Assessment of psychological distress among Asian adolescents and young adults (AYA) cancer patients using the distress thermometer: a prospective, longitudinal study

• Published in: Supportive care in cancer 2018-09, Vol.26 (9), p.3257-3266
• Main Authors: Chan, Alexandre, Poon, Eileen, Goh, Wei Lin, Gan, Yanxiang, Tan, Chia Jie, Yeo, Kelvin, Chua, Annabelle, Chee, Magdalene, Law, Yi Chye, Somasundaram, Nagavalli, Kanesvaran, Ravindran, Ng, Quan Sing, Tham, Chee Kian, Toh, Chee Keong, Lim, Soon Thye, Tao, Miriam, Tang, Tiffany, Quek, Richard, Farid, Mohamad
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analysis; Asian Continental Ancestry Group; Brain tumors; Cancer; Cancer patients; Care and treatment; Clinical significance; Diagnosis; Ethnicity; Female; Health psychology; Humans; Longitudinal Studies; Male; Mass Screening; Medicine; Medicine & Public Health; Mental health; Neoplasms - psychology; Non-Hodgkin's lymphomas; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original Article; Pain Medicine; Prospective Studies; Quantitative analysis; Rehabilitation Medicine; Sarcoma; Stress; Stress (Psychology); Stress, Psychological - psychology; Teenagers; Young Adult; Young adults; Youth
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-018-4189-y

Purpose Since few studies have investigated whether the Distress Thermometer (DT) in Asian adolescent and young adult (AYA) cancer patients (between 15 and 39 years), we investigated the appropriateness of the DT as a screening tool for psychological symptom burden in these AYA patients and to evaluate AYA patients’ distress across a trajectory of three time points longitudinally over a 6-month period. Methods This was a prospective, longitudinal study. Recruited Asian AYA patients were diagnosed with lymphomas, sarcomas, primary brain malignancies, or germ cell tumors. Patients completed the DT, PedsQL Generic Core Scales, and the Rotterdam Symptom Checklist. Data were analyzed using STATA version 15. Results Approximately half of the patients experienced clinically significant DT distress (distress score ≥ 4) early in their cancer journey with 43.1% patients presenting with distress at time of diagnosis and 47.7% patients 1 month after diagnosis. Among AYA patients > 24 years old, worry (68.3%), insurance/financial issues (61%), treatment decisions (43.9%), work/school issues (41.5%), nervousness (41.5%), and sadness (41.5%) were the top five identified problems. On the other hand, the top five identified problems among AYA ≤ 24 years were worry (54.2%), nervousness (41.7%), bathing/dressing problems (37.5%), work/school issues (33.3%), and fatigue (33.3%). DT scores were significantly associated with certain psychological symptom burden items such as worry ( p