Distress Thermometer Intervention Trial (DiTIT)

The DiTIT study is a randomised controlled trial evaluating the cost-effectiveness of the Distress Thermometer and Problem List for patients with cancer receiving chemo or radiotherapy.

The distress thermometer and problem list is a structured way for a nurse or radiographer to discuss with a patient some of the concerns (e.g. practical, emotional, physical) that they may be experiencing during their treatment for cancer.

A Summary of the Study:

The diagnosis and treatment of cancer has been shown to lead to very high levels of distress among patients. Although treatments for cancer have become much better in recent years, the distress that accompanies diagnosis and treatment can have serious negative effects for patients. Research has shown that patients find it difficult to tell medical staff about the cause of their distress whether it is physical (e.g. pain), psychological (e.g. anxiety and depression), personal (e.g. problems with partners and family) or social (e.g. finances). Also, medical staff often fail to detect even high levels of distress. This means that a great deal of distress is not being treated and this may lead to more hospital and GP visits, and dissatisfaction with care. The Distress Thermometer and Problem List (DT&PL) is a simple method of identifying distress in cancer patients using the familiar image of a thermometer. It offers patients a list of common treatment-related difficulties to help them identify any sources of distress. A trained staff member uses the DT&PL to discuss with the patient different options for dealing with distress. This might include action taken by the patient or the staff member or a referral to another NHS staff member. Our study aims to measure whether the DT&PL, used during and at the end of chemotherapy and radiotherapy, is more effective than usual care in reducing cancer-related distress and improving satisfaction with care. We also want to know whether patients find it helpful to complete the DT&PL and whether using the DT&PL saves NHS time and money. This study has been funded by the National Institute for Health Research.

An Example of the Distress Thermometer in Action:

This audio file (290MB) provides an example as to how the distress thermometer might be used by a nurse or radiographer. It is based on a role play by a radiographer and a clinical psychologist who takes the role of the patient. The specific problems and potential solutions discussed are for illustration only. However the structure of the conversation (which lasts about 20 minutes) should be useful for nurses and radiographers planning to use the distress thermometer and problem list in their own practice.