Author(s): Ghazali N.; Jones T.; Shaw R.; Risk J.; Lowe D.; Rogers S.N.; Roe B.; Tandon S.
Source: Journal of Cranio-Maxillofacial Surgery; 2017
Publication Date: 2017
Publication Type(s): Article In Press
Abstract:Purpose: Cancer patients can experience significant distress during their cancer trajectory, which impacts upon clinical outcomes and quality of life. Screening for distress using holistic assessments can help identify and address unmet concerns/needs. The purpose of this study was to evaluate the relationship between concerns and distress, and the impact of distress on clinic outcomes in post-treatment head and neck cancer patients. Methods: 170 patients attending routine follow-up clinics were prospectively recruited. All patients completed the Patient Concerns Inventory (PCI) and the Distress thermometer (DT) at preconsultation. Results: The rate of significant distress (i.e. DT cut-off score >=4) was 36% (62/170). Significantly distressed patients selected more items overall than patients without distress (mean, median (QR) of 5.40, 5 (2-8) vs 2.61, 2 (0-4), p =4 or >=5 PCI items of concern selected. Both cut-off points demonstrated an acceptable level of sensitivity, specificity and predictive values for significant distress. Consultations were longer with increasing numbers of concerns. Conclusions: Just over one-third of patients are significantly distressed. They were more likely to express a higher number of concerns. A cutoff score >=4 or >=5 PCI items selected can identify those at risk of significant distress. Concerns causing significant distress were related to emotional/psychological issues and physical function.
Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery.