Providing Psychosocial Distress Screening, Coping Resources, and Self-care to Newly Diagnosed Cancer Survivors in a Canadian Small Town Setting

194 Background: Screening for psychosocial distress is an unmet need for cancer survivors. The oncology team has a critical role caring for the whole patient. We designed a comprehensive screening for newly referred patients in a community oncology setting. The purpose of our screening is early detection of moderate to severe distress and early intervention through social workers. Methods: This feasibility study included 292 newly diagnosed cancer and hematology patients entering our center between May 1 and July 31, 2015. Each participant completed the NCCN Distress Thermometer with checklist and PHQ-2 survey as part of the New Patient Questionnaire. The psychosocial team designed the triage process and contacted each patient if either the distress score or the PHQ-2 scores were ≥ 4. The screened patients underwent counseling by social work and were provided educational materials by nurse navigators and referred to community counselors as needed. Results: 67 % of the 292 newly diagnosed patients completed the screening tool. The average distress score was 4.31, and the average PHQ-2 score was 1.48. Based on the predefined criteria, 63% of all new patients reported significant distress. One-third of these patients had a distress score of 4, and were managed by nurse navigators. 63 patients with higher score were seen by social worker, 23 (37%) were referred to community counseling and 16 (25%) received ongoing follow-up. The documented need of psychosocial counseling increased by 28% during the program. By the end of the project period the early detection rate of severe depression (PHQ-2 ≥ 4) increased from 33% to 80%. The majority of the patients appreciated the distress screening, and the suggested coping strategies and support. Conclusions: Distress screening for newly diagnosed hematology and oncology patients is feasible in the community oncology setting. A large number of previously undetected patients with distress and depression were identified. The distress tool aided in early intervention and providing follow-up. The screening was also effective in identifying patients with high distress and in need to mitigate a crisis. Providing appropriate resources and referrals is essential to manage the extra workload on the psychosocial team.

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Cancer-related distress and unmet needs among newly diagnosed and longer-term cancer survivors from a community-based distress screening program.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.220 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 220-220 ◽

Cited By ~ 2

Author(s):

Joanne S. Buzaglo ◽

Melissa F Miller ◽

Victoria Kennedy ◽

Margaret Longacre ◽

Mitch Golant ◽

...

Keyword(s):

Health Care ◽

Cancer Survivors ◽

Screening Tool ◽

Unmet Needs ◽

Health Care Team ◽

Care Team ◽

First Year ◽

Newly Diagnosed ◽

Distress Screening ◽

Cancer Support

220 Background: As survival rates increase among cancer patients, quality of life needs become more salient. Cancer Support Source (CSS) is a distress screening, referral and follow up program that uses a validated distress screening tool and referral algorithm to link cancer patients to resources tailored to their needs. The objective of this study was to describe psychosocial concerns and unmet needs at different times since cancer diagnosis. Methods: English speaking cancer survivors (n = 905) across 26 affiliates of a nationwide cancer support organization participated in the CSS program by first completing a screening tool, including a 4 item depression subscale. Participants rated the level of concern (0 to 4) about 15 items and identified the help they wanted for each item (talk with a member of your health care team and/or connect you with online resources). We used regression analysis, adjusting for age, to examine differences by time since diagnosis ( < 1 y; ≥ 1 y) in level of distress; type of concerns (rated ≥ 2); and items selected to talk with the health care team. Results: The sample was 78% female, 10% Latino, 9% Black, and median age 57 y. 41% were breast cancer survivors, 6% lung, and 6% colorectal. More than half were within 1 y of their diagnosis (61%, n = 507); 39% ≥ 1 y (n = 331). Those newly diagnosed ( < 1 y) had significantly higher levels of distress (p = 0.011); increased risk for depression (p = 0.007); and more likely to be concerned about changes in work, school, or home life; body image; feeling nervous or afraid; worry about the future; and making a treatment decision (p < 0.05). Among those who indicated that an item was a concern, newly diagnosed patients were significantly more likely to want to talk to their health care team about pain; financial worries; exercising; feeling lonely or isolated; feeling nervous or afraid; and worry about the future (p < 0.05). Conclusions: These findings suggest that patients are more distressed and more likely to want to talk about their psychosocial needs within the first year of a cancer diagnosis. Future research should evaluate efforts to provide tailored resources within the first year of a diagnosis when distress levels are highest.

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Psychosocial distress screening at a single urban community oncology center: Trends among Hispanic and Caucasian women with newly diagnosed breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.198 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 198-198

Author(s):

Gregory Joseph Britt ◽

Rebecca C. Shay ◽

Monica Rassmusen ◽

Sandra Vannice ◽

Jana M Bolduan Lomax

Keyword(s):

Breast Cancer ◽

Native American ◽

Emotional Distress ◽

Screening Program ◽

Psychosocial Distress ◽

Anxiety And Depression ◽

Newly Diagnosed ◽

Distress Screening ◽

English Speaking ◽

Descriptive Scale

198 Background: We aim to describe our psychosocial distress screening program with attention to our female breast cancer population and symptoms of anxiety and depression among English-speaking Caucasians and Spanish speaking Hispanics. Methods: We retrospectively examined the emotional distress scores of 170 women with newly diagnosed breast cancer at the Cancer Centers of Colorado at SCL Heath/Saint Joseph Hospital from January-December 2015. SCL Health IRB approval was obtained. Patients were provided a distress screening questionnaire (English or Spanish) at their initial visit. Data points included: gender, age, ethnicity, primary language, emotional distress (worry/nervousness or anxiety/fears and sadness/depression) and degree of distress (“thermometer” scale 0-10 or not at all, slightly, moderately, seriously or very seriously). The degree of distress measures were revised in August 2015 from a “thermometer” scale to a descriptive scale. Results: Of 170 women studied, there were 104 Caucasian, 49 Hispanic, and 17 other race/ethnicity (including Black, Asian, Native American, and Pacific Islander). 76 women (40 Caucasian, 31 Hispanic, 5 other) did not participate in filling out the questionnaire. Of the 94 patients responding, 68% were Caucasian (n=64), 19% Hispanic (n=18), and 13% other (n=12). With regard to symptoms, 55% of Caucasians (n=35), 44% of Hispanics (n=8), and 50% of other (n=6) reported anxiety. Moreover, 36% of Caucasians (n=23), 56% of Hispanics (n=10), and 33% of other (n=4) recorded sadness/depression. Among the descriptive scale scores from August-December 2015, Hispanics were the only group to record “seriously” or “very seriously” in regard to anxiety or sadness/depression. Conclusions: Our retrospective study of emotional distress screening demonstrated lower participation among Hispanics with breast cancer. Concerns of anxiety and depression were common among all groups, with a small number of Hispanics reporting the highest levels. Emotional distress screening is an important component of cancer care for women with breast cancer and barriers for non-English speaking Hispanic patients need to be examined.

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Bridging the gap in psychosocial care in cancer survivorship: A pilot project evaluating psychosocial interventions through telemedicine.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.215 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 215-215

Author(s):

Kaitlin Bomar ◽

Elizabeth Willingham ◽

Terra Dillard ◽

Chad M Dingman ◽

Crystal Humphries ◽

...

Keyword(s):

Information Technology ◽

Patient Satisfaction ◽

Cancer Survivors ◽

Psychosocial Intervention ◽

Psychosocial Care ◽

Pilot Project ◽

Psychosocial Distress ◽

Distress Screening ◽

Community Based ◽

Face To Face

215 Background: Psychosocial distress is a well‐recognized consequence of cancer therapy, but psychosocial care for cancer survivors remains fragmented. Through the use of telemedicine, establishing an integrated, information technology‐based infrastructure between community‐based cancer programs may enhance coordination of survivorship care and increase psychosocial distress screening and intervention. We describe a one year pilot program intended to bridge institutional and geographic gaps in psychosocial intervention for cancer survivors through the use of telemedicine. Methods: There are 17 Commission on Cancer-accredited sites in South Carolina-only 31% of sites routinely conduct distress screening. This SC Cancer Alliance-supported pilot was designed as a quality care improvement project between two community-based cancer programs. The development and execution of the telemedicine project will be described. A survey-based, qualitative assessment of patient satisfaction with psychosocial intervention with between both physical and virtual counselling was performed and scored. Results: All patients seen in survivorship clinics at both institutions received psychosocial distress screening. By the end of the pilot project, 9 cancer survivors from the Spartanburg area were identified as having significant psychosocial distress, participated in counselling and reported on their experiences. Patients were seen either via face-to-face and/or virtual encounters. Counselling sessions performed via telemedicine were well accepted and that there was no difference in patient satisfaction as compared to face-to-face sessions. Anecdotal experiences and comments will be highlighted. Conclusions: Our pilot project demonstrates that psychosocial screening and intervention via telemedicine is feasible and may be effective at reducing psychosocial distress in cancer survivors. Psychosocial intervention via telemedicine may serve as a viable method of providing counselling services to resource poor areas, but significant barriers exist, including reimbursement, institutional variations in screening and care and information technology.

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Study on knowledge of chemotherapy's adverse effects and their self-care ability to manage - The cancer survivors impact

Clinical Epidemiology and Global Health ◽

10.1016/j.cegh.2021.100765 ◽

2021 ◽

pp. 100765

Author(s):

Serma Subathra Arunachalam ◽

Asha P. Shetty ◽

Nandakumar Panniyadi ◽

Chanchal Meena ◽

Jyothi Kumari ◽

...

Keyword(s):

Adverse Effects ◽

Cancer Survivors ◽

Self Care

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Implementing a Tailored Psychosocial Distress Screening Protocol in a Head and Neck Cancer Program

The Laryngoscope ◽

10.1002/lary.30000 ◽

2021 ◽

Author(s):

Eden R. Brauer ◽

Stephanie Lazaro ◽

Charlene L. Williams ◽

David A. Rapkin ◽

Amy B. Madnick ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Psychosocial Distress ◽

Distress Screening ◽

Cancer Program ◽

Screening Protocol

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Finding My Way: results of a multicentre RCT evaluating a web-based self-guided psychosocial intervention for newly diagnosed cancer survivors

Supportive Care in Cancer ◽

10.1007/s00520-018-4526-1 ◽

2018 ◽

Vol 27 (7) ◽

pp. 2533-2544 ◽

Cited By ~ 4

Author(s):

Lisa Beatty ◽

Emma Kemp ◽

Joseph R. Coll ◽

Jane Turner ◽

Phyllis Butow ◽

...

Keyword(s):

Cancer Survivors ◽

Psychosocial Intervention ◽

Newly Diagnosed ◽

Web Based

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Optimal Frequency of Psychosocial Distress Screening in Radiation Oncology

Journal of Oncology Practice ◽

10.1200/jop.2014.003392 ◽

2015 ◽

Vol 11 (4) ◽

pp. 298-302 ◽

Cited By ~ 8

Author(s):

Clayton B. Hess ◽

Maria Singer ◽

Aliasgher Khaku ◽

Justin Malinou ◽

Justin J. Juliano ◽

...

Keyword(s):

Radiation Oncology ◽

Psychosocial Distress ◽

Optimal Frequency ◽

Distress Screening ◽

Oncology Patients

Thirty-seven percent of radiation oncology patients reported distress at least once during treatment. Screening at every-other-week intervals optimized efficiency and frequency, identifying nearly 90 distressed patients with 12 screening events.

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‘A little good with the bad’: Newly diagnosed type 2 diabetes patients’ perspectives on self-care: A phenomenological approach

Nordic Journal of Nursing Research ◽

10.1177/2057158518775319 ◽

2018 ◽

Vol 39 (1) ◽

pp. 20-28 ◽

Cited By ~ 1

Author(s):

Marita Gabre ◽

Birgitta Wireklint Sundström ◽

Sepideh Olausson

Keyword(s):

Type 2 Diabetes ◽

Patient Population ◽

Self Care ◽

Phenomenological Approach ◽

Newly Diagnosed ◽

Patients Perspective ◽

Diabetes Patients

Increased knowledge is needed about what self-care means from the patients’ perspective, especially since the patient population with type 2 diabetes has been rising. The aim was to describe self-care, as experienced by patients with newly diagnosed type 2 diabetes. This study adopted a phenomenological approach. Eight patients were interviewed. A combination of photos and interviews were used. The essential meaning of self-care was found to be an existential struggle that evokes feelings of being in-between one’s old unhealthy life and a new healthier one. In this in-between condition, tension exits between contradictorily emotions of anxiety, hopelessness and hope. This struggle also means questioning one’s identity. It is important that diabetes nurses create an opening for reflection and dare to challenge their patients to reflect on this existential struggle.

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