Changes in Distress Measured by the Distress Thermometer as Reported by Patients in Home Palliative Care in Germany

To identify changes in distress as reported by patients in a home palliative care program over a 2-week period.

Prospective study in West Germany with consecutive patients cared for at home by a palliative care specialty team. Exclusion criteria were patients under 18 years of age, mentally or physically not able to complete the assessment questionnaires, or unable to comprehend German language. Distress was measured using the distress thermometer (DT); sociodemographic and medical data were collected from the patients' records.

One hundred three participated in the study (response rate of 69%) and 39 participants completed DT at 2-week follow-up (T₁; response rate = 38%; mean age = 67; female = 54.4%; married = 67%; living home with relatives = 60.2%; oncological condition = 91.3%; Karnofsky performance status [KPS] 0-40 = 18.9%, KPS 50-70 = 70.3%, KPS >80 = 10.8%). The mean DT score at the first visit (T₀) was 5.9 (2.3), with 82.1% of the participants scoring DT ≥5. At the 2-week follow-up (T₁), mean DT score was 5.0 (2.0), with 64.1% scoring DT ≥5, showing a statistically significant difference between T₀ and T₁. Comparing the single scores at T₀ and T₁ of each participant, the difference in DT scores was -0.9 (2.27).

The DT is a useful tool for screening severity and changes in psychological distress as well as sources of distress. The DT detected change in self-reported distress within a short treatment period, indicating success or failure of the palliative care treatment approaches.