Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice

Bultz, Barry D.; Groff, Shannon L.; Fitch, Margaret I.; Blais, Marie Claude; Howes, Janice; Levy, Karen S.; Mayer, Carole

doi:10.1002/pon.1932

Cited by 170 publications

(154 citation statements)

References 9 publications

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“…Referral, comprehensive assessment, or intervention by a more specialized health care professional can then be arranged if necessary 1,6,7 . It has been found that, when distress screening is implemented, staff members are enthusiastic about screening and appreciate the associated training 7 .…”

Section: Screening For Distressmentioning

confidence: 99%

“…Carlson et al 9 found that, despite enthusiasm, 38% of clinicians believe that screening is impractical for routine use, and 43% of nurses and radiographers rated a screening program as "not useful." And yet others argue that screening has several benefits: it allows for follow-up and coordination of appropriate services, and it increases outreach to patients 1,7,9,12,13 . Accordingly, debate is ongoing in the literature.…”

Section: Screening For Distressmentioning

confidence: 99%

“…Distress has been identified as the 6th vital sign in cancer care, and cancer programs across Canada are required to implement appropriate screening programs (reviewed in Bultz et al 1 and Thomas and Bultz 2 ). In 2008, experts and policymakers in the field of cancer gathered to revise current practices and to develop a new Canadian national strategy.…”

Section: Introductionmentioning

confidence: 99%

“…In 2008, experts and policymakers in the field of cancer gathered to revise current practices and to develop a new Canadian national strategy. Guidelines were put forth 1 , with recommendations about when and how to screen for distress.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Screening for Distress in Patients with Cancer: Methodologic Considerations

et al. 2014

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Distress has been declared the 6th vital sign in Canadian cancer care. Accordingly, health care professionals in Canada are expected to screen for distress in patients with cancer, for which a toolkit has been developed. Identifying patients who may be in need of further resources has the potential to improve quality of care because those patients are more likely to have their existing distress identified and to be referred for appropriate follow-up services. The present article briefly reviews the background literature and the validation of the measures in the toolkit, and highlights future directions for methodologic validation of the toolkit for use according to the protocol.

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Section: Screening For Distressmentioning

confidence: 99%

Section: Screening For Distressmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Screening for Distress in Patients with Cancer: Methodologic Considerations

et al. 2014

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“…How screening is implemented in the face of social, organizational and economic challenges [31][32][33] will be the next hurdle to overcome if psychosocial oncology is to find its place as a core program within the cancer care system worldwide.…”

mentioning

confidence: 99%

Screening for Distress, the 6th Vital Sign: where are we, and where are we going?

2011

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Incidence of and Factors Associated With Nonfatal Self-injury After a Cancer Diagnosis in Ontario, Canada

et al. 2021

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IMPORTANCE Psychological distress is a key component of patient-centered cancer care. While a greater risk of suicide among patients with cancer has been reported, more frequent consequences of distress, including nonfatal self-injury (NFSI), remain unknown. OBJECTIVE To examine the risk of NFSI after a cancer diagnosis. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study used linked administrative databases to identify adults diagnosed with cancer between 2007 and 2019 in Ontario, Canada. EXPOSURES Demographic and clinical factors. MAIN OUTCOMES AND MEASURESCumulative incidence of NFSI, defined as emergency department presentation of self-injury, was computed, accounting for the competing risk of death from all causes. Factors associated with NFSI were assessed using multivariable Fine and Gray models. RESULTSIn total, 806 910 patients met inclusion criteria. The mean (SD) age was 65.7 (14.3) years, and 405 161 patients (50.2%) were men. Overall, 2482 (0.3%) had NFSI and 182 (<0.1%) died by suicide. The 5-year cumulative incidence of NFSI was 0.27% (95% CI, 0.25%-0.28%). After adjusting for key confounders, prior severe psychiatric illness, whether requiring inpatient care (subdistribution hazard ratio [sHR], 12.6; 95% CI, 10.5-15.2) or outpatient care (sHR, 7.5; 95% CI, 6.5-8.8), and prior self-injury (sHR, 6.6; 95% CI, 5.5-8.0) were associated with increased risk of NFSI.Young adults (age 18-39 years) had the highest NFSI rates relative to individuals aged 70 years or older (sHR, 5.4; 95% CI, 4.5-6.5). The magnitude of association between prior inpatient psychiatric illness and NFSI was greatest for young adults (sHR, 17.6; 95% CI, 12.0-25.8). Certain cancer subsites were also associated with increased risk, including head and neck cancer (sHR, 1.5; 95% CI, 1.2-1.9). CONCLUSIONS AND RELEVANCEIn this study, patients with cancer had a higher incidence of NFSI than suicide after diagnosis. Younger age, history of severe psychiatric illness, and prior self-injury were independently associated with risk of NFSI. These exposures appeared to act synergistically, placing young adults with a prior mental health history at the greatest risk of NFSI. These factors should be used to identify at-risk patients.

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Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice

Cited by 170 publications

References 9 publications

Screening for Distress in Patients with Cancer: Methodologic Considerations

Screening for Distress in Patients with Cancer: Methodologic Considerations

Screening for Distress, the 6th Vital Sign: where are we, and where are we going?

Incidence of and Factors Associated With Nonfatal Self-injury After a Cancer Diagnosis in Ontario, Canada

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