What to do with screening for distress scores? Integrating descriptive data into clinical practice

Palliat Support Care. 2014 Feb;12(1):25-38. doi: 10.1017/S1478951513000059. Epub 2013 Aug 2.

Abstract

Objective: Implementation of routine Screening for Distress constitutes a major change in cancer care, with the aim of achieving person-centered care.

Method: Using a cross-sectional descriptive design within a University Tertiary Care Hospital setting, 911 patients from all cancer sites were screened at the time of their first meeting with a nurse navigator who administered a paper questionnaire that included: the Distress Thermometer (DT), the Canadian Problem Checklist (CPC), and the Edmonton Symptom Assessment System (ESAS).

Results: Results showed a mean score of 3.9 on the DT. Fears/worries, coping with the disease, and sleep were the most common problems reported on the CPC. Tiredness was the most prevalent symptom on the ESAS. A final regression model that included anxiety, the total number of problems on the CPC, well-being, and tiredness accounted for almost 50% of the variance of distress. A cutoff score of 5 on the DT together with a cutoff of 5 on the ESAS items represents the best combination of specificity and sensitivity to orient patients on the basis of their reported distress.

Significance of results: These descriptive data will provide valuable feedback to answer practical questions for the purpose of effectively implementing and managing routine screening in cancer care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / nursing*
  • Anxiety Disorders / psychology
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / nursing*
  • Depressive Disorder / psychology
  • Fatigue / diagnosis
  • Fatigue / nursing
  • Fatigue / psychology
  • Female
  • Health Services Needs and Demand
  • Hospice and Palliative Care Nursing*
  • Humans
  • Male
  • Mass Screening / nursing*
  • Middle Aged
  • Neoplasms / nursing*
  • Neoplasms / psychology*
  • Nursing Assessment / statistics & numerical data*
  • Patient-Centered Care*
  • Psychometrics / statistics & numerical data
  • Quebec
  • Reproducibility of Results
  • Sick Role*
  • Surveys and Questionnaires*
  • Tertiary Care Centers
  • Young Adult