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The Five Steps of Comprehensive Psychosocial Distress Screening

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Abstract

Despite the growing recognition of the impact psychosocial distress has on the quality of life of patients with cancer, the implementation of the National Comprehensive Cancer Network (NCCN) Distress Management Guidelines and the mandate of evidence-based policy for routine distress screening continue to lag. To speed adoption of the guideline, the American Psychosocial Oncology Society (APOS) and Yale School of Nursing (YSN) launched the Screening for Psychosocial Distress Program in 2014. The program resulted in the development of five steps necessary to carry out routine psychosocial distress screening. The steps are consistent with the NCCN Distress Management Guidelines and the new criterion for accreditation by the American College of Surgeons (ACS) Commission on Cancer as of 2015. These five steps are as follows: (1) screening, (2) evaluating, (3) referring, (4) following up, and (5) documenting and quality improvement. The purpose of this article is to summarize the detailed procedure of the five steps for cancer care professionals—including oncologists, nurses, psychiatrists, psychologists, and social workers—so they can manage psychosocial distress efficiently in their own clinical environments.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Artherholt SB, Fann JR. Psychosocial care in cancer. Curr Psychiatry Rep. 2012;14(1):23–9.

    Article  PubMed  Google Scholar 

  2. Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, hematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160–74.

    Article  PubMed  Google Scholar 

  3. Rodin G. The treatment of depression in patients with cancer. Lancet. 2008;372(9632):8–10.

    Article  PubMed  Google Scholar 

  4. Holland J, Watson M, Dunn J. The IPOS New International Standard of Quality Cancer Care: integrating the psychosocial domain into routine care. Psychooncology. 2011;20(7):677–80.

    Article  PubMed  Google Scholar 

  5. Holland JC, Andersen B, Breitbart WS, Buchmann LO, Compas B, Deshields TL, et al. Distress management. J Natl Compr Canc Netw. 2013;11(2):190–209.

    PubMed  Google Scholar 

  6. American College of Surgeons Commission on Cancer. Cancer Program Standards 2012 Version 1.1: Ensuring patient-centered care. Available at: http://www.facs.org/cancer/coc/programstandards2012.html. Accessed 2 Jan 2013.

  7. Clark PG, Bolte S, Buzaglo J, Golant M, Daratsos L, Loscalzo M. From distress guidelines to developing models of psychosocial care: current best practices. J Psychosoc Oncol. 2012;30(6):694–714.

    Article  PubMed  Google Scholar 

  8. Lazenby M, McCorkle R, Fitch M. Interdisciplinary programmatic approaches to comprehensive distress screening for implementing the quality care standard of whole-patient care. Palliat Support Care. 2014;12(1):1–4.

    Article  PubMed  Google Scholar 

  9. Jacobsen P, Donovan K, Trask P, et al. Screening for psychologic distress in ambulatory cancer patients. Cancer. 2005;103(7):1494–502.

    Article  PubMed  Google Scholar 

  10. Holland JC, Jacobsen PB, Andersen B, et al. NCCN clinical practice guidelines in oncology: distress management. Version 3.2012. Available at NCCN.org. Accessed 30 May 2014.

  11. Jacobsen PB, Ransom S. Implementation of NCCN Distress Management Guidelines by member institutions. J Natl Compr Canc Netw. 2007;5(1):99–103.

    PubMed  Google Scholar 

  12. Donovan KA, Jacobsen PB. Progress in the implementation of NCCN guidelines for distress management by member institutions. J Natl Compr Canc Netw. 2013;11(2):223–6.

    PubMed  Google Scholar 

  13. Pirl WF, Fann JR, Greer JA, et al. Recommendations for the implementation of distress screening programs in cancer centers: report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force. Cancer. 2014;120(19):2946–54. This paper makes recommendations for implementation of distress screening programs using experts from the three professions most often involved in screening patients for distress. It is focused on practical steps cancer centers can take to meet the American College of Surgeons Commission on Cancer’s psychosocial distress screening accreditation standard.

    Article  PubMed  Google Scholar 

  14. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: distress management (v 1. 2012). Fort Washington, PA. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/distress.pdf. 2012

  15. Wagner LI, Spiegel D, Pearman T. Using the science of psychosocial care to implement the new American college of surgeons commission on cancer distress screening standard. J Natl Compr Canc Netw. 2013;11(2):214–21.

    PubMed  Google Scholar 

  16. Lazenby M, Dixon J, Bai M, McCorkle R. Comparing the distress thermometer (DT) with the patient health questionnaire (PHQ)-2 for screening for possible cases of depression among patients newly diagnosed with advanced cancer. Palliat Support Care. 2014;12(1):63–8.

    Article  PubMed  Google Scholar 

  17. Howell D, Keller-Olaman S, Oliver T, et al. A pan-Canadian practice guideline: screening, assessment and care of psychosocial distress (depression, anxiety) in adults with cancer. Canadian Partnership Against Cancer (Cancer Journey Action Group) and the Canadian Association of Psychosocial Oncology, 2010. www.capo.ca/pdf/ENGLISH_Depression_Anxiety_Guidelines_for_ Posting_Sept2011.pdf

  18. Andersen BL, DeRubeis RJ, Berman BS, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol. 2014;32(15):1605–19. The paper makes recommendations for screening, assessing, and caring for patients with anxiety and depression that can be adapted to the local practice environment. It suggests validated tools for identifying patients who are anxious or depressed. It also presents treatment pathways for both anxiety and depression.

    Article  PubMed  Google Scholar 

  19. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Ryan DA, Gallagher P, Wright S, Cassidy EM. Sensitivity and specificity of the distress thermometer and a two-item depression screen (Patient Health Questionnaire-2) with a ‘help’ question for psychological distress and psychiatric morbidity in patients with advanced cancer. Psychooncology. 2012;21(12):1275–84.

    Article  PubMed  Google Scholar 

  21. Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:617–27.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Sheldon LK, Swanson S, Dolce A, Marsh K, Summers J. Putting evidence into practice: evidence-based interventions for anxiety. Clin J Oncol Nurs. 2008;12(5):789–97.

    Article  PubMed  Google Scholar 

  23. Carlson LE, Waller A, Mitchell AJ. Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol. 2012;30(11):1160–77. This review summarizes findings from studies on distress screening and psychometric properties of commonly used distress screening tools. It also describes the process of implementing distress screening programs, including recommendations for training staff. It reviews patient-reported outcomes that can be used for quality improvement.

    Article  PubMed  Google Scholar 

  24. Hollingworth W, Metcalfe C, Mancero S, et al. Are needs assessments cost effective in reducing distress among patients with cancer? A randomized controlled trial using the Distress Thermometer and Problem List. J Clin Oncol. 2013;31(29):3631–8.

    Article  PubMed  Google Scholar 

  25. Estes JM, Karten C. Nursing expertise and the evaluation of psychosocial distress in patients with cancer and survivors. Clin J Oncol Nurs. 2014;18(5):598–600.

    Article  PubMed  Google Scholar 

  26. Carlson L, Groff S, Maciejewski O, Bultz B. Screening for distress in lung and breast cancer outpatients: a randomized controlled trial. J Clin Oncol. 2010;28(33):4884–91.

    Article  PubMed  Google Scholar 

  27. Tuinman MA, Van Nuenen FM, Hagedoorn M, Hoeksra-Weebers JE. Distress, problems and referral wish of cancer patients: differences according to relationship status and life phase. Psychooncology. 2014. doi:10.1002/pon.3712.

    PubMed Central  Google Scholar 

  28. O’Hea EL, Cutillo A, Dietzen L, Harralson T, Grissom G, Person S, et al. Randomized control trial to test a computerized psychosocial cancer assessment and referral program: Methods and research design. Contemp Clin Trial. 2013;35(1):15–24.

    Article  Google Scholar 

  29. Jacobsen PB, Kadlubek P. Changes over time in quality of psychosocial care: results from the Quality Oncology Practice Initiative (QOPI). J Clin Oncol. 2010;28(suppl):15s.

    Google Scholar 

  30. Weisman AD, Worden JW. The existential plight in cancer: significance of the first 100 days. Int J Psychiatry Med. 1976;7(1):1–15.

    Article  PubMed  Google Scholar 

  31. McCorkle R, Young K. Development of a symptom distress scale. Cancer Nurs. 1978;1(5):373–8.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work was partially supported by NIH Grant No. R25CA177553-02, Ruth McCorkle, PI.

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Conflict of Interest

Mark Lazenby, Hui Tan, Nick Pasacreta, Elizabeth Ercolano, and Ruth McCorkle declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Yale University School of Nursing, PO Box 27399, West Haven, CT, 06516-7399, USA

    Mark Lazenby, Hui Tan, Nick Pasacreta, Elizabeth Ercolano & Ruth McCorkle

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  1. Mark Lazenby
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  2. Hui Tan
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  3. Nick Pasacreta
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  4. Elizabeth Ercolano
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  5. Ruth McCorkle
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Correspondence to Mark Lazenby.

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This article is part of the Topical Collection on Palliative Medicine

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Lazenby, M., Tan, H., Pasacreta, N. et al. The Five Steps of Comprehensive Psychosocial Distress Screening. Curr Oncol Rep 17, 22 (2015). https://doi.org/10.1007/s11912-015-0447-z

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