Now What? Toward an Integrated Research and Practice Agenda in Distress Screening

Abstract

Significant gains have been made in the detection and treatment of cancer, contributing to increased survival, but a cancer diagnosis and treatment may be accompanied by physical and psychosocial after-effects. Distress screening has been championed as a mechanism to identify patients with high levels of psychosocial morbidity for subsequent assessment and psychosocial care delivery. However, implementation of distress screening has been variable, in scope and in the consistency and quality of metrics and methods used. This capstone article identifies challenges in the measurement and implementation of distress screening and examines future opportunities for research and implementation.

Everybody wants it done but nobody wants to do it: an exploration of the barrier and enablers of critical components towards creating a clinical pathway for anxiety and depression in cancer

“…The ownership of a clinical pathway by the whole cancer services team, including leadership, was shown to be crucial to successful implementation. The extant literature also confirms the importance of being strategic, collaborative and explicitly aware of the culture of health care delivery [ 5 , 29 ] and engaging clinicians in the implementation process [ 27 ].…”

“…Lack of resources [time, finances, equipment and skills] are well documented as significant barriers to guideline implementation in chronic health conditions [ 30 - 32 ], distress screening in cancer [ 33 ], and in organising psychosocial services [ 34 ]. Enabling strategies include using phased-in approaches to implementation, using research and evaluation as support tools and partnering proactively with stakeholders [ 29 ]. Our findings further suggest integrating clinical pathways into existing hospital systems including cancer services policy and IT systems, and for hospital leadership to endorse such activities.…”

“…Although fewer participants in this study reflected on patient reluctance, there was very strong support for education for patients as a means to reducing the stigma attached to mental health issues and referral. Openly acknowledging resistance from patients and staff can facilitate greater acceptance of distress screening and after-care [ 29 ].…”

Emotional Distress in Patients Newly Diagnosed with Late Stage Cancers

“…In addition, data presented in this secondary analysis were cross-sectional and represented only one data collection point. Although there have been a number of interventions identified to assist patients [31,32], additional research is needed to see if it is applicable for patients newly diagnosed with late stage cancers who may be at risk for long-term distress [33].…”

ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report

“…New standards of oncology care related to distress screening place oncology social workers in a visible and potentially more powerful position to enhance oncology care systems’ response to patient and family needs [38]. Doing so requires skill in the implementation of distress screening protocols, selection of appropriate instruments and evaluation of patient outcomes [39, 40, 41, 42]. Participant goals have focused heavily on the need to develop robust screening strategies to address recommended IOM [1] and Commission on Cancer [43] guidelines for identifying patients most at risk for distress.…”