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Symptom distress was defined as the degree of discomfort reported by the patient in relation to his/her perception of the symptoms being experienced. The ten symptoms included in the symptom distress scale were nausea, mood, appetite, insomnia, pain, mobility, fatigue, bowel pattern, concentration and appearance. The scale was tested on fifty-three patients with advanced medical conditions. Total symptom distress scores for these patients ranged from ten to forty-one; the mean was twenty. The reliability coefficient alpha was .82143 and the standardized alpha was .82557. More testing of the scale is needed, especially with different types of chronic diseases and visible signs of illness.
McCorkle et al. (Sun,) studied this question.