From Distress Screening to Uptake: An Italian Multicenter Study of Cancer Patients

Abstract

Introduction: Little consideration is given to the referral and uptake of available supportive services after distress screening. However, identifying the reasons for accepting or refusing help is mandatory for implementing a screening policy. The present study explored the practical usefulness of and potential barriers to the application of distress management. Methods: 406 cancer patients were consecutively selected and asked to complete the Distress Thermometer (DT) and Problem Check List (PL). All patients with a DT score ≥6 were invited for a post-DT telephone interview with a trained psychologist. Results: The 112 patients who refused to take part were more often older, retired, at a more advanced stage of illness, and with no previous experience of psychological intervention with respect to those who accepted. Of the 78 patients with a score ≥6 who were referred to the Psycho-Oncology Service, 65.4% accepted the telephone interview. Twenty-two patients rejected the initial invitation immediately for various reasons including logistic difficulties, physical problems, and feeling embarrassed about opening up to a psychologist. Conclusions: Our study confirms that screening per sé is insufficient to deal with the problem of distress and that more emphasis should be placed on implementing referral and treatment.

Implementing a nurse‐led screening clinic for symptom distress with community‐based referral for cancer survivors: A feasibility study

“…Previous studies showed highly-distressed patients often decline referral to mental health specialist-delivered psychosocial services 31,33,34 ; patients seemingly prefer interventions from nurses. 33 We adopt a multi-disciplinary approach where a community nurse case manager coordinates a team of allied health professionals to deliver a broad spectrum of psychosocial services. This approach both minimizes the stigma of mental health or psychosocial services 31 and broadens potential solutions.…”

Cancer mortality in Common Mental Disorders: A 10-year retrospective cohort study

“…A psycho-oncology service has been operating for many years in the region [ 24 ]. Specific psychological support services are usually integrated within hospital cancer units [ 25 ] and home palliative care units [ 26 ]. In addition, a consultation liaison psychiatric service for primary care is available to support general practitioners, usually treating individuals with milder clinical conditions.…”

Distress in hospitalized cancer patients: Associations with personality traits, clinical and psychosocial characteristics

“…Different cut‐off scores were used for the DT 24 . Based on previous studies examining mixed samples of cancer patients, we choose a cut‐off of ≥6 at the visual analog scale, which indicates clinically significant distress 12,25,26 …”