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

Elena Meggiolaro,Sabrina Prati,Marina Bragagni,Federica Ruffilli,Stefano Tamberi,Ilaria Massa,Tatiana Bertelli,Flavia Foca,Silvia De Padova,Luigi Zerbinati,Luigi Grassi,Lidia Pisotti,Ugo De Giorgi,Elisa Tiberto

doi:10.3390/cancers13153761

Abstract

Simple SummaryAn evaluation process and adequate referrals are an important part of a distress screening program but insufficient consideration is given to referrals and uptake of available supportive services. Identifying the reasons for accepting or refusing help is needed to implement a screening-for-distress policy in a clinical cancer setting, as confirmed in the present study. It is vital to reach and motivate the highest possible number of patients to be referred to psycho-oncology services when needed. A multidisciplinary approach could help to raise awareness of the benefit of screening for distress, the implementation of which would improve uptake.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.

Highlights

Little consideration is given to the referral and uptake of available supportive services after distress screening
Significant differences among the three Distress Thermometer (DT) groups were found in the Problem Check List (PL) areas involving practical, relational, emotional and spiritual issues, but not physical issues (Table 2)
The present study aimed to explore the practical usefulness of and potential barriers to the application of distress management guidelines in three hospitals

Summary

Introduction

Little consideration is given to the referral and uptake of available supportive services after distress screening. All patients with a DT score ≥6 were invited for a post-DT telephone interview with a trained psychologist. Of the 78 patients with a score ≥6 who were referred to the Psycho-Oncology Service, 65.4% accepted the telephone interview. 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. Cancer diagnosis and treatment often lead to patients experiencing considerable emotional consequences and psychological problems. Neglected and untreated symptoms of distress cause an additional burden for the healthcare system because patients are more likely to use healthcare services more frequently and for longer as they undergo further chemotherapy lines [8,9,10]

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