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Patient-reported distress and problems among elderly patients with hematological malignancy in Korea

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Abstract

Purpose

Treatment for hematological malignancies (HMs) and functional decline associated with age can cause distress in elderly patients with HMs. However, information about the nature and effects of distress in this population is scarce. Therefore, this study examined the level of distress, its source, and the practical/familial/physical/emotional problems among elderly patients with HMs.

Methods

We conducted a cross-sectional study of patients with HMs aged ≥ 65 years who visited an outpatient clinic at a tertiary medical center in Korea between November 2019 and March 2020. Patient-reported distress and problems were measured using the distress thermometer (DT) and 39‐item Problem List by the National Comprehensive Cancer Network. Descriptive statistics, χ2 test or Fisher’s exact test, and multivariate logistic regression analyses were conducted (N = 132).

Results

In total, 62.1% of patients had moderate to severe distress (DT score ≥ 4), experiencing an average of nine problems. Significant sources of distress on multivariate logistic analysis included problems with transportation, depression, and constipation, accounting for 47% of distress variance. Most patients had physical (97.0%) or emotional problems (79.5%). Among these, fatigue (60.6%), worry (59.8%), tingling (59.8%), difficulty with mobility (47.0%), and memory/concentration (40.2%) were the most frequently reported problems.

Conclusions

Elderly patients with HMs have a high burden of distress, which is affected by different sources, compared with younger patients with solid tumors. Thus, in this population, assessment and management of distress need to be conducted considering the unique features of their source and burden. Further research on distress should consider the cancer type and population age.

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Data availability

The datasets generated and/or analyzed during the present study are available from the corresponding author on reasonable request.

References

  1. Surveillance, epidemiology, and end results program 2018 SEER cancer statistics review 1975–2014: age distribution at diagnosis and death. seer.cancer.gov/archive/csr/1975_2014/results_merged/topic_age_dist.pdf. Accessed 10 February 2022

  2. Johnsen AT, Tholstrup D, Petersen MA, Pedersen L, Groenvold M (2009) Health related quality of life in a nationally representative sample of haematological patients. Eur J Haematol 83(2):139–148. https://doi.org/10.1111/j.1600-0609.2009.01250.x

    Article  PubMed  PubMed Central  Google Scholar 

  3. Else M, Smith AG, Cocks K, Richards SM, Crofts S, Wade R et al (2008) Patients’ experience of chronic lymphocytic leukaemia: baseline health-related quality of life results from the LRF CLL4 trial. Brit J Haematol 143(5):690–697. https://doi.org/10.1111/j.1365-2141.2008.07407.x

    Article  Google Scholar 

  4. Barata A, Wood WA, Choi SW, Jim HS (2016) Unmet needs for psychosocial care in hematologic malignancies and hematopoietic cell transplant. Curr Hematol Malig Rep 11(4):280–287. https://doi.org/10.1007/s11899-016-0328-z

    Article  PubMed  Google Scholar 

  5. Franchini M, Frattini F, Crestani S, Bonfanti C (2013) Bleeding complications in patients with hematologic malignancies. Semin Thromb Hemost 39:94–100. https://doi.org/10.1055/s-0032-1331154

    Article  PubMed  Google Scholar 

  6. Hurria A, Li D, Hansen K, Patil S, Gupta R, Nelson C et al (2009) Distress in older patients with cancer. J Clin Oncol 27(26):4346–4351. https://doi.org/10.1200/JCO.2008.19.9463

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hong JF, Zhang W, Song YX, Xie LF, Wang WL (2015) Psychological distress in elderly cancer patients. Int J Nurs Sci 2(1):23–27. https://doi.org/10.1016/j.ijnss.2015.02.006

    Article  Google Scholar 

  8. Shreders AJ, Niazi SK, Hodge DO, Chimato NT, Kureti M, Kirla N et al (2018) Correlation of sociodemographic and clinical parameters with depression and distress in patients with hematologic malignancies. Ann Hematol 97(3):519–528. https://doi.org/10.1007/s00277-017-3198-0

    Article  PubMed  Google Scholar 

  9. Riba MB, Donovan KA, Andersen B, Braun I, Breitbart WS, Brewer BW et al (2019) Distress management version 3.2019 NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 17(10):1229–1249. https://doi.org/10.6004/jnccn.2019.0048

    Article  PubMed  PubMed Central  Google Scholar 

  10. Troy JD, de Castro CM, Pupa MR, Samsa GP, Abernethy AP, LeBlanc TW (2018) Patient-reported distress in myelodysplastic syndromes and its association with clinical outcomes: a retrospective cohort study. J Natl Compr Canc Netw 16(3):267–273. https://doi.org/10.6004/jnccn.2017.7048

    Article  PubMed  PubMed Central  Google Scholar 

  11. Musiello T, Dixon G, O’Connor M, Cook D, Miller L, Petterson A (2017) A pilot study of routine screening for distress by a nurse and psychologist in an outpatient haematological oncology clinic. Appl Nurs Res 33:15–18. https://doi.org/10.1016/j.apnr.2016.09.005

    Article  PubMed  Google Scholar 

  12. Troy JD, Locke SC, Samsa GP, Feliciano J, Richhariya A, LeBlanc TW (2019) Patient-reported distress in hodgkin lymphoma across the survivorship continuum. Support Care Cancer 27(7):2453–2462. https://doi.org/10.1007/s00520-018-4523-4

    Article  PubMed  Google Scholar 

  13. VanHoose L, Black LL, Doty K, Sabata D, Twumasi-Ankrah P, Taylor S et al (2015) An analysis of the distress thermometer problem list and distress in patients with cancer. Support Care Cancer 23(5):1225–1232. https://doi.org/10.1007/s00520-014-2471-1

    Article  PubMed  Google Scholar 

  14. Graves KD, Arnold SM, Love CL, Kirsh KL, Moore PG, Passik SD (2007) Distress screening in a multidisciplinary lung cancer clinic: prevalence and predictors of clinically significant distress. Lung Cancer 55(2):215–224. https://doi.org/10.1016/j.lungcan.2006.10.001

    Article  PubMed  Google Scholar 

  15. Mehnert A, Hartung TJ, Friedrich M, Vehling S, Brähler E, Härter M et al (2018) One in two cancer patients is significantly distressed: prevalence and indicators of distress. Psychooncology 27(1):75–82. https://doi.org/10.1002/pon.4464

    Article  CAS  PubMed  Google Scholar 

  16. Ownby KK (2019) Use of the distress thermometer in clinical practice. Journal J Adv Pract Oncol 10(2):175. https://doi.org/10.6004/jadpro.2019.10.2.7

    Article  PubMed  Google Scholar 

  17. Berry DL, Blonquist TM, Hong F, Halpenny B, Partridge AH (2015) Self-reported adherence to oral cancer therapy: relationships with symptom distress, depression, and personal characteristics. Patient Prefer Adherence 4(9):1587–1597. https://doi.org/10.2147/PPA.S91534

    Article  Google Scholar 

  18. American College of Surgeons Commission on Cancer 2020 Optimal resources for cancer care (2020 standards). American College of Surgeons Commission on Cancer: Chicago, IL, USA. https://www.facs.org/-/media/files/quality-programs/cancer/coc/optimal_resources_for_cancer_care_2020_standards.ashx. Accessed 10 February 2022

  19. Jacobsen PB, Donovan KA, Trask PC, Fleishman SB, Zabora J, Baker F et al (2005) Screening for psychologic distress in ambulatory cancer patients: a multicenter evaluation of the distress thermometer. Cancer 103(7):1494–1502. https://doi.org/10.1002/cncr.20940

    Article  PubMed  Google Scholar 

  20. McFarland DC, Jutagir DR, Miller A, Nelson C (2020) Physical problem list accompanying the distress thermometer: its associations with psychological symptoms and survival in patients with metastatic lung cancer. Psychooncology 29(5):910–919. https://doi.org/10.1002/pon.5367

    Article  PubMed  PubMed Central  Google Scholar 

  21. Jewett PI, Teoh D, Petzel S, Lee H, Messelt A, Kendall J et al (2020) Cancer-related distress: revisiting the utility of the National Comprehensive Cancer Network distress thermometer problem list in women with gynecologic cancers. JCO Oncol Pract 16(8):649–659. https://doi.org/10.1200/JOP.19.00471

    Article  Google Scholar 

  22. Clover KA, Oldmeadow C, Nelson L, Rogers K, Mitchell AJ, Carter G (2016) Which items on the distress thermometer problem list are the most distressing? Support Care Cancer 24(11):4549–4557. https://doi.org/10.1007/s00520-016-3294-z

    Article  PubMed  Google Scholar 

  23. Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL (2018) Predictors of emotional distress a year or more after diagnosis of cancer: a systematic review of the literature. Psychooncology 27(3):791–801. https://doi.org/10.1002/pon.4601

    Article  PubMed  PubMed Central  Google Scholar 

  24. Bergerot CD, Clark KL, Nonino A, Waliany S, Buso MM, Loscalzo M (2015) Course of distress, anxiety, and depression in hematological cancer patients: association between gender and grade of neoplasm. Palliat Support Care 13(2):115–123. https://doi.org/10.1017/S1478951513000849

    Article  PubMed  Google Scholar 

  25. Subramaniam S, Kong YC, Chinna K, Kimman M, Ho YZ, Saat N et al (2018) Health-related quality of life and psychological distress among cancer survivors in a middle-income country. Psychooncology 27(9):2172–2179. https://doi.org/10.1002/pon.4787

    Article  PubMed  Google Scholar 

  26. Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191. https://doi.org/10.3758/BF03193146

    Article  PubMed  Google Scholar 

  27. National Comprehensive Cancer Network 2013 Distress thermometer and problem list https://www.nccn.org/professionals/physician_gls/pdf/distress_tool_korean.pdf. Accessed 10 February 2022

  28. Park JS, Oh YJ (2012) Development and evaluation of the psychosocial distress nursing intervention for patients with gynecological cancer. Korean J Adult Nurs 24(3):219–231. https://doi.org/10.7475/kjan.2012.24.3.219

    Article  Google Scholar 

  29. Statistics Korea: household income trends in the fourth quarter of 2019. http://kostat.go.kr/portal/eng/pressReleases/6/1/index.board. Accessed 10 February 2022

  30. Wochna Loerzel V (2015) Symptom experience in older adults undergoing treatment for cancer. Oncol Nurs Forum 42(3):269–278. https://doi.org/10.1188/15.ONF.E269-E278

    Article  Google Scholar 

  31. Youn HM, Lee HJ, Lee DW, Park EC (2020) The impact of poverty transitions on frailty among older adults in South Korea: findings from the Korean longitudinal study of ageing. BMC Geriatr 20(1):1–10

    Article  Google Scholar 

  32. Ascencio-Huertas L, Allende-Pérez SR, Pastrana T (2021) Associated factors of distress in patients with advanced cancer: A retrospective study. Palliat Support Care 19(4):447–456. https://doi.org/10.1017/S1478951520001066

    Article  PubMed  Google Scholar 

  33. Jang SY, Seon JY, Oh IH (2020) Influencing factors of transportation costs regarding healthcare service utilization in Korea. J Korean Med Sci 35(35):e290. https://doi.org/10.3346/jkms.2020.35.e290

    Article  PubMed  PubMed Central  Google Scholar 

  34. Jeong A, An JY, Park JH, Park K (2017) What cancer means to the patients and their primary caregivers in the family-accounted Korean context: a dyadic interpretation. Psychooncology 26(11):1777–1783. https://doi.org/10.1002/pon.4364

    Article  PubMed  Google Scholar 

  35. Oh Y, Han E (2019) Review of studies on spousal caregivers of frail spouses in South Korea. Int Soc Work 62(2):529–548. https://doi.org/10.1177/0020872817731144

    Article  Google Scholar 

  36. Silva S, Bártolo A, Santos IM, Pereira A, Monteiro S (2022) Towards a better understanding of the factors associated with distress in elderly cancer patients: a systematic review. Int J Environ Res 19(6):3424. https://doi.org/10.3390/ijerph19063424

    Article  Google Scholar 

  37. Parpa E, Tsilika E, Gennimata V, Mystakidou K (2015) Elderly cancer patients’ psychopathology: a systematic review: aging and mental health. Arch Gerontol Geriatr 60(1):9–15. https://doi.org/10.1016/j.archger.2014.09.008

    Article  PubMed  Google Scholar 

  38. Spoletini I, Gianni W, Repetto L, Bria P, Caltagirone C, Bossu P et al (2008) Depression and cancer: an unexplored and unresolved emergent issue in elderly patients. Crit Rev Oncol Hematol 65(2):143–155. https://doi.org/10.1016/j.critrevonc.2007.10.005

    Article  PubMed  Google Scholar 

  39. Dore MP, Pes GM, Bibbò S, Tedde P, Bassotti G (2018) Constipation in the elderly from northern sardinia is positively associated with depression, malnutrition and female gender. Scand J Gastroenterol 53(7):797–802. https://doi.org/10.1080/00365521.2018.1473485

    Article  PubMed  Google Scholar 

  40. Talley NJ 2004. Definitions, epidemiology, and impact of chronic constipation. Rev Gastroenterol Disord 4:3–10. https://pubmed.ncbi.nlm.nih.gov/15184814/

  41. McFarland DC, Shaffer KM, Tiersten A, Holland J (2018) Physical symptom burden and its association with distress, anxiety, and depression in breast cancer. Psychosomatics 59(5):464–471. https://doi.org/10.1016/j.psym.2018.01.005

    Article  PubMed  PubMed Central  Google Scholar 

  42. Siegel K, Lekas H-M, Maheshwari D (2012) Causal attributions for fatigue by older adults with advanced cancer. J Pain Symptom Manage 44(1):52–63. https://doi.org/10.1016/j.jpainsymman.2011.07.013

    Article  PubMed  PubMed Central  Google Scholar 

  43. Cataldo JK, Paul S, Cooper B, Skerman H, Alexander K, Aouizerat B et al (2013) Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study. BMC Cancer 13(1):1–16. https://doi.org/10.1186/1471-2407-13-6

    Article  Google Scholar 

  44. Li T, Timmins HC, Lazarus HM, Park SB (2020) Peripheral neuropathy in hematologic malignancies–past, present and future. Blood Rev 43:100653. https://doi.org/10.1016/j.blre.2020.100653

    Article  CAS  PubMed  Google Scholar 

  45. Caillet P, Laurent M, Bastuji-Garin S, Liuu E, Culine S, Lagrange J-L et al (2014) Optimal management of elderly cancer patients: usefulness of the comprehensive geriatric assessment. Clin Interv Aging 9:1645. https://doi.org/10.2147/CIA.S57849

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Graduate School, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea

    Sun-young Park

  2. Division of New Health Technology Assessment, National Evidence-Based Healthcare Collaborating Agency, 400 Neungdong-ro, Gwangjin-gu, Seoul, 04554, Korea

    Sun-young Park

  3. Department of Nursing, College of Healthcare Sciences, Far East University, Eumseong-gun, Chungcheongbuk-do, Seoul, South Korea, 27601

    Yoonjoo Kim

  4. National Cancer Center, 323 Ilsan-ro, Goyang-si, Gyeonggi-do, 10408, Korea

    Hyunju Hong

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Contributions

All authors contributed to the study conception and design. Specifically, Park S. performed the statistical analysis and drafted the manuscript. Kim Y. was involved in revising the manuscript for important intellectual contents. Hong H. collected the data and helped to draft the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hyunju Hong.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of National Cancer Center (Number NCC 2019–0282).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Park, Sy., Kim, Y. & Hong, H. Patient-reported distress and problems among elderly patients with hematological malignancy in Korea. Support Care Cancer 30, 9019–9027 (2022). https://doi.org/10.1007/s00520-022-07315-9

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