The distress thermometer (DT) is a rating scale used to measure distress: 0 (no distress) to 10 (extreme distress); it is similar to the rating scale used to measure pain. It serves as a rough initial single-item question screen, which identifies distress coming from any source even if unrelated to cancer.

The patient in the waiting room places a mark on the DT scale answering, "How distressed have you been during the past week on a scale of 0 to 10?"

Score of four or higher suggest a level of distress that has clinical significance.
If the patient's distress level is four or higher, the nurse looks at the problem list to identify key issues of concern and asks further questions to determine to which resource the patient should be referred.
If the patient's distress level is mild (score is less than 4 on the DT), the primary oncology team may choose to manage the concerns by usual clinical supportive care management.

DT has been validated by several studies in patients with different types of cancer and has shown good sensitivity and specificity.

The National Comprehensive Cancer Network pairs the DT with a 35-item Problem List, which asks patients to identify their problems in five different categories: practical, family, emotional, spiritual/religious and physical.

See the DT at the reference.

Adapted from National Comprehensive Cancer Network, Inc. Distress Management. Internet. Accessed on June 23, 2016.