Abstract
Purpose
The distress thermometer (DT) and the emotion thermometers (ET) are short screening instruments for use in oncological practice. The aim of this study was to provide normative values and to analyze the correlational structure of the ET.
Methods
A representative sample of the adult German general population (N = 2437) completed the ET, the PHQ-4, the FACIT-fatigue scale, and the demoralization scale.
Results
The percentages of people above the cutoff (≥ 4) and the mean scores of the five ET scales were as follows: distress: 39.0%, M = 3.15 ± 2.62, anxiety: 12.3%, M = 1.36 ± 1.93, depression: 16.1%, M = 1.65 ± 2.11, anger: 24.5%, M = 2.33 ± 2.16, and need for help: 10.7%, M = 1.18 ± 1.90. Women reported significantly higher levels of burden than men, with effect sizes between 0.07 (anger) and 0.36 (anxiety). All ET dimensions were interrelated (r between 0.44 and 0.69) and significantly correlated with the other scales (r between 0.36 and 0.68).
Conclusions
The normative scores can help qualify assessments of groups of patients. The new four dimensions of the ET provide relevant additional information that is not already covered by the DT.
References
Mitchell, A. J. (2010). Short screening tools for cancer-related distress: A review and diagnostic validity meta-analysis. Journal of the National Comprehensive Cancer Network, 8(4), 487–494.
Mitchell, A. J. (2007). Pooled results from 38 analyses of the accuracy of distress thermometer and other ultra-short methods of detecting cancer-related mood disorders. Journal of Clinical Oncology, 25(29), 4670–4681.
National Comprehensive Cancer Network (NCCN). (2003). Distress management. Clinical practice guidelines. Journal of the National Comprehensive Cancer Network, 1(3), 344–374.
Roth, A. J., Kornblith, A. B., Batel-Copel, L., Peabody, E., Scher, H. I., & Holland, J. C. (1998). Rapid screening for psychologic distress in men with prostate carcinoma. Cancer, 82(10), 1904–1908.
Recklitis, C. J., Blackmon, J. E., & Chang, G. (2016). Screening young adult cancer survivors for distress with the distress thermometer: Comparisons with a structured clinical diagnostic interview. Cancer, 122(2), 296–303.
Ma, X., Zhang, J., Zhong, W., Shu, C., Wang, F., Wen, J., et al. (2014). The diagnostic role of a short screening tool—The distress thermometer: A meta-analysis. Supportive Care in Cancer, 22(7), 1741–1755.
Donovan, K. A., Grassi, L., McGinty, H. L., & Jacobsen, P. B. (2014). Validation of the distress thermometer worldwide: State of the science. Psycho-Oncology, 23(3), 241–250.
Leclair, T., Carret, A.-S., Samson, Y., & Sultan, S. (2016). Stability and repeatability of the distress thermometer (DT) and the Edmonton Symptom Assessment System-Revised (ESAS-r) with parents of childhood cancer survivors. PLoS ONE, 11(7), e0159773.
Mitchell, A. J., Baker-Glenn, E. A., Park, B., Granger, L., & Symonds, P. (2010). Can the distress thermometer be improved by additional mood domains? Part II. What is the optimal combination of emotion thermometers? Psycho-Oncology, 19(2), 134–140.
Mitchell, A. J., Baker-Glenn, E. A., Granger, L., & Symonds, P. (2010). Can the distress thermometer be improved by additional mood domains? Part I. Initial validation of the emotion thermometers tool. Psycho-Oncology, 19(2), 125–133.
Mitchell, A. J., Morgan, J. P., Petersen, D., Fabbri, S., Fayard, C., Stoletniy, L., et al. (2012). Validation of simple visual-analogue thermometer screen for mood complications of cardiovascular disease: The emotion thermometers. Journal of Affective Disorders, 136(3), 1257–1263.
Beck, K. R., Tan, S. M., Lum, S. S., Lim, L. E., & Krishna, L. K. (2016). Validation of the emotion thermometers and hospital anxiety and depression scales in Singapore: Screening cancer patients for distress, anxiety and depression. Asia-Pacific Journal of Clinical Oncology, 12(2), 9.
Schubart, J. R., Mitchell, A. J., Dietrich, L., & Gusani, N. J. (2015). Accuracy of the emotion thermometers (ET) screening tool in patients undergoing surgery for upper gastrointestinal malignancies. Journal of Psychosocial Oncology, 33(1), 1–14.
van Oers, H. A., Schepers, S. A., Grootenhuis, M. A., & Haverman, L. (2017). Dutch normative data and psychometric properties for the distress thermometer for parents. Quality of Life Research, 26(1), 177–182.
Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., et al. (2010). A 4-item measure of depression and anxiety: Validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122(1–2), 86–95.
Yellen, S. B., Cella, D. F., Webster, K., Blendowski, C., & Kaplan, E. (1997). Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. Journal of Pain and Symptom Management, 13(2), 63–74.
Cella, D., Lai, J.-S., Chang, C.-H., Peterman, A., & Slavin, M. (2002). Fatigue in cancer patients compared with fatigue in the general United States population. Cancer, 94(2), 528–538.
Mehnert, A., Vehling, S., Hocker, A., Lehmann, C., & Koch, U. (2011). Demoralization and depression in patients with advanced cancer: Validation of the German version of the demoralization scale. Journal of Pain and Symptom Management, 42(5), 768–776.
Kissane, D. W., Wein, S., Love, A., Lee, X. Q., Kee, P. L., & Clarke, D. M. (2004). The demoralization scale: A report of its development and preliminary validation. Journal of Palliative Care, 20(4), 269–276.
Faller, H., Weis, J., Koch, U., Brähler, E., Härter, M., Keller, M., et al. (2017). Utilization of professional psychological care in a large German sample of cancer patients. Psycho-Oncology, 26(4), 537–543.
Bidstrup, P. E., Mertz, B. G., Dalton, S. O., Deltour, I., Kroman, N., Kehlet, H., et al. (2012). Accuracy of the Danish version of the ‘distress thermometer’. Psycho-Oncology, 21(4), 436–443.
Lazenby, M., Dixon, J., Bai, M., & McCorkle, R. (2014). Comparing the distress thermometer (DT) with the patient health questionnaire (PHQ)-2 for screening for possible cases of depression among patients newly diagnosed with advanced cancer. Palliative & Supportive Care, 12(1), 63–68.
Ryan, D. A., Gallagher, P., Wright, S., & Cassidy, E. M. (2012). Sensitivity and specificity of the distress thermometer and a two-item depression screen (Patient Health Questionnaire-2) with a ‘help’ question for psychological distress and psychiatric morbidity in patients with advanced cancer. Psycho-Oncology, 21(12), 1275–1284.
Rogers, S. N., Mepani, V., Jackson, S., & Lowe, D. (2017). Health-related quality of life, fear of recurrence, and emotional distress in patients treated for thyroid cancer. British Journal of Oral & Maxillofacial Surgery, 55(7), 666–673.
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., et al. (2008). Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Medical Care, 46(3), 266–274.
Ziegler, M., Kemper, C. J., & Kruyen, P. (2014). Short scales—five misunderstandings and ways to overcome them. Journal of Individual Differences, 35(4), 185–189.
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The study was approved by the Ethics Committee of the University of Leipzig. All procedures were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Hinz, A., Mitchell, A.J., Dégi, C.L. et al. Normative values for the distress thermometer (DT) and the emotion thermometers (ET), derived from a German general population sample. Qual Life Res 28, 277–282 (2019). https://doi.org/10.1007/s11136-018-2014-1
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DOI: https://doi.org/10.1007/s11136-018-2014-1