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Most diagnoses occurred in 2014 (46%; N = 25) or 2015 (13%; N = 7). Prior radiation or a different chemotherapy regimen was reported by 46% of participants (N = 25)[JP1] .
Cycle/week of chemotherapy or number of radiation treatment was coded and divided into first cycle/week, second cycle/week, third cycle/week to halfway point, halfway point to second-to-last cycle/week, and last cycle/week. Nine participants (5%) reported palliative treatment until end of life and 15 (27%) could not remember at what point in their treatment plan they were.
Participants were asked to rate their distress level over the previous week using the number scale on the thermometer (Table 3). The most common response was 0 (22%; N = 12), followed closely by 1 (16%; N = 9), and 2 (15%; N = 8). Only 1 patient called the nurse navigator to locate more resources, and this was related to insurance and financial needs.
TABLE 3. Distress Levels Reported
| Level | Percent Reporting Level (N) |
| 0 | 22% (12) |
| 1 | 16% (9) |
| 2 | 15% (8) |
| 3 | 11% (6) |
| 4 | 9% (5) |
| 5 | 3% (2) |
| 6 | 9% (5) |
| 7 | 2% (1) |
| 8 | 6% (3) |
| 9 | 6% (3) |
| 10 | 2% (1) |
Self-report of problems Participants were asked to check “Yes” or “No” for each item on a list of 38 problems, divided into 5 categories (Table 4). Practical problems, ranked in order of percentage of “Yes” responses, were: insurance/financial (32.7%), treatment decisions (27.3%), transportation (10.9%), work/school (5.5%), housing (3.6%), and child care (0%). Family problems, per the same ranking order, were: family health issues (21.8%), dealing with a partner (12.7%), dealing with children (10.9%), and ability to have children (0%). Emotional problems, per the same ranking order, were: worry (43.6%), fears (40%), sadness (38.2%), loss of interest in usual activities (34.5%), nervousness (30.9%), and depression (27.3%). Spiritual/religious concerns are not divided into subcategories; only 7.3% of respondents checked “Yes” for this item.
TABLE 4. Responses to Problems On NCCN Distress Thermometer
| Problem | No Percent (N) | Yes Percent (N) |
| Practical Problems | ||
| Child Care | 100 (55) | 0 |
| Housing | 96.4 (53) | 3.6 (2) |
| Insurance/financial | 67.3 (37) | 32.7 (18) |
| Transportation | 89.1 (49) | 10.9 (6) |
| Work/school | 94.5 (52) | 5.5 (3) |
| Treatment decisions | 72.7 (40) | 27.3 (15) |
| Family Problems | ||
| Dealing with children | 94.5 (52) | 10.9 (3) |
| Dealing with partner | 87.3 (48) | 12.7 (7) |
| Ability to have children | 100 (55) | 0 |
| Family health issues | 78.2 (43) | 21.8 (12) |
| Emotional Problems | ||
| Depression | 72.7 (40) | 27.3 (15) |
| Fears | 60 (33) | 40 (22) |
| Nervousness | 69.1 (38) | 30.9 (17) |
| Sadness | 61.8 (34) | 38.2 (21) |
| Worry | 56.4 (31) | 43.6 (24) |
| Loss of interest in usual activities | 65.5 (36) | 34.5 (19) |
| Spiritual/religious concerns | 92.7 (51) | 7.3 (4) |
| Physical Problems | ||
| Appearance | 70.9 (39) | 29.1 (16) |
| Bathing/dressing | 89.1 (49) | 10.9 (6) |
| Breathing | 81.8 (45) | 18.2 (10) |
| Changes in urination | 90.9 (50) | 9.1 (5) |
| Constipation | 60 (33) | 40 (22) |
| Diarrhea | 74.5 (41) | 25.5 (14) |
| Eating | 67.3 (37) | 32.7 (18) |
| Fatigue | 36.4 (20) | 63.6 (35) |
| Feeling swollen | 76.4 (42) | 23.6 (13) |
| Fevers | 92.7 (51) | 7.3 (4) |
| Getting around | 70.9 (39) | 29.1 (16) |
| Indigestion | 74.5 (41) | 25.5 (14) |
| Memory/concentration | 60 (33) | 40 (22) |
| Mouth sores | 89.1 (49) | 10.9 (6) |
| Nausea | 63.6 (35) | 36.4 (20) |
| Nose dry/congested | 74.5 (41) | 25.5 (14) |
| Pain | 54.5 (30) | 45.5 (25) |
| Sexual | 89.1 (49) | 10.9 (6) |
| Skin dry/itchy | 56.4 (31) | 43.6 (24) |
| Sleep | 61.8 (34) | 38.2 (21) |
| Tingling in hands/feet | 72.7 (40) | 27.3 (15) |
| Key: NCCN, National Comprehensive Cancer Network. | ||
Ranked in order of percentage of “Yes” responses, physical problems were: fatigue (63.6%), pain (45.5%), dry or itchy skin (43.6%), memory/concentration (40%), constipation (40%), sleep (38.2%), nausea (36.4%), eating (32.7%), appearance (29.1%), getting around (29.1%), tingling in hands/feet (27.3%), nose dry/congested (25.5%), diarrhea (25.5%), indigestion (25.5%), feeling swollen (23.6%), breathing (18.2%), bathing/dressing (10.9%), mouth sores (10.9%), sexual (10.9%), changes in urination (9.1%), and fevers (7.3%).
