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Evaluation of the adherence of distress screening with the distress thermometer in cancer patients 4 years after implementation

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Abstract

Purpose

Identifying and assessing psychosocial distress with an appropriate screening instrument is essential when caring for cancer patients. Since 2012, the distress thermometer (DT) has been used by nurses for all cancer inpatients at the Comprehensive Cancer Center Zurich. We wanted to identify nurses’ adherence to the screening protocol, differences between screened and not screened patients and the relationship between screening rate and productivity.

Methods

This retrospective descriptive study used screening and referral data as well as socioeconomic and disease-related data of inpatients at the Comprehensive Cancer Center Zurich. This was collected from the electronic patient documentation system. Additionally, data showing the productivity of all wards was used. All data were analyzed descriptive.

Results

Since 2012, 40.6% (4541) of the 11,184 patients have been screened. The screening rate was initially significantly lower but settled at 40% after 2 years. There was a higher screening rate among Swiss, married, male, and emergency patients and patients with hematology diseases, brain tumors, or head and neck cancer (p < 0.001). Every fourth patient with a moderate to severe distress level requested referral to a psychosocial service. Significantly more screened patients were referred to the social service (44.7%) than to the psycho-oncology service (9.4%). Only 22.9% of all referrals were made on the day of screening or a day later. There were only two wards of 15 with a significant relationship between productivity and screening rate.

Conclusions

Screening is useful in recognizing distress among patients, but screening practice needs to be reconsidered.

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References

  1. Holland JC, Andersen B, Breitbart WS, Compas B, Dudley MM, Fleishman S, Fulcher CD, Greenberg DB, Greiner CB, Handzo GF, Hoofring L, Jacobsen PB, Knight SJ, Learson K, Levy MH, Loscalzo MJ, Manne S, McAllister-Black R, Riba MB, Roper K, Valentine AD, Wagner LI, Zevon MA, NCCN Distress Management Panel (2010) Distress management. J Natl Compr Cancer Netw 8(4):448–485

    Article  CAS  Google Scholar 

  2. Feldstain A, Tomei C, Bélanger M, Lebel S (2014) Screening for distress in patients with cancer: methodologic considerations. Curr Oncol 21(2):e330–e333

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Mehnert A et al (2006) Assessment of psychosocial distress and resources in oncology--a literature review about screening measures and current developments. Psychother Psychosom Med Psychol 56(12):462–479

    Article  PubMed  Google Scholar 

  4. NCCN, NCCN clinical practice guidelines in oncology, in Distress management. 2016: NCCN.org

  5. Götz A, Kröner A, Staudacher D, Spirig R (2017) Einführung des Belastungsthermometers auf einer onkologischen Station. Pflege 30(5):289–297

    Article  PubMed  Google Scholar 

  6. McCarter K, Britton B, Baker AL, Halpin SA, Beck AK, Carter G, Wratten C, Bauer J, Forbes E, Booth D, Wolfenden L (2018) Interventions to improve screening and appropriate referral of patients with cancer for psychosocial distress: systematic review. BMJ Open 8(1):e017959

    Article  PubMed  PubMed Central  Google Scholar 

  7. Mitchell AJ (2013) Screening for cancer-related distress: when is implementation successful and when is it unsuccessful? Acta Oncol 52(2):216–224

    Article  PubMed  Google Scholar 

  8. Tondorf T, Grossert A, Rothschild SI, Koller MT, Rochlitz C, Kiss A, Schaefert R, Meinlschmidt G, Hunziker S, Zwahlen D (2018) Focusing on cancer patients’ intentions to use psychooncological support: a longitudinal, mixed-methods study. Psychooncology 27(6):1656–1663

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Zebrack B, Kayser K, Bybee D, Padgett L, Sundstrom L, Jobin C, Oktay J (2017) A practice-based evaluation of distress screening protocol adherence and medical service utilization. J Natl Compr Cancer Netw 15(7):903–912

    Article  Google Scholar 

  10. Carlson LE, Waller A, Mitchell AJ (2012) Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol 30(11):1160–1177

    Article  Google Scholar 

  11. Fulcher CD, Gosselin-Acomb TK (2007) Distress assessment: practice change through guideline implementation. Clin J Oncol Nurs 11(6):817–821

    Article  PubMed  Google Scholar 

  12. Hahn C, Joo SH, Chae JH, Lee CU, Kim TS (2017) Feasibility of psychosocial distress screening and management program for hospitalized cancer patients. Psychiatry Investig 14(6):734–745

    Article  PubMed  PubMed Central  Google Scholar 

  13. Zebrack B, Kayser K, Sundstrom L, Savas SA, Henrickson C, Acquati C, Tamas RL (2015) Psychosocial distress screening implementation in cancer care: an analysis of adherence, responsiveness, and acceptability. J Clin Oncol 33(10):1165–1170

    Article  PubMed  Google Scholar 

  14. Chiang AC, Buia Amport S, Corjulo D, Harvey KL, McCorkle R (2015) Incorporating patient-reported outcomes to improve emotional distress screening and assessment in an ambulatory oncology clinic. J Oncol Pract 11(3):219–222

    Article  PubMed  Google Scholar 

  15. Pretto M, Spirig R, Milisen K, DeGeest S, Regazzoni P, Hasemann W (2009) Effects of an interdisciplinary nurse-led Delirium Prevention and Management Program (DPMP) on nursing workload: a pilot study. Int J Nurs Stud 46(6):804–812

    Article  PubMed  Google Scholar 

  16. Mitchell AJ, Lord K, Slattery J, Grainger L, Symonds P (2012) How feasible is implementation of distress screening by cancer clinicians in routine clinical care? Cancer 118(24):6260–6269

    Article  PubMed  Google Scholar 

  17. Mitchell AJ, Vahabzadeh A, Magruder K (2011) Screening for distress and depression in cancer settings: 10 lessons from 40 years of primary-care research. Psychooncology 20(6):572–584

    Article  PubMed  Google Scholar 

  18. Admiraal JM, van Nuenen FM, Burgerhof JGM, Reyners AKL, Hoekstra-Weebers JEHM (2016) Cancer patients' referral wish: effects of distress, problems, socio-demographic and illness-related variables and social support sufficiency. Psychooncology 25(11):1363–1370

    Article  CAS  PubMed  Google Scholar 

  19. Bauwens S, Baillon C, Distelmans W, Theuns P (2014) Systematic screening for distress in oncology practice using the Distress Barometer: the impact on referrals to psychosocial care. Psychooncology 23(7):804–811

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Comprehensive Cancer Center Zurich, University Hospital Zurich, Rämistr. 100, 8001, Zurich, Switzerland

    Anna Götz, A. Kröner & J. Jenewein

  2. PhD Program, Department of Nursing Science, University Witten/Herdecke, Witten, Germany

    Anna Götz & R. Spirig

  3. Institute of Nursing Science, University of Basel, Basel, Switzerland

    R. Spirig

Authors
  1. Anna Götz
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  2. A. Kröner
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  3. J. Jenewein
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  4. R. Spirig
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Corresponding author

Correspondence to Anna Götz.

Ethics declarations

This study was carried out in compliance with the project plan, the current version of the Helsinki Declaration, and Swiss law. The research project was approved by the Cantonal Commission for Ethics in Zurich in December 2016 (BASEC-NR. 2016-01372).

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The authors declare that they have no conflict of interest.

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Götz, A., Kröner, A., Jenewein, J. et al. Evaluation of the adherence of distress screening with the distress thermometer in cancer patients 4 years after implementation. Support Care Cancer 27, 2799–2807 (2019). https://doi.org/10.1007/s00520-018-4579-1

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  • DOI: https://doi.org/10.1007/s00520-018-4579-1

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