Special feature Screening for distress: Responding is a critical function for oncology nurses

Margaret I. Fitch, Doris Howell, Deborah McLeod, Esther Green

Abstract


The practice of routine screening for distress in cancer populations has been gaining worldwide support over the past several years with the conceptualization of distress as the sixth vital sign. Across Canada, experience with screening for distress is growing, as cancer facilities implement screening programs. Early learning from these efforts has emphasized the need for a programmatic approach and the importance of oncology nurses in screening and providing the initial response to distress.

To date, little has been written from the nursing perspective about the oncology nursing role in a program screening for distress and responding to the identified patient concerns. This article describes the current thinking about distress; explores how screening for and responding to distress is integral to oncology nursing practice; and shares the early learning and experiences of cancer nurses in implementing screening for distress initiatives.


Full Text:

PDF

References


Adler, N.E., & Page, A.E.K. (Eds.). (2008). Cancer care for the whole

patient: Meeting psychosocial health needs. Institute of Medicine.

Washington, DC: The National Academic Press.

Arnold, E. (1999). Communication with clients in stressful situations.

In E. Arnold & K.U. Boggs (Eds.), Interpersonal relationships:

Professional communication skills by nurses (3rd ed.). Toronto,

ON: W.B. Saunders Company Inc.

Barney, L.J., Griffiths, K.M., Christensen, H., & Jorm, A.F. (2009).

Exploring the nature of stigmatizing beliefs about depression

and help-seeking: Implications for reducing stigma. BMC Public

Health, 9, 61–69. doi:10.1186/1471-2458-9-61

Botti, M., Endacott, R., Watts, R., Cairns J., Lewis, K., & Kenny, A.

(2006). Barriers in providing psychosocial support for patients

with cancer. Cancer Nursing, 29(4), 309–316.

Brown, K.W., Levy, A.R., Rosberger, Z., & Edgar, L. (2003).

Psychological distress and cancer survival: A follow-up 10

years after diagnosis. Psychosomatic Medicine, 65, 636–643.

doi:10.1097/ 01.PSY.0000077503.96903.A6

Bruera, E., Kuehn, N., Miller, M.J., Selmser, P., & Macmillan, K. (1991).

The Edmonton Symptom Assessment System (ESAS): A simple

method of assessment of palliative patients. Journal of Palliative

Care, 7, 6–9.

Bultz, B., & Carlson, L. (2006). Emotional distress: The sixth vital

sign-future directions in cancer care. Psycho-Oncology, 15, 93–95.

doi:10.1002/pon.1022

Canadian Association of Nurses in Oncology/Association canadienne

des infirmieres en oncologie (CANO/ACIO). (1995). Standards for

oncology nursing practice. Toronto, ON: CANO/ACIO.

Canadian Partnership Against Cancer. (2009). Cancer System Quality

Index (2010). Toronto: Cancer Care Ontario.

Cancer Care Ontario. (2011). Symptom Management Guides.

Retrieved from http://www.cancercare.on.ca/toolbox/symptools

Carlson L.E., & Bultz, B.D. (2004). Efficacy and medical cost offset

of psychosocial interventions in cancer care: Making the case for

economic analyses. Psycho-Oncology, 13, 837–849. doi:10.1002/

pon.832

Carlson L.E., Angen, M., Cullum J., et al. (2004). High levels of

untreated distress and fatigue in cancer patients. Br J Cancer, 90,

–2304. doi:10.1038/sj.bjc.6601887

Carlson, L., & Bultz, B. (2003). Benefits of psychosocial oncology care:

Improved quality of life and medical cost offset. Health Quality

of Life Outcomes, 1, 8. doi:10.1186/1477-7525-1-8

Cleeland, C.S., Gonin, R., Hatfield, A.K., Edmonsen, J.H., Blum, R.H.,

Stewart, J.A., & Panya, K.J. (1994). Pain and its treatment in

outpatients with metastatic cancer. N Engl J Med, 330, 592–596.

Corner, J. (1996). Beyond survival rates and side effects: Cancer

nursing as therapy (Robert Tiffany Address). 9th International

Conference on Cancer Nursing. Brighton, UK.

Coyne, J.C., Thompson, R., Palmer, S.C., Kagee, A., & Maunsell,

E. (2000). Should we screen for depression? Caveats and

potential pitfalls. Applied & Preventive Psychology, 9, 101–121.

doi:10.1016/S0962-1849(00)80009-8

Fallowfield, L., Ratcliffe, D., Jenkins, V., & Saul, J. (2001). Psychiatric

morbidity and its recognition by doctors in patients with cancer.

Br J Cancer, 84, 1011–1015. doi:10.1054/bjoc.2001.1724

Fisch, M. (2004). Treatment of depression in cancer. J Natl Cancer

Inst Monogr, 32, 105–111. doi:10.1093/jncimonographs/lgh011

Fitch, M.I. (In press). Supportive care needs of patients with advanced

disease undergoing radiotherapy for symptom control. Canadian

Oncology Nursing Journal.

Fitch, M.I. (2008). Supportive Care Framework: Theoretical

Underpinnings. In M.I. Fitch, H.B. Porter & B.D. Page (Eds.),

Supportive Care Framework: A foundation for person-centred

care. Pembroke, ON: Pappin Communications.

Folkman, S., & Greer, S. (2000). Promoting psychological well-being

in the face of serious illness: When theory, research and practice

inform each other. Psycho-Oncology, 9, 11–19.

Fulcher, C.D., Badger, T., Gunter, A.K., & Marrs, J.A. (2008). Putting

evidence into practice: Interventions for depression. Clin J Oncol

Nur, 12(1), 131–140. doi:10.1188/08.CJON.131-140

Gerteis M., Edgman-Levitan S., Daley J., & Delbanco, T.L. (1993).

Through the Patient’s Eyes: Understanding and Promoting Patient-

Centered Care. San Francisco, CA: Jossey-Bass.

Given, B., & Sherwood, R.R. (2005). Nursing sensitive patient

outcomes: A white paper. Oncology Nursing Forum, 32(4), 1538–

doi:10.1188/05.ONF.773-784

Groenvold, M., Petersen, M.A., Idler, E., Bjorner, J.B., Fayers, P.M., &

Mouridsen, H.T. (2007). Psychological distress and fatigue predicted

recurrence and survival in primary breast cancer patients. Breast

Cancer Res Treat, 105, 209–219. doi:10.1007/s10549-006-9447-x

Grunfeld, E., Coyle, D., Whelan, T., Clinch, J., Reyno, L., Earle, C.C., et al.

(2004). Family caregiver burden: Results of a longitudinal study of

breast cancer patients and their principal caregivers. Canadian Medical

Association Journal, 170, 1795–1801. doi:10.1503/cmaj.1031205

Hack, T.F., Degner, L.F., & Parker, P.A. (2005). The communication

goals and needs of cancer patients: A review. Psycho-Oncology,

(10), 831–845. doi:10.1002/pon.94

Holland, J.C., Kelly, B.J., & Weinberger, M.I. (2010). Why psychosocial

care is difficult to integrate into routine cancer care: Stigma is the

elephant in the room. J Natl Compr Canc Netw, 8(4), 362–366.

Howell, D. (2010). Psychological distress as a nurse sensitive

outcome. In D. Doran (Ed.), Nurse Outcomes; State of the Science

(pp. 285–358). Mississauga, ON: Jones & Bartlett Publishers Inc.

Howell, D., Currie, S., Mayo, S., Jones, G., Boyle, M., Hack, T., Green,

E., Hoffman, L., Simpson, J. Collacutt, V., McLeod, D. & Digout, C.

(2009, mai). Guide pancanadien de pratique clinique : évaluation

des besoins en soins psychosociaux du patient adulte atteint de

cancer, Toronto, Partenariat canadien contre le cancer (groupe

d’action pour l’expérience globale du cancer) et Association

canadienne d’oncologie psychosociale.

Institute of Medicine (IOM). (2008). Cancer care for the whole patient:

Meeting psychosocial health needs. Nancy E. Adler and Ann E.K.

Page, Eds. Washington, DC: The National Academies Press.

Jacobsen, P.B. (2009). Promoting evidence-based psychosocial care

for cancer patients. Psycho-Oncology, 18(1), 6–13. doi:10.1002/

pon.1468

Jacobsen, P.B., Shibata, D., Siegel, E.M., Lee, J., Alemany, C.A., Brown, R.,

et al. (2009). Initial evaluation of quality indicators for psychosocial

care of adults with cancer. Cancer Control, 16(4), 328–334.

Kennard B.D., Smith S.M., Olvera, R., et al. (2004). Nonadherence in

adolescent oncology patients: Preliminary data on psychological

risk factors and relationships to outcome. J Clin Psych Medical

Settings, 11, 30–39. doi:10.1023/B:JOCS.0000016267.21912.74

Kleinpell, R.M. (2001). Outcome assessment in advanced practice

nursing. New York, NY: Springer Publishing Company Inc.

Lepore, S.L., & Coyne, J.C. (2006). Psychological interventions for

distress in cancer patients: A review of reviews. Annals of Behavioral

Medicine, 32(2), 85–92. doi:10.1207/s15324796abm3202_2

Longo, C.J., Fitch, M., Deber, R.B., & Williams, A.P. (2006). Financial

and family burden associated with cancer treatment in Ontario,

Canada. Supportive Care in Cancer, 14, 1077–1085. doi:10.1007/

s00520-006-0088-8

McCaffery, M., & Pasero, C. (1999). Pain: Clinical Manual (2nd ed.).

St. Louis, MO: Mosby.

McCloskey, J., & Bulechek, G. (1996). NIC: Nursing Intervention

Classification System. St. Louis, MO: Mosby.

McCormack, B., & McCance, T.V. (2006). Development of a framework

for person-centered nursing. Journal of Advanced Nursing, 56(5),

–479. doi:10.1111/j.1365-2648.2006.04042.x

McLeod, D.L., Tapp, D.M., Moules, N.J., & Campbell, M.E. (2010).

Knowing the family: Interpretations of family nursing in oncology

and palliative care. European Journal of Oncology Nursing, 14(2),

–100.

McLeod, D., & Morck, A. (2011). Screening for Distress, the 6th Vital

Sign: Outcomes of a web-based education resources to support

a national screening for distress program. Paper presented at

the Canadian Association of Psychosocial Oncology, May 5, 2011,

Toronto, Ontario.

Merckaert, I., Libert, Y., Delvaux, N., Marchal, S., Boniver, J., Etienne,

A.M., Klastersky, J., … Razavi, D. (2005). Factors that influence

physicians’ detection of distress in patients with cancer: Can a

communication skills training program improve physicians’

detection? Cancer, 104(2), 411–421.

Mitchell, A.J., & Kakkadasam, V. (2010). Ability of nurses to identify

depression in primary care, secondary care and nursing homes:

A meta-analysis of routine clinical accuracy. International

Journal of Nursing Studies, 48(3), 359–368. doi: 10.1016/

j.ijnurstu.2010.05.012

Mitchell, A.J., Hussain, N., Grainger, L., & Symonds, P. (2010).

Identification of patient-reported distress by clinical nurse

specialists in routine oncology practice: A multicentre UK study.

Psycho-Oncology, 20(10), 1076–1083. doi: 10.1002/pon.1815

National Comprehensive Cancer Network (NCCN). (2010).

Distress Management. Retrieved from http://www.nccn.org/

professionals/physician_gls/f_guidelines.asp

National Institute for Clinical Excllence (NICE). (2004). Improving

supportive and palliative care for adults with cancer: Executive

Summary. London, England.

Newell, S.A., Sanson-Fisher, R.W., Savolainen, N.J. (2002). Systematic

review of psychological therapies for cancer patients: Overview

and recommendations for future research. J Natl Cancer Inst, 94,

–584. doi:10.1093/jnci/94.8.558

Patrick, D.L., Ferketich, S.L., Frame, P.S., Harris, J.J., Hendricks

C.B., Levin, B., et al. (2003). National Institutes of Health Stateof-

the-Science Conference Statement: Symptom Management in

Cancer — Pain, Depression and Fatigue, July 15–17, 2002. J Natl

Cancer Inst, 95(15), 1110–1117. doi:10.1093/jnci/djg014

Plummer, S.E., Gourney, K., Goldberg, D., Ritter, S.A., Mann, A.H., &

Blizard, R. (2000). Detection of psychosocial distress of practice

nurses in general practice. Psychology Med, 15, 863–872.

Programme Qmentum, Services de traitement du cancer et oncologie.

(2010). Agrément Canada : Ottawa. http://www.accreditation.ca/

fr/content.aspx?pageid=50&langType=3084 (voir « Les normes »

à gauche)

Richardson, A., Medina, J., Brown, V., & Sitzia, J. (2007). Patients’

needs assessments in cancer care: A review of assessment tools.

Supportive Care in Cancer, 15(10), 1125–1144. doi:10.1007/

s00520-006-0205-8

Sanson-Fisher, R.W., Girgis, A., Boyes, A., Bonevski, B., Burton, L.,

Cook, P., et al. (the Supportive Care Review Group). (2000). The

unmet supportive care needs of patients with cancer. Cancer, 88,

–237.

Skarstein, J., Aass, N., Fossa, S.D., Skovlund, E., & Dahl, A.A. (2000).

Anxiety and depression in cancer patients: Relation between

the Hospital Anxiety and Depression Scale and the European

Organization for Research and Treatment of Cancer Core Quality

of Life Questionnaire. J Psychosom Res, 49, 27–34.

Steele, R., & Fitch, M. (2008). Why patients with lung cancer do not

want help with some needs. Supportive Care in Cancer, 16(3),

–259. doi: 10.1007/s00520-007-0301-4

Steele, R., & Fitch, M. (2008). Supportive care needs of women

with gynecological cancer. Cancer Nursing, 31(4), 284–291.

doi:10.1097/01.NCC.0000305743.64452.30

Stewart, M. (2001). Towards a global definition of patient-centered

care. BMJ, 322, 444–445. doi:10.1136/bmj.322.7284.444

Union for International Cancer Control (UICC). (2010). World Cancer

Congress, Shenchen, China.

Vachon, M. (2006). Psychosocial distress and coping after cancer

treatment. Cancer Nursing, 29(2 Suppl.), 26–31.

Vachon, M.L. (1998). Psychosocial needs of patients and families.

Journal of Palliative Care, 14, 49–53.

Vodermaier A., & Linden W. (2008). Emotional distress screening in

Canadian Cancer Care. Oncology Exchange, 7(4), 37–40.

Von Essen, I., Larsson, G., Oberg, K., & Sjoden, P.O. (2002).

Satisfaction with care: Associations with health-related quality

of life and psychosocial function among Swedish patients with

endocrine and gastrointestinal tumors. Eur J Cancer Care, 11,

–99.

Weisman A.D. (1976). Early diagnosis of vulnerability in cancer

patients. Am J Med Sci, 271, 187–196.

Wen, K.Y., & Gustafson, D.H. (2004). Needs assessment for cancer

patients and their families. Health and Quality of Life Outcomes,

, 11. doi:10.1186/1477-7525-2-11

Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi,

S. (2001). The prevalence of psychological distress by cancer site.

Psycho-Oncology, 19(1), 19–28.


Refbacks

  • There are currently no refbacks.