uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Identification of distress in oncology patients: a comparison of the Hospital Anxiety and Depression Scale and a thorough clinical assessment
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
2016 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 39, no 2, E31-E39 p.Article in journal (Refereed) Published
Abstract [en]

Background:

Screening is recommended to identify cancer patients with distress,anxiety, and depression. The ability of current methods to identify distress inoncology patients is of high importance.

Objective:

We compared the HospitalAnxiety and Depression Scale (HADS) with a thorough clinical assessment.Furthermore, we explored the agreement of HADS with clinical assessment outcomesas a function of age, sex, and treatment intention.

Methods:

One hundredforty-six oncology patients, representing both sexes, different ages (<65/Q65 years),and treatment intention (curative/palliative), completed the HADS before the clinicalassessment. Two study team members (blind to the HADS results) completedclinical assessments of anxiety, depression, and distress analogous to categoriesused in the HADS.

Results:

The HADS identified 49 participants and the clinicalassessment 71 participants as having anxiety, depression, or distress. The overall agreement between the HADS and the clinical assessment was moderate. The greatest differences were found to be a function of participant sex and age.Agreement between the methods was better for females than for males in relation to distress and anxiety and better for the older (Q65 years) than younger participants in relation to depression. By treatment intention, agreement was equal for alldomains.

Conclusion:

Especially male and young participants appear to have potential problems that the HADS fails to identify.

Place, publisher, year, edition, pages
2016. Vol. 39, no 2, E31-E39 p.
National Category
Cancer and Oncology
Research subject
Medical Science
Identifiers
URN: urn:nbn:se:uu:diva-222016DOI: 10.1097/NCC.0000000000000267ISI: 000371546700004OAI: oai:DiVA.org:uu-222016DiVA: diva2:713410
Funder
Swedish Cancer Society
Available from: 2014-04-23 Created: 2014-04-07 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Screening and Assessment of Distress, Anxiety, and Depression in Cancer Patients
Open this publication in new window or tab >>Screening and Assessment of Distress, Anxiety, and Depression in Cancer Patients
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims and Methods The overall aim was to evaluate methods of screening and assessment of distress, anxiety, and depression in cancer patients. Further, to evaluate effects of a psychosocial intervention and to explore changes of distress, anxiety, depression, and HRQoL during six months. Study I included 495 consecutive patients screened with the Hospital Anxiety and Depression Scale (HADS) at their first visit to an Oncology Department. Half of the patients with >7 on any of HADS subscales received standard care (SCG), and half received a psychosocial intervention (IG). To compare HADS with a thorough clinical assessment (CA), Study II included 171 identified patients representing both sexes, <65/≥65 years, and curative/palliative treatment intention.

Results Screening with HADS identified anxiety or/and depression symptoms in 36% of the 495 patients. Thirty-six (43%) of 84 IG patients attended CA, resulting in support for 20 (24%) of them. There were no differences between SC and IG during follow-up, anxiety and depression decreased and HRQoL increased, although anxiety was still present and HRQoL impaired at six months. The Distress Thermometer (DT) ≥4 (sensitivity 87%, specificity 73%) is valid for screening of distress; its ability to measure changes over time is comparable to HADS. Of 319 patients screened with <8 on both HADS subscales, 196 (80%) were stable non-cases with HRQoL comparable to that of the general population and 49 (20%) patients were unstable non-cases, with deteriorated anxiety, depression, and HRQoL. >4 on HADS subscales may be useful for early detection of unstable non-cases. In Study II, HADS identified 49 (34%) and the CA 71 (49%) patients as having distress, anxiety or depression. CA identified more men and more young patients with distress than HADS did.

Conclusion Screening and assessment identifies patients with persistent symptoms and increases access to CA and support. The DT may be used routinely in oncology care. When HADS is used, healthcare professionals should be aware of psychosocial problems perceived by patients but not covered by HADS. Most patients identified with distress seem to have resources to manage problems without needing additional support. Patients screened as non-cases indicate no need for re-assessment.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1006
Keyword
Screening and assessment, anxiety, depression, psychosocial intervention, health-related quality of life, hospital anxiety and depression scale, distress thermometer, cancer
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-221956 (URN)978-91-554-8965-6 (ISBN)
Public defence
2014-06-12, Uppsala universitet, sal IX, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2014-05-22 Created: 2014-04-07 Last updated: 2014-06-30

Open Access in DiVA

No full text

Other links

Publisher's full text

Authority records BETA

Thalén-Lindström, AnnikaGlimelius, BengtJohansson, Birgitta

Search in DiVA

By author/editor
Thalén-Lindström, AnnikaGlimelius, BengtJohansson, Birgitta
By organisation
Experimental and Clinical Oncology
In the same journal
Cancer Nursing
Cancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 1045 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf