Addressing distress management challenges: Recommendations from the consensus panel of the American Psychosocial Oncology Society and the Association of Oncology Social Work

Abstract

Distress management (DM) (screening and response) is an essential component of cancer care across the treatment trajectory. Effective DM has many benefits, including improving patients' quality of life; reducing distress, anxiety, and depression; contributing to medical cost offsets; and reducing emergency department visits and hospitalizations. Unfortunately, many distressed patients do not receive needed services. There are several multilevel barriers that represent key challenges to DM and affect its implementation. The Consolidated Framework for Implementation Research was used as an organizational structure to outline the barriers and facilitators to implementation of DM, including: 1) individual characteristics (individual patient characteristics with a focus on groups who may face unique barriers to distress screening and linkage to services), 2) intervention (unique aspects of DM intervention, including specific challenges in screening and psychosocial intervention, with recommendations for resolving these challenges), 3) processes for implementation of DM (modality and timing of screening, the challenge of triage for urgent needs, and incorporation of patient-reported outcomes and quality measures), 4) organization-inner setting (the context of the clinic, hospital, or health care system); and 5) organization-outer setting (including reimbursement strategies and health-care policy). Specific recommendations for evidence-based strategies and interventions for each of the domains of the Consolidated Framework for Implementation Research are also included to address barriers and challenges.

Timely Palliative Care: Personalizing the Process of Referral

“…Several randomized controlled trials have found that routine symptom monitoring is not only associated with improved quality of life, but also longer survival. Since 2015, the Commission on Cancer has mandated distress screening, requiring oncology providers to implement standardized screening and to document an action plan [ 47 , 48 , 49 ]. Systematic symptom screening can help identify patients who may benefit from specialist referral.…”

Resilience in the Face of Pandemic: The Impact of COVID-19 on the Psychologic Morbidity and Health-Related Quality of Life Among Women With Ovarian Cancer

“…Regarding psychologic measurements, not all instruments used were cancer-specific and abbreviated tools were used to allow the survey to be of reasonable length, which similar to clinical practice, might have decreased sensitivity and specificity. 29,30 Heterogeneity among phone interviewers, including providers that the patient might have interacted with as part of their care team previously, might have biased both how patients responded and which patients responded.…”

Screening for Distress and Health Outcomes in Head and Neck Cancer

“…Despite evidence that significant distress is associated with negative health outcomes and screening for distress is associated with improved emotional well-being and fewer physical and practical concerns in previous HNC research [ 8 ], the uptake of distress screening in institutions remains limited. Improving health outcomes by screening for emotional distress requires attention to best practices from implementation science research [ 57 ]. Since positive screening must be followed by effective psychosocial care, an institution’s clinical capacity may determine which screening tool is optimal.…”