Related Experiment Videos
Distress screening, rater agreement, and services in pediatric oncology
Sunita K Patel1, Wendy Mullins, Anne Turk
1Department of Population Sciences, City of Hope Medical Center, Duarte, California 91010, USA. spatel@coh.org
Insights
The distress thermometer effectively screens distress in pediatric cancer patients and caregivers. Discrepancies in caregiver distress ratings impacted psychosocial service delivery, highlighting the need for accurate screening.
Area of Science:
- Oncology
- Psychosocial Care
- Patient Screening Tools
Background:
- The National Comprehensive Cancer Network (NCCN) recommends the distress thermometer for patient distress screening.
- Its validity and utility in pediatric oncology settings remain understudied.
- Accurate distress assessment is crucial for timely psychosocial support in pediatric cancer care.
Purpose of the Study:
- To investigate the validity of an adapted distress thermometer for pediatric oncology patients.
- To assess agreement among physicians, psychosocial staff, and patients/caregivers regarding distress levels.
- To evaluate the relationship between distress levels and provided psychosocial services.
Main Methods:
- Prospective assessment of 91 pediatric cancer patients and their caregivers over 1 year at 3-month intervals.
- Utilized an adapted distress thermometer and standardized measures for validity assessment.
- Logged the quantity of psychosocial services provided to each family over a 12-month period.
Main Results:
- Convergent validity was established through agreement between the pediatric distress tool and standardized measures.
- Demographic and medical predictors of distress aligned with previous findings.
- While child distress ratings showed agreement, caregiver distress ratings differed between self-reports and staff assessments, impacting service provision.
Conclusions:
- The single-item distress thermometer is a feasible and valid rapid screening tool for pediatric cancer patients and their caregivers.
- It efficiently identifies individuals requiring further psychosocial evaluation.
- Addressing discrepancies in caregiver distress perception is vital for optimizing psychosocial service delivery.
Objective:
Empirically based data support the validity of the distress thermometer recommended by the National Comprehensive Cancer Network as a standard screen for patient distress. However, the feasibility and utility of the distress thermometer has not been studied in the pediatric oncology setting. We conducted a study to: (1) investigate the validity of an adapted distress thermometer with pediatric oncology patients, (2) assess the degree of agreement among different respondents, including physician and psychosocial staff, with respect to (a) the pediatric cancer patient's distress and (b) the caregiver/parent's distress, and (3) to evaluate the relationship between distress levels and the psychosocial services provided to patients and families.
Methods:
Ninety-one patients and their English and Spanish-speaking caregivers were prospectively assessed at 3-month intervals for 1 year. The quantity of psychosocial services provided to each family was logged for a 12-month period.
Results:
Convergent validity was demonstrated by reasonable agreement between the pediatric distress rating tool and standardized measures. Additionally, the demographic and medical predictors of distress were consistent with previously reported findings using more extensive assessment. There was reasonable agreement among multiple raters of the child's distress; however, there was discrepancy between self-ratings of caregiver distress and psychosocial staff ratings of caregiver distress. This difference in perception impacted the quantity of psychosocial services provided following the baseline assessment.
Conclusion:
The single-item distress thermometer is a viable option as a rapid screening tool of patient and caregiver distress to help efficiently identify those who should be evaluated further.