Operationalizing Symptom Distress in Adults With Cancer: A Literature Synthesis

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Abstract
To address inconsistencies in the definition and operationalization of symptom distress by synthesizing the literature on cancer-related symptom distress in adults. Electronic nursing, psychology, and medicine databases; online meeting abstracts; and various print sources. Eight distinct methods of operationalizing the concept were identified. Gender, ethnic, developmental, cultural, and individual differences in symptom distress have not been identified. Relationships among symptom frequency, intensity, and distress are unclear. Lack of clarity and consensus in defining and operationalizing symptom distress hinder meta-analysis, research synthesis, and research utilization. Symptom distress may be emerging as a component of the multidimensional symptom experience. Defining and operationalizing symptom distress consistently will enhance research synthesis and assist clinicians with more effectively meeting the needs of people with cancer. Research is needed to identify the meanings of symptom distress to patients with cancer and to differentiate symptom distress from symptom frequency and intensity.

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