How feasible is implementation of distress screening by cancer clinicians in routine clinical care?

Abstract

BACKGROUND: There is considerable uncertainty regarding the acceptability of routine distress screening. METHODS: In an unfunded implementation study, the authors asked 50 clinicians (chemotherapy nurses and treatment radiographers/radiation technologists) to implement a screening program for distress as part of routine care and to record their feedback after each clinical encounter. In total, 379 patients were screened using a simple paper-and-pencil versions of distress thermometer and the emotion thermometer (ET). RESULTS: Across all screening applications, clinicians believed that screening was useful during 43% of assessments and was not useful during 35.9% of assessments, and they were unsure or neutral in 21.1% of assessments. The application of the screening program assisted staff in changing their clinical opinion after 41.9% of assessments, and clinicians believed that the screening program helped with communication in >50% of assessments. However, 37.5% believed that screening was impractical for routine use, and more chemotherapy nurses than radiographers rated the screening program as ''not useful.'' On multivariate analysis, 3 variables were associated with high staff satisfaction with screening, namely, receipt of prior training, talking with the patient about psychosocial issues, and improved detection of psychological problems. A favorable perception of screening also was linked to a change in clinical opinion. CONCLUSIONS: Opinions of cancer clinicians regarding routine distress screening were mixed: Approximately 33% considered screening not useful/impractical, whereas >50%n believed promoted good communication and/or helped with recognition. Clinicians who were more positive about screening gained greater benefits from screening in terms of communication and recognition. Cancer 2012;118:6260-9.

Which items on the distress thermometer problem list are the most distressing?

“…Brennan et al [21] considered items with the prevalence of less than 10 % for exclusion, combination or incorporation into other items. In order to allow for rarer items, we suggest using a free text option 'any other problem' as suggested by Mitchell et al [22].…”

Integrating Psychosocial Care into Routine Cancer Care

“…[28][29][30][31] These efforts vary widely in the tools used to screen, the methods used to collect information from patients and deliver it to clinicians, and whether the information obtained from patients is present to clinicians with referral recommendations -all of which are features that limit the ability to draw conclusions from this literature. However, reason exists to question the value of solely implementing distress screening without also implementing referral recommendations for distressed patients.…”

“…2,33 Additional reports have provided more in-depth descriptions of efforts to implement distress screening and psychosocial referral and the acceptability and impact on processes of care in those efforts. [28][29][30][31][32]35 Work in this area would also benefit from published findings from rigorously designed, quality improvement projects designed to document the processes used to improve psychosocial care and the outcomes achieved, including the impact on patient quality of life. Such studies should also consider relevant conceptual frameworks such as the PRECEDE-PROCEED model, which focuses on identifying and influencing predisposing, enabling, and reinforcing factors for implementing changes.…”

Application of Entropy-Based Metrics to Identify Emotional Distress from Electroencephalographic Recordings

“…This dysfunction often makes current human-machine interfaces (HMIs) unable to execute proper emotion-based actions [2]. Hence, more research is essential to improve affective computing systems, which are becoming increasingly applied to growing fields such as medicine [3,4], digital society [5] or computer games [6].…”