelines nccn guidelines are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. One of the most commonly used tools is the distress thermometer dt. The nccn recommends screening patients at the initial visit soon after diagnosis and at each visit, although the screening schedule may be revised as clinically indicated. Over a hipaasecure videoconference call, a cancer practicebased registered nurse assessed the patient using the nccn distress thermometer dt, amended for the hnc population to include issues such as jaw swelling and speech difficulties. No distress 10 9 8 7 6 5 4 3 2 1 0 10 9 8 7 6 5 4 3 2 1 0 nccn distress thermometer for patients help for distress distress is an unpleasant emotional state that may affect how you feel, think, and act. Important time points may include changes in disease activity. The dt is a simple, selfreport, pencil and paper measure consisting of a line or thermometer image with a 010 scale anchored at the zero point with no distress and at scale point ten with extreme. Changes in distress measured by the distress thermometer. Cancer has been known for many years as a stressful diagnosis that can challenge successful treatment of the disease. In an effort to address barriers to distress screening, the national comprehensive cancer network nccn recommends the distress thermometer dt, a singleitem selfreport measure of distress 14. The search terms used were cancer and distress thermometer. Regarding patients with intracranial tumours, keir et al.
Pdf distress is experienced by many cancer patients, adversely affecting quality of life and. The pds is a french adaptation of the national comprehensive cancer network distress thermometer. Also, with the focus on the patient, carer needs are often overlooked and only 50% of those with serious psychological distress will seek support 3,6. Important time points may include changes in disease activity such as remission, recurrence, or. Identification of patients suffering from elevated psychosocial distress, the sources of the distress, and the necessary treatment of the distress can be rather difficult within the neurosurgical setting e. High level of distress in longterm survivors of thyroid. This study was designed to translate and validate the national comprehensive cancer network nccn distress thermometer dt in regional language malayalam and to see the feasibility of using it in our patients. It has a scale on which you circle your level of distress.
Patients with cancer, and their families and carers, may experience a range of psychological symptoms. The nccn distress management guideline is a useful tool to screen for and manage. The nccn has advocated for the dt to be used to assess distress in cancer patients. Adapted and reproduced with permission from the nccn 1. The nccn introduced the dt as a screening tool to identify sources of distress. Nccn clinical practice guidelines in oncology nccn guidelines. Acceptability of the distress thermometer and problem list. Patients with a cancer diagnosis experience complex issues that can cause distress.
Permission may be requested by completing the nccn permissions request form. Distress thermometer dt the dt is a 1item, selfreport measure of psychological distress developed by the nccn. It is a rapidscreening measure with a 010 visual analogue scale, in the form of a thermometer labeled with no distress at 0, moderate distress at the midpoint, and extreme distress at 10. In addition, a search was conducted using web of science to identify all published studies that cited the first publication of the dt 9 or the validation study published in 2005 10. In patients with cancer in general, the prevalence of distress is high e. Patients are asked to rate their distress in the past week on an 11point visual analogue scale ranging from 0 no distress to 10 extreme distress. The nccn distress thermometer and problem list may not be used for any commercial purpose, including publication in journals, text books, etc. Incorporating distress screening improves referrals in. In 2003, the nccn distress management panel published more fully. Screening for distress in cancer patients grassi 20. The national comprehensive cancer network nccn practice guidelines for the management of psychosocial distress, 2014 defines distress as a multifactorial distressing. Pooled results from multiple studies suggest that approximately 40% of cancer. The nccn clinical practice guidelines nccn guidelines are a statement of evidence and consensus of the authors regarding.
If you have lung cancer or mesothelioma, please call either johanna lynch or lucy pike on. Originally devised by roth et al 19991 for the national comprehensive cancer network nccn, the distress thermometer dt is a simple selfscoring visual analogue scale for recording global distress a composite of physical wellbeing, psychosocial and spiritual issues. In 1999, the national comprehensive cancer network nccn, recommended routine screening for distress in all cancer patients. Most of the validation studies in cancer patients have validated the dt against the hads and established proper cutoff scores with. Little is known about the prevalence of psychiatric disorders in french cancer patients. In a study of 401 patients with cancer by mitchell et al, 6 45% had distress according to the distress thermometer dt, but nurses had difficulty identifying distress using their routine clinical judgment and made false. It was adopted into recommendations by the us national comprehensive cancer network. The distress thermometer dt is a singleitem rapid distress screening tool by use of which these. This study validated the effectiveness of the nccn distress thermometer and problem list for patients, validated tools for assessing distress in patients. Nccn distress thermometer and problem list for patients. A tool to measure levels of psychological distress.
Accuracy of the distress thermometer for home care. Use of distress thermometers in an outpatient oncology. There was also a significant difference in the number of. Patients are comfortable using the distress thermometer and problem list and physicians see these tools as useful checklists to prompt and guide questions about physical and psychological symptoms. The distress thermometer please circle or pick a number 010 from the drop down box that best describes how much distress you have been experiencing in the past week including today. Distress thermometer and problem list information nccn. An analysis of the distress thermometer problem list and. Download the nccn distress thermometer 296kb pdf from. Nccn distress thermometer and problem list disa psychosocial distress patient characteristics disb. About nccn new translations of nccn guidelines content available.
Screening for psychological distress in two french cancer. The nccn distress thermometer dt is a oneitem, 11point likert scale represented on a visual graphic of a thermometer that ranges from 0. Jonathan larsen, mpp, manager, global business development. Nccn distress thermometer for patients munson healthcare. Here we discuss some of the signs that a person may be having trouble dealing with distress, and discuss the types of help that are available. As the use of simple, straightforward, and clearly anchored scaling methods has consistently proved to be a successful and reliable mode of communicating. This article describes a pilot of the distress thermometer, a tool used to measure patients levels of distress, and found it. Nccn clinical practice guidelines in oncology nccn. Early evaluation and screening for distress leads to early and timely management of psychological distress, which in turn improves medical management. Diagnostic and statistical manual of mental disorders 5th ed. The distress thermometer is a tool that you can use to talk to your doctors about your distress. Distress in patients with newly diagnosed brain tumours. Methods first, the original version of the dt was translated using a forward and backward translation procedure according to the guidelines.
The journal of continuing education in nursing distress screening, using the distress thermometer for patients, is a valid, evidencebased approach to assess and facilitate the identification of. Translating research on the distress thermometer into practice. The consumer resource, cancer how are you travelling. It can include feelings of unease, sadness, worry, anger, helplessness, guilt, and so forth. More than 50% of patients with advanced lifethreatening conditions suffer from psychosocial distress. The nurse identified areas of distress, then led patients in a discussion to elucidate specific concerns. This translation is a direct result of nccn s inaugural international day held. The distress thermometer is a pen and paper tool for patients to report how distressed they are about their psychosocial and physical problems.
A certain amount of distress is normal when you or a family member has cancer. The distress thermometer is a simple checklist assessment technique used in cancer care and other area of physical health. Researchers conducted a secondary data analysis of distress ratings n 1205 for people receiving outpatient care at a midwestern us cancer. The organization has published the first nccn guidelines for patients and nccn quick guide for distress. Nccn distress thermometer and problem list for patients version 2. This study aimed to assess the feasibility of a screening procedure using the psychological distress scale pds.
Purpose this study aims to translate the distress thermometer dt into indonesian, test its validity in indonesian women with breast cancer and determine norm scores of the indonesian dt for clinically relevant distress. Orlando, flin recognition of the distress associated with the diagnosis and treatment of cancer, the national comprehensive cancer network nccn has produced several resources to help patients report their distress and cope with it. Download the nccn distress thermometer and problem list here. The most frequently used instrument is the national comprehensive cancer network distress thermometer dt, a 0 to 10 point visual analog scale that is coupled with a problem checklist of 35 sources of distress. The national comprehensive cancer network nccn recently posted a new translation of the nccn clinical practice guidelines in oncology nccn guidelines for melanoma in turkish.