Patrizia Mordenti*1,Michela Monfredo1, Camilla Di Nunzio1, Ornella Bettinardi1, Andrea Spoto2, Luigi Cavanna1
*p.mordenti@ausl.pc.it
1Hospital Guglielmo da Saliceto, Piacenza, Italy
2University of Padua, Padua, Italy
Abstract
Given the high incidence of distress and its high negative impact on quality of life, routine screening for distress is today recognized as a standard of care in oncology practice. It is demonstrated that a quickly identification of distress may lead to prompt treatment and consequently to a better adherence to the oncologic plan. The main aims of this research were to identify factors associated with distress and propose a simple and acceptable method to measure distress and unmet needs of oncologic patients, apart from Distress Thermometer. During the first visit, a brief interview with a psychologist and two questionnaires (Hospital Anxiety and Depression Scale, Psychological Distress Inventory) were administered to all new patients accessing our Unit. From January to June 2013, 100 new oncologic patients were screened for distress. The presence of symptoms at diagnosis was related to type of cancer and gender, being pain more frequent in men and asthenia in women. Moreover, living alone resulted to be a risk factor for distress. Using a brief interview and two simple self-administered questionnaires, the detection of distress can be very quick. This may allow for fast interventions thus improving the quality of life and adherence to the oncologic treatment.
Keywords: distress, screening, cancer, unmet needs, supportive care
Published online: 2016/09/01
Published print: 2016/09/01
References
Adler, N. E., Page, A. E. K. (2008). Institute of Medicine (IOM). Cancer care for the whole patient: Meeting psychosocial health needs. Washington, DC: The National Academies Press.
Baker-Glenn, E. A., Park, B., Granger, L., Symonds, P., & Mitchell, A. J. (2011). Desire for psychological support in cancer patients with depression or distress: Validation of a single help question. Psycho-Oncology, 20, 523-531.
Bertolotti, G., Michielin, P., Vidotto, G., Sanavio, E., Bottesi, G., Bettinardi, O., & Zotti, A.M. (2015). Metric qualities of the cognitive behavioral assessment for outcome evaluation to estimate psychological treatment effects. Neuropsychiatric Disease and Treatment, 11, 2449-2460.
Bidstrup, P. E., Johansen, C., & Mitchell, A. J. (2011). Screening for cancer-related distress: Summary of evidence from tools to programs. Acta Oncologica, 50, 194-204.
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An update literature review. Journal of Psychosomatic Research, 52, 69-77.
Bonacchi, A., Rossi, A., Bellotti, L., Franco, S., Toccafondi, A., Miccinesi, G., et al. (2010). Assessment of psychological distress in cancer patients: a pivotal role for clinical interview. Psycho-Oncology,19, 1294-1302.
Bultz, B. D., & Johansen, C. (2011). Screening for distress, the 6th vital sign: Where are we, and where are we going? Psycho-Oncology, 20, 569-571.
Carlson, L. E., Groff, S. L., Maciejewski, O., & Bultz, B. D. (2010). Screening for distress in lung and breast cancer outpatients: A randomised controlled trial. Journal of Clinical Oncology, 28, 4884-4891.
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.
Castelli, L., Binaschi, L., Caldera, P., Mussa, A., & Torta, R. (2011). Fast screening of depression in cancer patients: the effectiveness of the HADS. European Journal of Cancer Care, 20, 528-533.
Castelli, L., Binaschi, L., Caldera, P., & Torta, R. (2009). Depression in lung cancer patients: is the HADS an effective screening tool? Supportive Care in Cancer, 17, 1129-1132.
Detmar, S. B., Muller, M. J., Schornagel, J. H., Wever, L. D., & Aaronson, N. K. (2002). Health-related quality-of-life assessments and patient-physician communication: A randomized controlled trial. The Journal of the American Medical Association, 288, 3027-3034.
Fillion, L., Cook, S., Veillette, A. M., Aubin, M., de Serres, M., Rainville, F., et al. (2012). Professional navigation framework: elaboration and validation in a Canadian context. Oncology Nursing Forum, 39, E58-E69.
Giese-Davis, J., Waller, A., Carlson, L. E., Groff, S., Zhong, L., & Neri E. (2012). Screening for distress, the 6th vital sign: Common problems in cancer outpatients over one year in usual care: associations with marital status, sex, and age. BMC Cancer, 12, 441.
Grassi, L., Rossi, E., Caruso, R., Nanni, M. G., Pedrazzi, S., Sofritti, S., et al. (2011). Educational intervention in cancer outpatient clinics on routine screening for emotional distress: An observational study. Psycho-Oncology, 20, 669-674.
Hamer, M., Chida, Y., & Molloy, G. J. (2009). Psychological distress and cancer mortality. Journal of Psychosomatic Research, 66, 255-258.
Harding, M. M. (2014). Incidence of distress and associated factors in women undergoing breast diagnostic evaluation. Western Journal of Nursing Research, 36, 475-494.
Holland, J. C., & Alici, Y. (2010). Management of distress in cancer patients. Journal of Supportive Oncology, 8, 4-12.
Holland, J. C., & Bultz, B. D. (2007). The NCCN guideline for distress management: A case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network, 5, 3-7.
Holland, J. C., Jacobsen, P. B., Andersen, B., Awasthi, S., Breitbart, W. S., Brewer, B.W., et al. The NCCN distress management guidelines, version 1, 2015. www.nccn.org/ (Accessed on January, 2015).
Jacobsen, P. B., & Wagner, L. I. (2012). A new quality standard: The integration of psychosocial care into routine cancer care. Journal of Clinical Oncology, 30, 1154-1159.
Layard, R., Clark, D., Knapp, M., & Mayraz, G. (2007). Cost benefit analysis of psychological therapy. National Institute Economic Review, 202, 90-98.
Lazenby, M., Tan, H., Pasacreta, N., Ercolano, E., & McCorkle, R. (2015). The Five Steps of Comprehensive Psychosocial Distress Screening. Current Oncology Repository, 17, 22.
Mitchell, A. J. (2007). Pooled results from 38 analyses of the accuracy of distress thermometer and other ultra-short methods of detecting cancer-related mood disorders. Journal of Clinical Oncology, 25, 4670-4681.
Mitchell, A. J. (2010). Short screening tools for cancer-related distress: A review and diagnostic validity meta-analysis. Journal of the National Comprehensive Cancer Network, 8, 487-494.
Morasso, G., Costantini, M., Baracco, G., Borreani, C., & Capelli, M. (1996). Assessing psychological distress in cancer patients: validation of a self-administered questionnaire. Oncology, 53, 295-302.
Néron, S., Correa, J. A., Dajczman, E., Kasymjanova, G., Kreisman, H., & Small, D. (2007). Screening for depressive symptoms in patients with unresectable lung cancer. Supportive Care in Cancer, 15, 1207-1212.
R Core Team (2014). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria.
Sanson-Fisher, R., Carey, M., & Paul, C. (2009). Measuring the unmet needs of those with cancer: A critical overview. Cancer Forum, 33, 1-4.
Sanson-Fisher, R., Girgis, A., Boyes, A., Bonevski, B., Burton, L., & Cook, P. (2000). The unmet supportive care needs of patients with cancer. Supportive Care Review Group. Cancer, 88, 226-237.
Shim, E. J., Mehnert, A., Koyama, A., Cho, S. J., Inui, H., & Paik, N.S. (2006). Health-related quality of life in breast cancer: A cross-cultural survey of German, Japanese, and South Korean patients. Breast Cancer Research and Treatment, 99, 341-350.
Sollner, W., Maislinger, S., König, A., Devries, A., & Lukas, P. (2004). Providing psychosocial support for breast cancer patients based on screening for distress within a consultation-liaison service. Psycho-Oncology, 13, 893-897.
Strupp, H. H., Lambert, M. J., & Horowitz, L. M. (1997). Measuring patient changes in mood, anxiety and personality disorders: Toward a core battery. Washington DC: American Psychological Association.
van Scheppingen, C., Schroevers, M. J., Smink, A., van der Linden, Y. M., Mul, V. E., Langendijk, J. A., et al. (2011). Does screening for distress efficiently uncover meetable unmet needs in cancer patients? Psycho-Oncology, 20, 655-663.
Velikova, G. (2010). Patient benefit from psychosocial care: Screening for distress and models of care. Journal of Clinical Oncology, 28, 4871-4873.
Velikova, G., Booth, L., Smith, A. B., Brown, P. M., Lynch, P., Brown, J. M., et al. (2004). Measuring quality of life in routine oncology practice improves communication and patient well-being: A randomized controlled trial. Journal of Clinical Oncology, 22, 714-724.
Von Essen, L., Larsson, G., Oberg, K., & Sjödén, P. O. (2002). Satisfaction with care: Association with health-related quality of life and psychosocial function among Swedish patients with endocrine gastrointestinal tumors. European Journal of Cancer Care, 11(2), 91-99.
Zebrack, B., Kayser, K., Sundstrom, L., Savas, S. A., Henrickson, C., Acquati, C., et al. (2015). Psychosocial Distress Screening Implementation in Cancer Care: An Analysis of Adherence, Responsiveness, and Acceptability. Journal of Clinical Oncology, 33, 1165-1170.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361-370.
