Measuring symptom distress in patients with lung cancer - A pilot study ofexperienced intensity and importance of symptoms

Patients with cancer experience high levels of symptom distress. Current me asures of symptoms generally weight the importance of each symptom equally, and do not generally address the relative importance of different symptoms to patients. The purpose of this pilot study was to explore whether the as sumption of equal weighting is warranted in measurements of symptom distres s. Consecutive patients presenting with primary lung cancer at the Lung Med icine Unit of one Swedish hospital completed the Symptom Distress Scale and a Thurstone scale eliciting patients' weightings of the symptoms' relative importance three times: after first contact with the unit, then 1 and 2 mo nths later. The results show that subjects weighted some symptoms as signif icantly more important than others, and the ordering of symptoms was found to differ by intensity and perceived importance in this group. Outlook was the symptom rated most important at T1. Fatigue received the highest intens ity score, bur ranked second lowest in importance. Kendall's coefficient sh owed minimal agreement among these patients as to the specific order for th e weighting of the importance of symptoms. In addition to theoretical relev ance, this issue is clinically relevant in selecting symptoms that should b e the focus of intervention and in determining how the success of intervent ions should be judged.