ATS American Thoracic Society
Recent Abstracts

Symptom Distress Scale

Name of Questionnaire

Symptom Distress Scale (SDS)


Cancer-specific tool for assessing cancer-related symptoms. Subjects respond about how they have been feeling during the preceding week. Validation with chronic disease (primarily cancer) patients.


Ruth McCorkle


Professor Ruth McCorkle
Yale University
School of Nursing
100 Church Street South
New Haven, CT 06536


Cost & availability

Permission to use instrument is granted upon request.



Time to complete

5-10 minutes

Number of items


Domains & categories


Name of categories/domains


Scaling of items

1 to 5 Likert-type scales, with 5 indicating the most distress


Items rated 3 or higher are considered to indicate serious distress. A total summed score of 25 or above indicates moderate distress; scores of 33 or above indicate severe distress that requires immediate intervention1.


a. Test-retest/ reproducibility Reported1
b. Internal consistency Reported2


Compared with Ware's health perception questionnaire in cancer patients2. Discriminated between cancer patients and cardiac patients2. Instrument scores correlated with survival3.


Reported2, 4

Minimally important difference

Not reported (testing is ongoing1)

Research use

Reported - symptom distress in women with advanced lung cancer5, symptom distress in cancer6

Clinical use

Not reported


Dutch, English, Italian, Spanish, Swedish, Taiwanese


  1. McCorkle R, Cooley ME, Shea JA. A user's manual for the Symptom Distress Scale. 1998; Philadelphia: University of Pennsylvania.
  2. McCorkle R. The measurement of symptom distress. Seminars in Oncology Nursing 1987;3:248-56.
  3. Kukull WA, McCorkle R, Driever M. Symptom distress, psychosocial variables and survival from lung cancer. J Psychosocial Onc 1986;4:91-104.
  4. McCorkle R, Benoliel JQ, Donaldson G, Georgiadou F, Moinpour C, Goodell B. A randomized clinical trial of home nursing care for lung cancer patients. Cancer 1989;64:199-206.
  5. Sarna L, Brecht M-L. Dimensions of symptom distress in women with advanced lung cancer: a factor analysis. Heart Lung 1997;26:23-30.
  6. Degner LF, Sloan JA. Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer. J Pain Symptom Manage 1995;10:423-31.

Date of information

May 1999

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