Screening for Psychological Distress in Surgical Breast Cancer Patients

Jane R. Schubart, Matthew Emerich, Michelle Farnan, J. Stanley Smith, Gordon L. Kauffman, Rena Kass

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: This pilot study assessed the levels of patient emotional distress and impact on clinic throughput time. Methods: From April through August 2012, 149 breast cancer patients at the Penn State Hershey Breast Center were screened with the emotions thermometer (ET), a patient-rated visual 0–10 scale that measures distress, anxiety, depression, anger, burden, and need for help. Also, patients indicated their most pressing cancer-related concerns. Clinic visit time was computed and compared with a control group. Results: Using a previously validated cut point ≥4 for any thermometer, we found emotional difficulty in the following proportions: distress 22 %, anxiety 28 %, depression 18 %, anger 14 %, burden 16 %, and need for help 10 %; 35 % scored above the cut point on at least 1 thermometer. We found higher levels of distress in all domains associated with younger age at diagnosis. More extensive surgery (bilateral mastectomy vs unilateral mastectomy vs. lumpectomy) was correlated with higher levels of psychosocial distress. Most often cited concerns, experienced by >20 %, included eating/weight, worry about cancer, sleep problems, fatigue, anxiety, and pain. Mean clinic visit time for evaluable patients screened using the ET (n = 109) was 43.9 min (SD 18.6), compared with 42.6 min (SD 16.2) for the control group (n = 50). Conclusions: Utilizing the ET, more than one-third of women screened met criteria for psychological distress. Younger age at diagnosis and more extensive surgery were risk factors. The ET is a simple validated screening tool that identifies patients in need of further psychological evaluation without impacting clinic throughput time.

Original languageEnglish (US)
Pages (from-to)3348-3353
Number of pages6
JournalAnnals of Surgical Oncology
Volume21
Issue number10
DOIs
StatePublished - Jan 1 2014

Fingerprint

Thermometers
Breast Neoplasms
Psychology
Emotions
Anxiety
Mastectomy
Anger
Ambulatory Care
Depression
Control Groups
Segmental Mastectomy
Fatigue
Neoplasms
Sleep
Breast
Eating
Weights and Measures
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Schubart, Jane R. ; Emerich, Matthew ; Farnan, Michelle ; Smith, J. Stanley ; Kauffman, Gordon L. ; Kass, Rena. / Screening for Psychological Distress in Surgical Breast Cancer Patients. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 10. pp. 3348-3353.
@article{f2cdfebc13c34ab1a8f25e77b8c805f5,
title = "Screening for Psychological Distress in Surgical Breast Cancer Patients",
abstract = "Background: This pilot study assessed the levels of patient emotional distress and impact on clinic throughput time. Methods: From April through August 2012, 149 breast cancer patients at the Penn State Hershey Breast Center were screened with the emotions thermometer (ET), a patient-rated visual 0–10 scale that measures distress, anxiety, depression, anger, burden, and need for help. Also, patients indicated their most pressing cancer-related concerns. Clinic visit time was computed and compared with a control group. Results: Using a previously validated cut point ≥4 for any thermometer, we found emotional difficulty in the following proportions: distress 22 {\%}, anxiety 28 {\%}, depression 18 {\%}, anger 14 {\%}, burden 16 {\%}, and need for help 10 {\%}; 35 {\%} scored above the cut point on at least 1 thermometer. We found higher levels of distress in all domains associated with younger age at diagnosis. More extensive surgery (bilateral mastectomy vs unilateral mastectomy vs. lumpectomy) was correlated with higher levels of psychosocial distress. Most often cited concerns, experienced by >20 {\%}, included eating/weight, worry about cancer, sleep problems, fatigue, anxiety, and pain. Mean clinic visit time for evaluable patients screened using the ET (n = 109) was 43.9 min (SD 18.6), compared with 42.6 min (SD 16.2) for the control group (n = 50). Conclusions: Utilizing the ET, more than one-third of women screened met criteria for psychological distress. Younger age at diagnosis and more extensive surgery were risk factors. The ET is a simple validated screening tool that identifies patients in need of further psychological evaluation without impacting clinic throughput time.",
author = "Schubart, {Jane R.} and Matthew Emerich and Michelle Farnan and Smith, {J. Stanley} and Kauffman, {Gordon L.} and Rena Kass",
year = "2014",
month = "1",
day = "1",
doi = "10.1245/s10434-014-3919-8",
language = "English (US)",
volume = "21",
pages = "3348--3353",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "10",

}

Screening for Psychological Distress in Surgical Breast Cancer Patients. / Schubart, Jane R.; Emerich, Matthew; Farnan, Michelle; Smith, J. Stanley; Kauffman, Gordon L.; Kass, Rena.

In: Annals of Surgical Oncology, Vol. 21, No. 10, 01.01.2014, p. 3348-3353.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Screening for Psychological Distress in Surgical Breast Cancer Patients

AU - Schubart, Jane R.

AU - Emerich, Matthew

AU - Farnan, Michelle

AU - Smith, J. Stanley

AU - Kauffman, Gordon L.

AU - Kass, Rena

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: This pilot study assessed the levels of patient emotional distress and impact on clinic throughput time. Methods: From April through August 2012, 149 breast cancer patients at the Penn State Hershey Breast Center were screened with the emotions thermometer (ET), a patient-rated visual 0–10 scale that measures distress, anxiety, depression, anger, burden, and need for help. Also, patients indicated their most pressing cancer-related concerns. Clinic visit time was computed and compared with a control group. Results: Using a previously validated cut point ≥4 for any thermometer, we found emotional difficulty in the following proportions: distress 22 %, anxiety 28 %, depression 18 %, anger 14 %, burden 16 %, and need for help 10 %; 35 % scored above the cut point on at least 1 thermometer. We found higher levels of distress in all domains associated with younger age at diagnosis. More extensive surgery (bilateral mastectomy vs unilateral mastectomy vs. lumpectomy) was correlated with higher levels of psychosocial distress. Most often cited concerns, experienced by >20 %, included eating/weight, worry about cancer, sleep problems, fatigue, anxiety, and pain. Mean clinic visit time for evaluable patients screened using the ET (n = 109) was 43.9 min (SD 18.6), compared with 42.6 min (SD 16.2) for the control group (n = 50). Conclusions: Utilizing the ET, more than one-third of women screened met criteria for psychological distress. Younger age at diagnosis and more extensive surgery were risk factors. The ET is a simple validated screening tool that identifies patients in need of further psychological evaluation without impacting clinic throughput time.

AB - Background: This pilot study assessed the levels of patient emotional distress and impact on clinic throughput time. Methods: From April through August 2012, 149 breast cancer patients at the Penn State Hershey Breast Center were screened with the emotions thermometer (ET), a patient-rated visual 0–10 scale that measures distress, anxiety, depression, anger, burden, and need for help. Also, patients indicated their most pressing cancer-related concerns. Clinic visit time was computed and compared with a control group. Results: Using a previously validated cut point ≥4 for any thermometer, we found emotional difficulty in the following proportions: distress 22 %, anxiety 28 %, depression 18 %, anger 14 %, burden 16 %, and need for help 10 %; 35 % scored above the cut point on at least 1 thermometer. We found higher levels of distress in all domains associated with younger age at diagnosis. More extensive surgery (bilateral mastectomy vs unilateral mastectomy vs. lumpectomy) was correlated with higher levels of psychosocial distress. Most often cited concerns, experienced by >20 %, included eating/weight, worry about cancer, sleep problems, fatigue, anxiety, and pain. Mean clinic visit time for evaluable patients screened using the ET (n = 109) was 43.9 min (SD 18.6), compared with 42.6 min (SD 16.2) for the control group (n = 50). Conclusions: Utilizing the ET, more than one-third of women screened met criteria for psychological distress. Younger age at diagnosis and more extensive surgery were risk factors. The ET is a simple validated screening tool that identifies patients in need of further psychological evaluation without impacting clinic throughput time.

UR - http://www.scopus.com/inward/record.url?scp=84930981032&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930981032&partnerID=8YFLogxK

U2 - 10.1245/s10434-014-3919-8

DO - 10.1245/s10434-014-3919-8

M3 - Article

C2 - 25034820

AN - SCOPUS:84930981032

VL - 21

SP - 3348

EP - 3353

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 10

ER -