Please circle or pick a number (0-10) from the drop down box that best describes how much distress you have been experiencing in the past week including today.
If you have Lung Cancer or Mesothelioma, please call either Johanna Lynch or Lucy Pike on: 01895 279584
(during office hours, Monday - Friday 9am-4pm)
to discuss your scores on the distress thermometer.
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Second, please indicate if any of the following has been a problem for you
in the past week including today.
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Practical Problems
Child Care
Housing
Insurance/financial
Transportation
Work/school
Family Problems
Dealing with children
Dealing with partner
Dealing with close friend/relative
Emotional Problems
Depression
Fears
Nervousness
Sadness
Worry
Loss of interest in usual activities
Spiritual/religious concerns
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Physical Problems
Appearance
Bathing/dressing
Breathing
Changes in urination
Constipation
Diarrhoea
Eating
Fatigue
Feeling Swollen
Fevers
Getting around
Indigestion
Memory/concentration
Mouth sores
Nausea
Nose dry/congested
Pain
Sexual
Skin dry itchy
Sleep
Tingling in hands/feet
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