A cancer diagnosis and subsequent treatment is a grueling ordeal for many patients, which causes not only physical discomfort but tremendous psychological and emotional pressures as well. The research article Detecting Distress by O’Connor, Tanner, Miller, Watts, & Musiello (2017) discusses the prevalence and effects of distress in cancer patients as well as measures that can be taken to detect and address the condition.
The purpose of this report is to offer a detailed analysis and critique of the research article to determine whether distress should be considered a recognizable oncological vital sign. The pain caused by the various challenges of cancer treatment is associated with poor health and outcomes in patients, suggesting the need for early intervention in order to help patients with unmet needs and reducing the burden on the health system.
Official statistics of psychological distress among cancer patients range from 35-49% (O’Connor et al., 2017). However, these rates can be higher since standard clinical assessments are not effective at detecting it in comparison to specialized screening tools or clinical interviews. A tool named Distress Thermometer (DT) has been developed, which takes no more than 5 minutes to complete and can be used for preliminary identification of signs in patients.
In 2006, the government of Western Australia determined the need for improved diagnosis and referral of gynecological cancer, including aspects of psychological distress through the screening program. The study focuses primarily on the research of whether psychological distress is prevalent and identifiable in patients as well as the experience of the staff using screening tools such as DT with success, allowing to further refer patients. The author of this report believes it is necessary to examine such research questions in order to ensure that patients are provided the best quality and support of service along with the efficacy of simple screening tools such as DT.
The study utilizes a mixed-method design. Quantitative data is collected through DT, and a Problems List through a cross-sectional study. Meanwhile, qualitative information is gathered through interviews with healthcare staff (O’Connor et al., 2017). The advantages of this design are combining both quantitative and qualitative data to create a more wholesome context for the research. This allows having a broader perspective on the issue, combining deductive thinking and reasoning.
The mixed methods can help reduce bias and improve the validity of evidence supported by varied data. The primary disadvantage is that the study becomes more expensive and time-consuming to conduct. Mixed methods design is multifaceted, requiring expertise from researchers to perform and present the findings correctly (CIRT, n.d.). The author most likely selected this design to support the complexity of the issue, which requires both quantitative support to determine prevalence rates while collecting qualitative information regarding the causes and symptoms that patients experience.
The sample consisted of 62 gynecologic cancer patients in a pre-admission clinic. The participants were at least 18 years of age and had a diagnosis of gynecologic cancer. The sample size is relatively small but can be considered adequate to make initial judgments regarding the prevalence of distress and competency of the DT test. However, these results would not be generalizable since the scope of the study attempts to identify the issue of pain; the sample should be much more significant to accurately determine percentage rates. There is an evident gap between the numbers, most likely due to the limited geographic area of the study and a specific, less common type of cancer selected.
Direct data collection was conducted by an oncology nurse at the clinic with the presence of a social worker. Interviews were conducted with research officers. The tools used were the DT test with a Problems List which are meant to identify distress and possible experiences of patients. An ethics committee approved the study, and participants were fully informed, signing a consent form. There were not evident ethical issues with the task.
The authors of the study identify limitations as not all patients in the clinic could be approached due to a busy environment. Furthermore, referrals after the completion of DT were not tracked to identify the viability of the tool as a practical solution. It should be noted that another limitation is a small sample size, leading to a lack of generalizability of the findings. These limitations can be overcome by a more structured and more extensive study introducing better methods to attract participants. Limitations are vital in providing context to studies, improving validity, and helping in designing future research.
Findings identified that approximately a third of the participants scored in each category of the Distress Thermometer. The majority (207) of problems identified include physical issues, 147 emotional, 53 practical, 24 familial, and two spiritual (O’Connor et al., 2017). It shows that a wide selection of problems affects cancer patients during treatment. The findings generally answered the research questions posed by offering prevalence data as well as the impact of the screening on both patients and staff. The results are credible as they were statistically analyzed and supported by recorded interview data.
Psychological distress is common in cancer patients and can lead to adverse outcomes or burdens on the health system. Early identification of pain through simple screening tools such as DT allows for early prevention and referral of patients to meet their needs. The evidence demonstrates the need for a change in practice, but it is limited and needs to be examined on a more significant level. Practice change is warranted since clinical care should offer comprehensive support beyond the physical symptoms and consider psychological health as well. By identifying this gap in clinical knowledge, significant changes can be made to improve the quality of care for cancer patients.
CIRT. (n.d.). Overview of mixed methods. Web.
O’Connor, M., Tanner, P., Miller, L., Watts, K., & Musiello, T. (2017). Detecting distress: Introducing routine screening in a gynecological cancer setting. Clinical Journal of Oncology Nursing, 21(1), 79-85.