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

Published online by Cambridge University Press:  02 August 2013

Marie-Claude Blais ,
Alexandre St-Hilaire ,
Lise Fillion ,
Marie De Serres  and
Annie Tremblay
Marie-Claude Blais*
Affiliation:
Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
Alexandre St-Hilaire
Affiliation:
School of Psychology, Laval University, QC, Canada
Lise Fillion
Affiliation:
Nursing Faculty, Laval University, QC, Canada
Marie De Serres
Affiliation:
Centre Hospitalier Universitaire de Québec (CHUQ), Hôtel-Dieu de Québec, QC, Canada
Annie Tremblay
Affiliation:
Centre Hospitalier Universitaire de Québec (CHUQ), Hôtel-Dieu de Québec, QC, Canada
*
Address correspondence and reprint requests to: Marie-Claude Blais, Pavillon Michel Sarrazin, Département de Psychologie, Université du Québec à Trois-Rivières, C.P. 500, Trois-Rivières, Québec, G9A 5H7, Canada. E-mail: marie-claude.blais1@uqtr.ca
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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.

Keywords

CancerScreening for DistressChange of practiceDistressPatients' needsNurse navigator
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 1 , February 2014 , pp. 25 - 38
Copyright
Copyright © Cambridge University Press 2013 

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