Screening of Distress and Referral Need in Dutch oncology practice

Abstract

‘Screening of Distress and Referral Need’ contributes to better cancer care Patients with cancer can experience physical, emotional, social, practical, and spiritual problems (distress) due to the disease and its treatment. Psychosocial problems are not always discussed during consultations, even though a timely professional response can lead to better quality of life. To improve patients’ psychosocial care, the Netherlands Comprehensive Cancer Organisation, location Groningen (IKNL-G) developed the process ‘Screening of Distress and Referral Need’(SDRN). The SDRN-process steps are: 1. Patient completes a Distress Thermometer and Problem List (DT&PL) to gain insight into the nature and severity of their perceived problems, 2. Care provider and patient discuss the responses, 3. Care provider refers the patient, if necessary, to psychosocial and/or allied healthcare. Van Nuenen investigated several aspects of the SDRN-process and its implementation in daily practice of 23 hospitals. Patients and care providers were predominantly positive about the SDRN process and the DT&PL as signaling instrument. Introducing SDRN into daily practice appears to be desirable and feasible. The more process steps the patients completed, the more satisfied they were. Discussing the DT&PL responses with the care provider proved to be essential. The effect study shows that, post-SDRN implementation, patients reported fewer and less severe practical, social, and emotional problems than patients did pre-implementation. The IKNL-G implementation project underlines the importance of adequate psychosocial care as an integrated part of oncology care. Continuous attention for this, further implementation, and optimization of the execution remain necessary, e.g., by making time and training available.