Psychosocial distress screening program can improve outcomes in cancer patients

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NEW ORLEANS—A psychosocial distress screening program developed by experts from multiple disciplines can help improve outcomes among cancer patients dealing with stress, according to research presented at the Oncology Nursing Society 37th Annual Congress.

Oncology nurses understand that cancer patients experience numerous stressors during treatment, which can negatively impact outcomes. The American College of Surgeons recently established new standards to address the need for psychosocial distress screening in cancer care.

In response to the new standards, members of the Cancer Committee at Franciscan Health System, Tacoma, WA, led by Judy Ferraz, RN, OCN, and S. Keith Helmka, MSW, LICSW, organized a multidisciplinary subcommittee—consisting of the oncology department's two social workers, a registered dietician, the on-site American Cancer Society Navigator, and two oncology nursing RNs—to develop a distress screening program.

The committee members decided to administer the Distress Thermometer Screening Tool from the National Comprehensive Cancer Network (NCCN) to outpatients in order to improve patient outcomes by positively impacting adherence and compliance to treatment. RNs on the outpatient oncology unit were asked to ensure patients received the questionnaire at their initial chemotherapy visit and to review the tool after completion.

Patients who identified a high level of distress (score of 6 or greater) or immediate needs were referred to the oncology social worker. All other patients (score of 5 or less) spoke with an American Cancer Society Patient Navigator or an oncology nurse on the unit. As part of the process, the cancer center filed the completed screening tools into the chart along with any interventions provided by the screeners, such as referral to psychiatry or financial assistance getting to and from the hospital. They also tracked how long the navigators spent with patients and what interventions and resources were utilized most.

The center noted the effectiveness of the multidisciplinary team approach upon completion of the pilot and noted that input from many health care providers provided global perspective on how the program would work across the health care system.

“The pilot program will be a valuable tool in the practice of the outpatient oncology nurse in providing for the psychosocial health of patients, thus maximizing positive outcomes. As resources for providing quality cancer care diminish, engagement of all disciplines for the creation of new programs will have increasing value,” the care team stated.

Judy Ferraz, one of the study authors, credited NCCN for starting the process and giving them a place to go and noted that the screening program could not have been so successful without the help of a multidisciplinary care team.

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