Distress is defined in the NCCN Guidelines for Distress Management as a multifactorial, unpleasant experience of a psychologic (ie, cognitive, behavioral, emotional), social, spiritual, and/or physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Early evaluation and screening for distress leads to early and timely management of psychologic distress, which in turn improves medical management. The panel for the Distress Management Guidelines recently added a new principles section including guidance on implementation of standards of psychosocial care for patients with cancer.

BACKGROUND To the authors' knowledge, few studies to date have evaluated the effects of survivorship care planning on the care transition process from specialty cancer care to self‐management and primary care, patient experience, or health outcomes. The Patient‐owned Survivorship Transition Care for Activated, Empowered survivors (POSTCARE) is a single coaching encounter based on the Chronic Care Model that uses motivational interviewing techniques to engage survivors of breast cancer. The current study examined the effects of the POSTCARE intervention on patient outcomes and care coordination. METHODS A total of 79 survivors of American Joint Commision on Cancer TNM System stage 0 to IIIB breast cancer were randomized to POSTCARE (40 patients) or usual care (39 patients). Patient outcomes were assessed using the 36‐Item Short Form Health Survey (SF‐36), Social/Role Activities Limitations, Self‐Efficacy for Managing Chronic Disease 6‐Item Scale, the Patient Activation Measure–Short Form, and Patient Health Questionnaire depression scale at baseline and at 3‐month follow‐up. Care coordination was assessed using confirmed primary care physician visits and reported discussion of the survivorship care plan at the 3‐month follow‐up. Logistic and linear regression analyses were conducted to examine the effect of POSTCARE on selected outcomes. RESULTS Participants in the intervention group versus those receiving usual care demonstrated significantly higher self‐reported health (F‐statistic (3,71), 3.63; P =.017) and lower social role limitations (F (3,70), 3.82; P =.014) and a trend toward greater self‐efficacy (F (3,69), 2.51; P = .07). Three quality‐of‐life domains reached clinically meaningful improvement at the 3‐month follow‐up, including physical role (P =.0009), bodily pain (P =.03), and emotional role (P =.04). CONCLUSIONS The POSTCARE intervention appeared to have a positive impact on patient outcomes and demonstrated promise as a strategy with which to improve survivors' experience, care coordination, and health outcomes. Cancer 2016;122:3232–42. © 2016 American Cancer Society.

A navigator-led ACP program was feasible and may be associated with lower rates of resource utilization near EOL.

Given the paucity of research on differences between older adults representing the many Asian-American subcategories, the present study explored physical and mental health status in five subcategories of Asian Americans aged 60 and older: Chinese, Japanese, Korean, Vietnamese, and Filipino. Data were drawn from the 2007 California Health Interview Survey (CHIS). Background characteristics and physical and mental health conditions were compared, with results showing differences cross the five subcategories of older Asian Americans. Specific patterns were identified in chronic diseases, disease comorbidity, and disability rates. Vietnamese and Filipinos tended to have poorer physical health than Chinese, Japanese, and Koreans. The poorest self-rated health and the highest disability rate were found in the older Vietnamese. Filipinos also exhibited the greatest number of chronic diseases, including the highest rates of asthma, high blood pressure, and heart disease. Although Koreans had the fewest self-reported chronic diseases and the least evidence of disease comorbidity, they also had the highest psychological distress. The lowest psychological distress was found in older Japanese. Findings suggest that generalizing findings from one particular Asian category or from an aggregate Asian category may be problematic and may not reflect an accurate picture of the burden of health in specific Asian categories. Being aware of these differences in background and health characteristics may help providers to better serve older Asian clients.

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