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Promoting quality breast cancer care: Psychosocial distress screening

Published online by Cambridge University Press:  29 October 2013

M. Tish Knobf ,
Maureen Major-Campos ,
Anees Chagpar ,
Andrea Seigerman  and
Ruth Mccorkle
M. Tish Knobf*
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
Maureen Major-Campos
Affiliation:
Women's Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut
Anees Chagpar
Affiliation:
Yale School of Medicine, Department Surgery and The Breast Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut
Andrea Seigerman
Affiliation:
Department of Social Work and the Breast Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut
Ruth Mccorkle
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
*
Address correspondence and reprint requests to: M. Tish Knobf, Yale University School of Nursing, 100 Church Street South, New Haven, CT. 06536-0740. E-mail: [email protected]
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Abstract

Objective:

To evaluate the feasibility of implementing psychosocial distress screening in a breast center of a comprehensive cancer center, using a model of structure (personnel, resources), process (screening), and outcome (number of patients screened, number referred).

Methods:

The first step in the project was to establish administrative support, educate and engage breast center staff, identify stakeholders and persons with expertise in the conduct of evidence based initiatives. A two-phase implementation approach was agreed upon with Phase I being screening of new patients in surgical oncology and Phase II being screening women in medical oncology.

Results:

A total of 173 patients were screened. The new patients screened in surgical oncology reported higher average distress scores compared to patients in medical oncology (5.7 vs. 4.0). However, a greater number of patients in medical oncology reported scores >4 compared to the new patients screened in surgery (54% vs. 35%). Psychological distress was the most commonly reported distress for patients in surgery. In contrast, 60% of scores >4 in medical oncology were symptom related, managed by the nurse or physician.

Significance of results:

Nurse led implementation of psychosocial distress screening is feasible, addressing this important quality indicator of patient-centered care.

Keywords

Breast cancerDistress screeningNursingQuality care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 1 , February 2014 , pp. 75 - 80
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Adler, N.E. & Page, A.E. (2008). Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Institute of Medicine. Washington, DC: National Academies Press.Google Scholar
Beesley, V., Eakin, E., Stegnina, S., et al. (2008). Unmet needs of gynaecological cancer suvrivrs: Implications for developing community support services. Psychology-Oncology, 17, 392–400.Google Scholar
Bultz, B. & Johansen, C. (2011). Screening for distress, the 6th vital sign:where are we, and where are we going? Psychology-Oncology, 20, 569–571.Google Scholar
Carlson, L.E., Waller, A., Groff, S.L., et al. (2012). Online screening for distress, the 6th vital sign, in newly diagnosed oncology outpatients: Randomised controlled trial of computerized vs personalized triage. British Journal of Cancer, 107, 617–625.Google Scholar
Carlson, L.E., Waller, A. & Mitchell, A.J. (2012). Screening for distress and unmet needs in patients with cancer: Review and recommendations. Journal of Clinical Oncology, 30, 1160–1177.Google Scholar
Commission on Cancer: Cancer Program standards (2012). Ensuring Patient-Centered Care. www.facs.org/cancer/coc/cocprogramstandardsGoogle Scholar
Donabedian, A. (1980). The Definition of Quality and Approaches to Its Assessment. Ann Arbor: Health Administration Press.Google Scholar
Fann, J.R., Ell, K. & Sharpe, M. (2012). Integrating psychosocial care into cancer services. Journal of Clinical Oncology, 30, 1178–1186.Google Scholar
Fashoyin-Aje, L.A., Martinez, K.A. & Dy, S.M. (2012). New patient-centered care standards from the Commission on Cancer: opportunities and challenges. Journal of Support Oncology, 10, 107–111.Google Scholar
Frost, G.W., Zevon, M.A., Gruber, M., et al. (2011). Use of distress thermometer in an outpatient setting. Health & Social Work, 16, 293–297.Google Scholar
Hegel, M.T., Collins, D., Kearing, S., et al. (2008). Sensitivity and specificity of the Distress Thermometer for depression in newly diagnosed breast cancer patients. Psycho-Oncology, 17, 556–560.Google Scholar
Hewitt, M., Herdman, R. & Holland, J. (2004). Meeting the Psychosocial Needs of Women with Breast Cancer. Washington, DC: National Academies Press.Google Scholar
Jacobsen, P.B. & Kadlubek, P. (2012). Changes over time in quality of psychosocial care. Results from the Quality Oncology Practice Initiative (QOPI). Journal of Clinical Oncology, 28, 447s.Google Scholar
Jacobsen, P.B., Shibata, D., Siegel, E.M., et al. (2011). Evaluating the quality of psychosocial care in outpatient medical oncology settings using performance indicators. Psychology-Oncology, 20, 1221–1227.Google Scholar
Jacobsen, P.B. & Wagner, L.I. (2010). A new quality standard: The integration of psychosocial care into routine cancer care. Journal of Clinical Oncology, 30, 1154–1159.Google Scholar
Kendall, J., Glaze, K., Oakland, S., et al. (2011). What do 1281 distress screeners tell us about cancer patients in a community cancer center? Psychology-Oncology, 20, 594–600.Google Scholar
Knobf, M.T. (2011). Clinical update: Psychosocial responses in breast cancer survivors. Sem Oncology Nursing, 27, e1–e14.Google Scholar
Mehnert, A. & Koch, U. (2008). Psychological morbidity and health-related quality of life and its association with awareness, utilization and need for psychosocial support in a cancer register- based sample of long term breast cancer survivors. Journal of Psychosomatic Research, 64, 383–391.Google Scholar
Mitchell, A.J., Kaar, S., Coggan, C. et al. (2008). Acceptability of common screening methods used to detect distress and related mood disorders-preferences of cancer specialists and non-specialist. Psychology-oncology, 17, 226–236.Google Scholar
Montgomery, M. & McCrone, S.H. (2010). Psychological distress associated with the diagnostic phase for suspected breast cancer: systematic review. Journal of Advance Nursing, 66, 2372–2390.Google Scholar
National Comprehensive Cancer Network (2012). Distress management. www.nccn.orgGoogle Scholar
Rosswurm, M. & Larabee, J.H. (1999). A model for change to evidence-based practice. Image Journal of Nursing Scholarship, 31, 317–322.CrossRefGoogle Scholar
Sollner, W., Maislinger, S., Konig, A., et al. (2004). Providing psychosocial support for breast cancer patients based on screening for distress with a Consultation-Liaison service. Psychology-Oncology, 13, 893–897.Google Scholar
Vilhauer, R.P. (2008). A qualitative study of the experiences of women with metastatic breast cancer. Palliative Supportive Care, 6, 249–258.Google Scholar