Brief Distress Screening in Clinical Practice: Does it Help to Effectively Allocate Psycho-Oncological Support to Female Cancer Inpatients?

Abstract

Background: The usefulness of distress screening in cancer inpatient settings has rarely been investigated. This study evaluated a brief distress screening of inpatients in a breast cancer centre and a gynaecological cancer centre. Patients and Methods: Hospitalised patients with breast or gynaecological cancers were screened with the Distress Thermometer. Patients who scored above the cut-off, were referred by the medical staff, or self-referred were offered bedside psycho-oncological counselling. Results: Of 125 patients, 68 (54.4%) received an offer of counselling, and 62 patients (49.6%) accepted. Most of the counselling was induced by distress screening. Only 4 (3.2%) patients self-referred to the counselling service. Of the counselled patients, 65.8% stated that they had substantially benefited from psycho-oncological support; only 5.6% of the non-counselled patients indicated that they might have benefited from psycho-oncological support. Conclusion: Almost all patients who will accept and benefit from psycho-oncological counselling can be identified if distress screening is used in conjunction with referrals by physicians and nurses. Distress screening is a worthwhile component in a framework of psycho-oncological support in a cancer inpatient setting. It paves the way to counselling for cancer inpatients who need it and are willing to accept it but hesitate to self-refer to psycho-oncological services.

Following patient pathways to psycho‐oncological treatment: Identification of treatment needs by clinical staff and electronic screening

“…Finally, the standardised enquiry about patients' wish may have lowered the barrier to accepting help. The latter may have been especially true for patients with ThyCa, who have long been considered as experiencing only mild psychological distress because of their favourable prognosis …”

“…The latter may have been especially true for patients with ThyCa, who have long been considered as experiencing only mild psychological distress because of their favourable prognosis. [20][21][22][23]36 Patients with current or a history of depressive mood were most likely to express POT wish. As those patients were more likely to be or have been in psychosocial treatment or care, the barrier for them to accept professional support could have been lower.…”

“…18,19 These patients' unrecognised QOL impairments and unmet psychosocial treatment needs have only recently gained attention. 17,20,21 Generally, few patients self-refer to PO counselling, 17,22,23 and health care professionals (HCPs) often fail to identify patients needing psycho-oncological treatment (POT) for reasons such as time constraints, lack of human resources, focus on physical aspects, or difficulties in recognising and addressing emotional problems. 10,12,20 To overcome this problem, it is essential to adequately identify and measure distress in clinical routines, 24 eg, through stepped-care approaches, such as questionnaire-assisted screening followed by personal triage.…”

Determinants of adherence to physical cancer rehabilitation guidelines among cancer patients and cancer centers: a cross-sectional observational study

“…Screening is a key aspect in the delivery of healthcare. Patients who will accept and benefit from rehabilitation programs can be identified and encouraged to participate in PCRPs by using the DT [ 59 , 60 ]. Encouraging screening with the DT in daily cancer care will help promote the implementation of PCR guidelines.…”

“…Regrettably, it appears that adherence to current guidelines on physical cancer rehabilitation (PCR) is low [49][50][51][52][53], and material on approaches to implementing PCR guidelines is scarce [54][55][56][57][58]. Patients who will accept and benefit from PCRPs can be identified by means of the Distress Thermometer (DT) [59,60]. Using the DT for screening appears to be a good starting point for accomplishing adherence to current PCR guidelines, but evidence supporting this hypothesis is missing.…”