Distress screening in cancer survivorship.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 138-138
Author(s):  
Julia P. Brockway-Marchello ◽  
Haley Hines Theroux ◽  
Sophia Tsesmelis Piccolino ◽  
Qiuchen Yang ◽  
Cardinale B. Smith
Keyword(s):  
Multivariate Analysis ◽  
Cancer Survivors ◽  
Screening Tool ◽  
Descriptive Analysis ◽  
Clinic Visit ◽  
Solid Cancer ◽  
Distress Screening ◽  
Cross Sectional ◽  
Data Set ◽  
Cancer Support

138 Background: Cancer survivors have varied physical, psychosocial, emotional and financial needs that may differ from needs of active cancer treatment patients. Distress screening identifies and monitors the needs of patients and is mandated for certain accreditations. There is a paucity of data on the application of distress screening among survivors. We used a validated distress screening tool to conduct a needs assessment of cancer survivors in solid oncology. Methods: The Cancer Support Source Distress Screening tool is an 18-item survey given on the 2nd and every 3-month clinic visit to assess depression and distress. The first analysis, merged patient data (patients completing ≥ 2) with cancer registry to identify solid cancer survivors from July 2015 to October 2018. A descriptive analysis of these patients was performed. The second analysis was cross-sectional with a larger data set of all solid tumor patients completing a survey at any time pre, during, or post treatment. We compared distress and depression scores using analysis of variance. A bivariate and multivariate analysis evaluating change in depression and distress scores over time is ongoing. Results: In analysis one, 92 patients were identified. Depression scores improved for most cancer types; distress scores improved for all cancers. Emotional, communication, provider relationship, system of care, body image and social support were associated with significant changes in survivorship concern. In the expanded dataset, 908 patients were identified. The distribution of depression and distress scores are shown in the table. There was a significant decrease for depression scores (p<.001) and distress scores (p<.001). Multivariate analysis to evaluate change in depression and distress scores across the survivorship trajectory is ongoing. Conclusions: A distress screening survey may be a useful tool in assessing the unmet needs of cancer survivors. Identifying prevalent domains of survivorship issues can highlight areas of greatest perceived need and can guide quality improvement initiatives within a cancer program. [Table: see text]

Distress screening in cancer survivorship.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 197-197
Author(s):  
Julia P. Brockway-Marchello ◽  
Haley Hines Theroux ◽  
Sophia Tsesmelis Piccolino ◽  
Qiuchen Yang ◽  
Cardinale B. Smith
Keyword(s):  
Multivariate Analysis ◽  
Cancer Survivors ◽  
Screening Tool ◽  
Patient Survey ◽  
Sociodemographic Factors ◽  
Clinic Visit ◽  
Distress Screening ◽  
Program Accreditation ◽  
Cancer Support ◽  
Cancer Program

197 Background: Cancer survivors have physical, psychosocial, emotional and financial needs that vary in prevalence and may differ from needs of patients on active cancer treatment. Distress screening is mandated for cancer program accreditation and identifies, addresses and monitors the needs of patients. There is a paucity of data on the clinical application of distress screening among survivors. We used a validated distress screening tool to conduct a needs assessment of cancer survivors in the solid oncology clinic. Methods: The Cancer Support Source Distress Screening tool is an 18-item questionnaire given to patients on their 2nd and every 3 month medical oncology clinic visit to assess depression and distress. We merged patient survey data (patients completing ≥ 2) with the cancer registry to identify cancer survivors from July 2015 to October 2018. We performed bivariate and multivariate analysis evaluating change in depression and distress scores over time. Results: 92 patients were identified. The table indicates changes in depression and distress scores by cancer. Depression scores improved for most cancer types with an improvement in distress scores across all cancers. Emotional/mental health, communication, provider relationship, system of care, body image and social support were associated with significant changes in survivorship concern. We are completing a multivariate analysis controlling for sociodemographic factors to evaluate change in depression and distress scores across the survivorship trajectory. Conclusions: A distress screening survey may be a useful tool in assessing the unmet needs of cancer survivors. Identifying prevalent domains of survivorship issues can highlight areas of greatest perceived need and can guide quality improvement initiatives within a cancer program. [Table: see text]

Discriminatory power of a 25-item distress screening tool CancerSupport Source: A cross-sectional study of 251 cancer survivors.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9599-9599
Author(s):  
Melissa F Miller ◽  
C. Daniel Mullins ◽  
Ebere Onukwugha ◽  
Christopher Gayer ◽  
Mitch Golant ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Screening Tool ◽  
Psychosocial Care ◽  
Summary Score ◽  
Discriminatory Power ◽  
Support Network ◽  
Distress Screening ◽  
Cross Sectional ◽  
Study Objective ◽  
Cancer Support

9599 Background: Distress screening and integrated psychosocial care is imperative for cancer patients, yet no tools are specifically tailored for the community provider setting where the majority of US patients are treated. Any screening tool must be validated and effective at discriminating those at risk for greater distress and the associated poorer health outcomes. The study objective was to test the discriminatory power of a 25-item distress screening tool CancerSupportSource for use among cancer survivors. Methods: A total of 251 members (90% female, median age 57 years; mixed diagnoses, 46% breast, 9% gynecologic, 7% blood, 6% colorectal, 32% other) of a community-based cancer support network completed a web-based distress screening tool. Participants were asked to rate each of 25 items according to the question “Today, how concerned are you about…?” using a five-point scale (0 not at all to 4 very seriously concerned). A summary score was calculated as the count of items rated ≥2 and the item discrimination index (IDI) as the difference between proportions of high and low scorers rating an item≥2. Cut-points at 13 and 4 yielded equal-sized groups and were used to classify participants as high (n=59) and low scorers (n=60). Results: Items with the greatest discriminatory power (IDI≥0.8) were: changes or disruptions in work, school or home life; worrying about the future and what lies ahead; feeling too tired to do the things you need or want to do; feeling sad or depressed; ability to exercise or be physically active; and feeling nervous or afraid. Conversely, items with the lowest IDI included: eating and nutrition; tobacco or substance use; transportation to treatment and appointments; considering taking your own life. Conclusions: The results highlight, among 25 items of a distress screening tool, those items with the greatest discriminatory power to identify cancer survivors with psychosocial distress. Results suggest priority areas for distress screening and referral for support services.

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

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 220-220 ◽  
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.

Discriminatory power of a 25-item distress screening tool: a cross-sectional survey of 251 cancer survivors

2014 ◽  
Vol 23 (10) ◽  
pp. 2855-2863 ◽  
Author(s):  
Melissa F. Miller ◽  
C. Daniel Mullins ◽  
Eberechukwu Onukwugha ◽  
Mitch Golant ◽  
Joanne S. Buzaglo
Keyword(s):  
Cancer Survivors ◽  
Screening Tool ◽  
Discriminatory Power ◽  
Distress Screening ◽  
Cross Sectional Survey ◽  
Cross Sectional

A Visual-Analogue Screening Tool for Assessing Mood and Quality of Daily Life Complications in Family Members of People Living With Cancer: Portuguese Version of the Emotion Thermometers: Burden Version

2019 ◽  
Vol 43 (4) ◽  
pp. 264-269
Author(s):  
Neide P. Areia ◽  
Alex Mitchell ◽  
Gabriela Fonseca ◽  
Sofia Major ◽  
Ana P. Relvas
Keyword(s):  
Diagnostic Accuracy ◽  
Screening Tool ◽  
Family Members ◽  
Cross Sectional Study ◽  
Brief Symptom Inventory ◽  
Distress Screening ◽  
Entire Family ◽  
Cross Sectional ◽  
Emotional Upset ◽  
Living With Cancer

Cancer is a disease that impacts not only the patient but also affects the entire family. Family members experience high levels of distress. Therefore, screening for cancer-specific distress among family members of people with cancer is important but relatively unexplored. This cross-sectional study aims to analyze the psychometric properties of a screening tool for family members of people with cancer. We examined the usefulness of the emotional thermometers burden version (ET-BV) in detecting caregiver emotional distress. The ET-BV is a simple multidomain visual analogue scale distributed in two major domains: “emotional upset” and “impact.” A total of 364 cancer patients’ family members completed the ET-BV and Brief Symptom Inventory. Analyses were aimed to examine the diagnostic accuracy (receiver operating characteristic) of the ET-BV. A fair to good diagnostic accuracy was achieved for ET-BV. For emotional upset thermometers, a cutoff of ≥5 was determined and for impact thermometers, a cutoff of ≥4 was established. ET-BV seems to be a useful, quick, and simple tool for distress screening in family members of people with cancer. A revision of a specific thermometer is discussed in order to increase ET screening performance and clinical utility.

Relationship Between Preferences for Advance Directive Treatments and Decisional Conflicts Among Low-Income, Home-Based Cancer Management Recipients in Korea

2019 ◽  
Vol 30 (6) ◽  
pp. 587-596
Author(s):  
Miyeong Kim ◽  
Seongkum Heo ◽  
Jung-Yi Hur ◽  
JaeLan Shim ◽  
JinShil Kim
Keyword(s):  
Cancer Survivors ◽  
Advance Directive ◽  
Low Income ◽  
Hospice Care ◽  
Community Dwelling ◽  
Solid Cancer ◽  
Cross Sectional ◽  
Early Integration ◽  
Cancer Management ◽  
Home Based

Introduction: Data-based research has rarely addressed advance directives (ADs) in community-dwelling Korean cancer survivors. The purpose of this study was to examine the relationship between AD treatment choices and decisional conflicts among low-income, home-based cancer management recipients. Method: This study uses a cross-sectional, correlational design. The cancer survivors completed the questionnaires (Korean-Advance Directive model and Decisional Conflict Scale). Results: Among the 103 participants (average age 67.92 years), 56.3% had solid cancer. Hospice care was the most desired (68.9%), followed by hemodialysis (18.4%), cardiopulmonary resuscitation/ventilation support (15.5% for each), and chemotherapy (12.6%). Patients who were older, unmarried, unemployed, or underweight/obese; lived alone; or had lower education experienced greater decisional conflicts. In the multivariate analyses, no hospice preference was associated with greater decisional conflicts ( t = −2.63, p = .01). Discussion: Early integration of AD discussion with the nurse-led, home-based service for this vulnerable population could serve as a liaison for quality and continuity of cancer survivorship care.

Loan repayment performance of clients of informal lending institutions

2017 ◽  
Vol 16 (3) ◽  
pp. 260-275 ◽  
Author(s):  
Goodluck Charles ◽  
Neema Mori
Keyword(s):  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Absorption Capacity ◽  
Cross Sectional ◽  
Data Set ◽  
Loan Repayment ◽  
Content Type ◽  
Ex Post ◽  
Information Gap ◽  
Lending Institutions

Purpose The purpose of this article is to examine the effects that dynamic incentives and the borrowing histories of clients of informal lending institutions have on loan repayment performance, in particular, the extent to which multiple borrowing and progressive lending affect the repayment of loans. Design/methodology/approach The paper uses a data set of 835 borrowers drawn from an informal lending institution in Tanzania. Descriptive analysis and econometric models are used to test the developed hypotheses. Findings Whereas clients with multiple loans are associated with poor loan repayment, progressive lending contributes to positive repayment outcomes. Multiple borrowers face increased debt levels and thereby an increased inability to meet their repayment obligations; in contrast, progressive lending by building up a lender–client relationship helps clients to obtain higher loans with a minimum amount of screening. Research limitations/implications This was a cross-sectional study based on a sample of individual clients drawn from a single institution. However, since the majority of clients had also taken out loans with other financial institutions, the sample is considered to be representative. Practical implications A client’s past repayment performance and multiple loan history must be assessed so that multiple borrowing can be prevented and credit absorption capacity can be gauged more accurately. The repeated nature of the interactions and the threat to cut off any future lending (if loans are not repaid) can be exploited to overcome any information deficit. Originality/value This study was conducted in a context in which the degree of information sharing was low and institutional access to clients’ credit histories was limited. It contributes knowledge on how lenders minimise the risk flowing from the ex ante information gap and moral hazards arising from the ex post information gap.

scholarly journals Exclusive Breastfeeding Practice And Associated Factors Among Employed And Unemployed Mothers In Ethiopia: Comparative Cross Sectional Study Using EDHS 2016

2021 ◽  
Author(s):  
Desta Markos Minamo
Keyword(s):  
Exclusive Breastfeeding ◽  
Maternity Leave ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Feeding Practice ◽  
Cross Sectional ◽  
Data Set ◽  
Factors Associated ◽  
The Impact ◽  
Breastfeeding Practice

Abstract Introduction Contrary to the recommendation, children under the age of 6 months be exclusively breastfed, many infants are also fed with other liquids such as water, non-milk liquids, and other milks before 6 months. Because of level of education and proportion of employed women in Ethiopia has been increasing gradually. Consequently the practice of exclusive breastfeeding became very lower. The main objective of this study was to assess the magnitude and factors associated with the practice of exclusive breastfeeding among employed and unemployed mothers in Ethiopia, using dataset from EDHS 2016. METHOD Data was extracted from Ethiopia Demographic and Health Survey (EDHS-2016). A total of 1089 mothers with infants aged 0 to 6 months in the data set were included in the analysis. Descriptive analysis, chi-square and binary logistic regression models were used. RESULT This study has demonstrated a 64.7%, 95%CI(58.9-70.5) and 75.4%, 95%CI(72.378.2) prevalence of EBF practices among employed and unemployed mothers respectively in the 24h preceding the survey. Other factors associated with EBF practice included being unemployed mother, larger to normal birth weight; infant aged 0-3 month old, infant being male, have radio in the house, infant being wanted, delivery by non CS mode and presence of ANC follow up during pregnancy were found to be significantly associated with exclusive breastfeeding practice. Conclusion the prevalence of exclusive breast feeding practice among employed mothers was significantly lower than that of unemployed mothers. Thus, Having in consideration the impact of appropriate infant and young children feeding practice on children’s nutritional status and mortality rate, policy makers still need to give more emphasis on promotion of exclusive breastfeeding through creating an enabling environment targeting the extension of postnatal maternity leave up to the first six month.

Development and validation of self- and caregiver-report of a distress screening tool for pediatric cancer survivors

2019 ◽  
Vol 27 (11) ◽  
pp. 4179-4187
Author(s):  
Soo Jin Yoon ◽  
Kyong-Mee Chung ◽  
Jung Woo Han ◽  
Seung Min Hahn ◽  
Sun Hee Kim ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Pediatric Cancer ◽  
Screening Tool ◽  
Distress Screening ◽  
Pediatric Cancer Survivors ◽  
Caregiver Report ◽  
Development And Validation

HSR19-100: CancerSupportSource®-15: Development and Evaluation of a Short Form of a Distress Screening Program for Cancer Survivors

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-100
Author(s):  
Shauna McManus ◽  
Alexandra K. Zaleta ◽  
Melissa F. Miller ◽  
Joanne S. Buzaglo ◽  
Julie S. Olson ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Cancer Survivors ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Short Form ◽  
Distress Screening ◽  
Cancer Support ◽  
Confirmatory Factor ◽  
Item Quality

Background: CancerSupportSource (CSS) is a 25-item distress screening tool implemented at community-based cancer support organizations and hospitals nationwide. CSS assesses distress over 5 domains: (1) emotional concerns (including depression and anxiety risk screening subscales), (2) symptom burden, (3) body and healthy lifestyle, (4) healthcare team communication, and (5) relationships. This study developed a short form of CSS and examined its psychometric properties. Methods: 2,379 cancer survivors enrolled in the Cancer Support Community’s Cancer Experience Registry. Participants provided demographic and clinical background and completed CSS-25 and PROMIS-29, a measure of health-related quality of life. Item reduction was conducted with a subsample of 1,435 survivors and included external item quality (correlations between items and PROMIS-29 scales), internal item quality (inter-item and inter-factor correlations, factor loadings and structure, and item communalities from an exploratory factor analysis of CSS-25), and professional judgement (ranking/prioritization of items by CSS-25 developers, accounting for theoretical and practical implications). Pearson correlations and confirmatory factor analysis were conducted on a separate subsample of 944 survivors to corroborate psychometric properties and dimensionality of the shortened scale. Results: Scale refinement resulted in a 15-item short form of CSS (CSS-15). At least 1 item from each of the 5 CSS-25 domains was retained to preserve multidimensionality, including anxiety and depression risk screening subscale items. Additionally, 1 item about tobacco/substance use was kept due to clinical significance for risk assessment. In confirmatory factor analysis, the model explained 59% of the variance and demonstrated good fit (RMSEA=0.068, 90% CI=0.061–0.075; SRMR=0.033; CFI=0.959; χ2(68)=334.75, P<.001). Correlation between CSS-15 and CSS-25 was 0.986, P<.001. Total distress was associated with PROMIS subscales (rs=−.65–.75, ps<.001); internal consistency reliability was excellent (α=.92). Conclusions: CSS-15 is a brief, reliable, and valid multidimensional measure of distress. The reduced measure retained excellent internal consistency and a stable factor structure, while correlating well with CSS-25 and PROMIS-29. CSS-15 can serve as a practical tool to efficiently screen for distress among cancer patients and survivors.

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