scholarly journals CancerSupportSource®: validation of a revised multi-dimensional distress screening program for cancer patients and survivors

2019 ◽  
Vol 28 (1) ◽  
pp. 55-64 ◽  
Author(s):  
Joanne S. Buzaglo ◽  
Alexandra K. Zaleta ◽  
Shauna McManus ◽  
Mitch Golant ◽  
Melissa F. Miller
Keyword(s):  
Cancer Patients ◽  
Screening Program ◽  
Distress Screening

The Engaged Patient

2021 ◽  
pp. 393-399
Author(s):  
Mitch Golant ◽  
Alexandra K. Zaleta ◽  
Susan Ash-Lee ◽  
Joanne S. Buzaglo ◽  
Kevin Stein ◽  
...  
Keyword(s):  
Cancer Patients ◽  
New Technologies ◽  
Screening Program ◽  
Psychosocial Oncology ◽  
Distress Screening ◽  
Patient Centered ◽  
Digital Platforms ◽  
Innovative Strategies ◽  
Psychosocial Experiences ◽  
Integrated Medical Care

Patient engagement is ever more essential to developing innovative strategies that shape how comprehensive, integrated medical care is delivered to cancer patients and their families. With over 300 licensed professionals across the network, Cancer Support Community (CSC) is the largest nonprofit employer of psychosocial oncology mental health professionals in the United States. Through decades of working with cancer patients, families, and caregivers, CSC has developed a portfolio of evidence-informed programs that engage patients around their most pressing concerns—unwanted aloneness, loss of control, and lack of hope. CSC’s facilities, which provide support groups, education, exercise and nutrition classes, children’s programs, and social activities, are available at no cost for families. These services are replicated on CSC’s helpline and digital platforms. This chapter highlights a comprehensive integrated model of developing and delivering evidence-informed psychosocial programs and services in the community. The chapter also reviews CSC patient-centered research projects including (1) the Cancer Experience Registry®, an online observational study of cancer patients, survivors, and informal caregivers to identify and quantify their psychosocial experiences; (2) CancerSupportSource®, a reliable, valid, multidimensional distress screening program for patients and caregivers; and (3) Open To Options®, a shared decision-making program that helps patients prepare a highly personalized list of questions, concerns, and goals to share with their doctor. The extent to which the psychosocial oncology community can integrate care across healthcare systems, by leveraging new technologies, behavioral and implementation science principles, and community-based services, will determine its success in meeting the needs of cancer patients.

Cancer-related distress screening in a radiation oncology clinic: A snapshot view of a Veterans Administration (VA) institution screening program.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21562-e21562
Author(s):  
Timothy A. Lomauro ◽  
George Anthony Dawson ◽  
Lori Magda ◽  
Kristen Tobias ◽  
Maria D. Kelly
Keyword(s):  
Mental Health ◽  
Cancer Patients ◽  
Radiation Oncology ◽  
Treatment Guidelines ◽  
Screening Program ◽  
Standards Of Care ◽  
Health Clinic ◽  
Distress Screening ◽  
Screening Process ◽  
Treatment Population

e21562 Background: The emotional and psychosocial stress experienced by cancer patients are significant factors impacting cancer treatment outcomes and quality of life. Increased emphasis upon programmatic approaches to identifying distress has evolved to current evidenced-based treatment guidelines as reflected by American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) have identified distress screening standards of care. This report is a snapshot of the results of a distress screening program in a VAMC Radiation Oncology clinic. Methods: Calendar year 2016 data was chosen for this quality improvement review. We wanted to assess the effectiveness of psychosocial distress screening process now routinely done in Radiation Oncology. Distress screening was completed utilizing the NCCN Distress Thermometer. The program’s goal was to administer distress screening to all patients at the time of their initial consultation and to follow up screening as appropriate. Results: The mean age of the patients was 68.6 years; 98% were male. The treatment population was 58% Caucasian, 38% African-American, 2% Hispanic, and 2% other. The most prevalent cancer diagnoses were: Prostate, 52%; Lung, 13.9%; Head & Neck Cancer, 7.2%, Skin, 4.6%; Esophageal or Gastric Cancer, 3.1%; Brain, 2.0%; and Breast, 2.0% Screenings were completed on 161 of 193 (83%) new consults in Radiation Oncology; 47.6% of patients screened scored at or above the established cut score of 4. Referrals to Oncology Psychology were initiated for 29.5% of total sample. Significant mental health co-morbidities were identified in the treatment population studied; 58.5% of patients had at least one mental disorder diagnosis. Examples: PTSD, Major Depressive Disorder, Substance Use Disorder, and Adjustment Disorder. Conclusions: Results reflect the usefulness of the distress screening process in identifying adjustment issues specific to cancer patients' experience, as well as exacerbations of existing mental health conditions. The screening process facilitated referral to specialty (Oncology Psychology) and general (Mental Health Clinic) services.

scholarly journals CancerSupportSource®-15+: development and evaluation of a short form of a distress screening program for cancer patients and survivors

2021 ◽  
Author(s):  
Alexandra K. Zaleta ◽  
Shauna McManus ◽  
Erica E. Fortune ◽  
Branlyn W. DeRosa ◽  
Joanne S. Buzaglo ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Cancer Patients ◽  
Screening Program ◽  
Short Form ◽  
Depression And Anxiety ◽  
Distress Screening ◽  
Community Based ◽  
Stable Factor ◽  
Significant Depression ◽  
Item Quality

Abstract Purpose CancerSupportSource® (CSS) is a distress screening program implemented at community-based organizations and hospitals nationwide. The 25-item CSS assesses distress across five domains, with capacity to screen for clinically significant depression and anxiety. This study examined psychometric properties of a shortened form to enhance screening opportunities when staff or patient burden considerations are significant. Methods Development and validation were completed in multiple phases. Item reduction decisions were made with 1436 cancer patients by assessing external/internal item quality and judging theoretical and practical implications of items. Pearson correlations and confirmatory factor analysis were conducted on a separate sample of 957 patients to corroborate psychometric properties and dimensionality of the shortened scale. Nonparametric receiver operating characteristic (ROC) curve analyses determined scoring thresholds for depression and anxiety risk scales. Results Scale refinement resulted in a 15-item short form plus one screening item assessing tobacco and substance use (CSS-15+). At least two items from each CSS domain were retained to preserve multidimensionality. In confirmatory analysis, the model explained 59% of the variance and demonstrated good fit. Correlation between CSS-15+ and 25-item CSS was 0.99, p < 0.001. Sensitivity of 2-item depression and 2-item anxiety risk scales in the confirmatory sample were 0.82 and 0.83, respectively. Conclusions CSS-15+ is a brief, reliable, and valid multidimensional measure of distress. The measure retained excellent internal consistency (α = 0.94) and a stable factor structure. CSS-15+ is a practical and efficient screening tool for distress and risk for depression and anxiety among cancer patients and survivors, particularly in community-based settings.

scholarly journals From Distress Screening to Uptake: An Italian Multicenter Study of Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3761
Author(s):  
Elena Meggiolaro ◽  
Silvia De Padova ◽  
Federica Ruffilli ◽  
Tatiana Bertelli ◽  
Marina Bragagni ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Telephone Interview ◽  
Psychological Intervention ◽  
Supportive Services ◽  
Distress Screening ◽  
Potential Barriers ◽  
Physical Problems ◽  
Practical Usefulness ◽  
Per Se ◽  
Opening Up

Introduction: Little consideration is given to the referral and uptake of available supportive services after distress screening. However, identifying the reasons for accepting or refusing help is mandatory for implementing a screening policy. The present study explored the practical usefulness of and potential barriers to the application of distress management. Methods: 406 cancer patients were consecutively selected and asked to complete the Distress Thermometer (DT) and Problem Check List (PL). All patients with a DT score ≥6 were invited for a post-DT telephone interview with a trained psychologist. Results: The 112 patients who refused to take part were more often older, retired, at a more advanced stage of illness, and with no previous experience of psychological intervention with respect to those who accepted. Of the 78 patients with a score ≥6 who were referred to the Psycho-Oncology Service, 65.4% accepted the telephone interview. Twenty-two patients rejected the initial invitation immediately for various reasons including logistic difficulties, physical problems, and feeling embarrassed about opening up to a psychologist. Conclusions: Our study confirms that screening per sé is insufficient to deal with the problem of distress and that more emphasis should be placed on implementing referral and treatment.

Distress Screening in Head and Neck Cancer Patients Planned for Cancer‐Directed Radiotherapy

2021 ◽  
Author(s):  
Shirley Lewis ◽  
Saket Pandey ◽  
Naveen Salins ◽  
Jayita Deodhar ◽  
Vijay Patil ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Distress Screening

Distress experienced by lung cancer patients and their family caregivers in the first year of their cancer journey

2021 ◽  
pp. 1-7
Author(s):  
Michèle Aubin ◽  
Lucie Vézina ◽  
René Verreault ◽  
Sébastien Simard ◽  
Éveline Hudon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Screening Program ◽  
Depression Scale ◽  
Participation Rate ◽  
Quebec City ◽  
Lung Cancer Patients ◽  
Distress Score ◽  
Ambulatory Oncology

Abstract Objectives Diagnosis of cancer is emotionally threatening not only for patients but also for their family caregivers (FC) who witness and share much of the illness experience. This study compares distress experienced by lung cancer patients and their FC during the year following the diagnosis. Methods A prospective cohort study of 206 patients recently diagnosed with inoperable lung cancer (participation rate 79.5%) and 131 FC (participation rate 63.6%) was conducted in an ambulatory oncology clinic in Quebec City (Canada). They completed validated questionnaires regarding their personal and psychological characteristics (Hospital and Anxiety Depression Scale—HADS), in the first months after the diagnosis of lung cancer and after 6 and 12 months. Univariate, bivariate, and linear mixed models were conducted to compare patient and FC distress. Results At baseline, 7.8% of patients reported distress (HADS total score >15) and their mean distress score was 7.0 ± 4.9 (range 0–42). In contrast, 33.6% of FC presented significant distress and their mean distress score was 12.0 ± 7.2 (P < 0.0001). Proportions of patients and FC with distress remained relatively stable at 6 and 12 months, and at every time point, FC reported higher levels of distress compared to their relative with cancer (P < 0.0001). Comparable trends were found when looking at the mean scores of distress, anxiety, and depression throughout the study. Significance of results Being diagnosed with lung cancer and going through its different phases seems to affect more FC than patients. The psychological impact of such diagnosis appears early after the diagnosis and does not significantly change over time. These findings reinforce the importance for oncology teams, to include FC in their systematic distress screening program, in order to help them cope with their own feelings and be able to play their role in patient support and care throughout the cancer journey.

scholarly journals Barriers and facilitators to implementing the commission on cancer's distress screening program standard

2018 ◽  
Vol 17 (03) ◽  
pp. 253-261 ◽  
Author(s):  
Andrea K. Knies ◽  
Devika R. Jutagir ◽  
Elizabeth Ercolano ◽  
Nicholas Pasacreta ◽  
Mark Lazenby ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Training Programs ◽  
Screening Program ◽  
Goal Achievement ◽  
Barriers And Facilitators ◽  
Distress Screening ◽  
Institutional Barriers ◽  
Institutional Factor ◽  
Achievement Data ◽  
American College Of Surgeons

AbstractObjectiveMany cancer centers struggle to implement standardized distress screening despite the American College of Surgeons’ Commission on Cancer 2012 mandate for a distress screening program standard of care by 2015. This paper presents outcomes for the first cohort of participants (n= 36) of a Screening for Psychosocial Distress Program (SPDP), a 2-year training program designed to assist clinicians in implementing routine distress screening as mandated by the American College of Surgeons Commission on Cancer. Specifically, participants’ success with distress screening implementation, institutional barriers and facilitators to implementation, and the role of the SPDP are described.MethodThis research followed a longitudinal pre- and posttest mixed methods design. An investigator-developed questionnaire collected qualitative (distress screening goals, institutional barriers and facilitators, facilitators associated with participation in the SPDP) and quantitative (level of goal achievement) data at 6, 12, and 24 months of participation in the SPDP. Conventional content analysis was applied to qualitative data. Mixed methods data analysis in Dedoose evaluated (1) types and number of distress screening goals, barriers, and facilitators, and (2) goal achievement at 6, 12, and 24 months of participation.ResultNinety-five percent of distress screening implementation goals were completed after 2 years of participation. Most common institutional barriers to distress screening implementation were “lack of staff,” “competing demands,” and “staff turn-over.” Most common institutional facilitators were “buy-in,” “institutional support,” and “recognition of participants’ expertise.” The number of reported facilitators associated with SPDP participation was higher than the number associated with any institutional factor, and increased over time of participation.Significance of resultsParticipating in training programs to implement distress screening may facilitate successful achievement of the Commission on Cancer's distress screening standard, and benefits seem to increase with time of participation. Training programs are needed to promote facilitators and overcome barriers to distress screening.

The Commission on Cancer Psychosocial Distress Screening Standard: The first year in review.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 198-198 ◽  
Author(s):  
Nina S. Miller ◽  
Ryan M. McCabe ◽  
Allison Knutson
Keyword(s):  
Cancer Patients ◽  
Treatment Plan ◽  
Psychosocial Care ◽  
Psychosocial Distress ◽  
Screening Tools ◽  
Institute Of Medicine ◽  
Distress Screening ◽  
Patient Centered ◽  
Screening Process ◽  
Cancer Program

198 Background: In response to recommendations from the 2007 Institute of Medicine report, Cancer Care for the Whole Patient, the American College of Surgeons’ Commission on Cancer developed a set of Continuum of Care standards, including a patient-centered standard regarding the delivery of psychosocial distress screening to all cancer patients. According to Cancer Program Standards 2012: Ensuring Patient-Centered Care, the accredited cancer program must implement a process to integrate and monitor on-site psychosocial distress screening and referral for the provision of psychosocial care. Patients experience psychological, social, financial, and behavioral issues that can interfere with their treatment plan and adversely affect outcomes. Screening processes result in the identification of distressed cancer patients and assessment and referral pathways to ensure appropriate psychosocial care provision can be obtained. The standard was established in 2012 with a 2015 implementation period allowing programs time to develop a screening, assessment, and referral process tailored to their patient population. Methods: Programs submit documentation to describe their process for delivery of care through an electronic activity report. Documentation of this standard includes the timing for delivery of the psychosocial distress screening tool; methodology; the specific tools selected with preference to validated and reliable screening tools; and a process for assessment, referral and documentation. This presentation will summarize the program submissions for 2015 and include an analysis of the details of the standard compliance as reported by accredited programs. Results: This analysis will include responses from all Commission on Cancer accredited programs reporting on this standard. The analysis will provide information about the trends in the timing, methods, and tools used by programs implementing a psychosocial distress screening process. Conclusions: This analysis will inform future decisions about standardization of a screening process and the feasibility of pooling data across centers.

Psychosocial distress screening in cancer care.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 187-187 ◽  
Author(s):  
N Mullai
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Trigger Point ◽  
Emotional Experience ◽  
Psychosocial Care ◽  
Specific Area ◽  
Psychosocial Distress ◽  
Medical Visit ◽  
Distress Screening ◽  
Distress Level

187 Background: Distress is a multifactorial, emotional experience that may interfere with patients’ ability to cope with cancer and its treatment. Recognizing and managing distress may benefit patients. The Commission on Cancer requires implementation of Standard 3.2, Psychosocial Distress Screening in 2015 and integrating distress intervention in cancer care. This study evaluates patients’ perception on benefits in this regard. Methods: Patients were screened at least once at a pivotal medical visit using a questionnaire that included various aspects of stress. NCCN’s Psychosocial Distress Screening Tool was used to measure seriousness of distress. Patients marked their distress level on a scale of 1 to 10. A threshold of 5 was set as a trigger point to start addressing distress. Results: Answers from 311 cancer patients (male 61%; female 39%) were evaluated since January 2015. A majority of patients had breast cancer (29%), followed by lung (18%), GI (18%), and hematological (12%) malignancies. The mean distress score was 3.72 (male 3.14; female 3.97). 131 patients had a score above five. Age group, 40-49 years had a higher distress (4.79) compared to others. Esophageal cancer (1%) had the highest mean score 7.33 followed by head & neck cancer (4%) with 5.67. In most patients, anxiety about cancer and its treatment was the cause of distress. However, they did not want any additional psychosocial intervention except for talking to their oncologist and primary physician. The distress of some patients was family related and they were unsure of the help needed. Two patients refused screening stating the questions were intrusive. Conclusions: Coordinated psychosocial care may benefit cancer patients with significant distress. NCCN tool helps to assess the severity of patients’ distress and to determine the need for intervention. The results (mean score of 3.72) suggest most cancer patients need no major intervention or special psychosocial counseling other than discussing with their physician and family, which is done routinely in most oncology practices. However, when stress is expressed, this tool does help the treating physicians to determine the specific area and degree of stress, to focus on the type of help needed for the patient, and to channel resources appropriately.

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