Although one-item distress thermometers have been demonstrated to be satisfactory measures of distress with adult patients, there is a gap in the literature regarding the psychometric properties of such a measure with pediatric patients. The current study explored the stability and generalizability of the Distress Rating Scale thermometer with pediatric cancer patients across developmental age groups. In addressing specific questions of validity, findings indicate reasonable agreement between patient self-ratings on the Distress Rating Scale and ratings by psychosocial staff and parents. The Distress Rating Scale was also shown to correlate significantly with total and subscale scores on standardized measures of psychosocial functioning in children, and its construct validity was supported by its sensitivity to critical medical events, such as hospitalization, acuteness of diagnosis, and bone marrow transplant. Adolescents indicated greater distress than younger patients during the hospitalization assessment period. The significant discrepancies between patient self-ratings and parent ratings of patients in the younger age groups warrants clinical attention to both patient and parent ratings when younger children are screened. Finally, the recommended cutoff score of 4 on distress thermometers used with adult populations was shown to be an appropriate cutoff score for pediatric patients. Findings from the current study warrant further investigation of the effectiveness of a distress thermometer to classify patients to services based on mild, moderate, and high levels of distress.
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