Screening for Distress Boosts Nurse Confidence in Delivering Personalized Care

Linda Watson, PhD, RN

Linda Watson, PhD, RN

A new study has found that tests that screen for distress, a problem affecting as many as 60% of patients with cancer, can improve the confidence of nurses and other clinicians in their abilities to deliver person-centered care.

“Distress can be caused by a variety of issues, concerns, or symptoms, but how distress is experienced and what underlies a person’s distress is unique to each person and changes over time,” senior study author Linda Watson, PhD, RN, said in a statement. “The SFD [screening for distress intervention] helps clinicians identify distressed patients and their issues, concerns, or symptoms driving their distress.”

For their study, Watson and colleagues at CancerControl Alberta in Canada recruited more than 250 healthcare practitioners (HCPs) across 17 facilities providing cancer care in the province. These HCPs participated in educational sessions and adopted SFD as standard practice.

Following a 10-month implementation period, 157 providers filled out post-implementation questionnaires. The impact of having navigators at regional and community cancer centers, where they help with implementing SFD, was also evaluated.

The researchers found a surge in provider confidence in managing distress among cancer patients. HCPs who implemented SFD also reported greater awareness of the importance of a patient-centered approach to care. This was especially true among those who practiced at smaller community cancer centers, compared with their colleagues at larger tertiary sites.

“We have found that utilizing a SFD tool that spans the physical, emotional, social, spiritual, practical, and informational domains has been helpful as it reflects the whole patient experience,” Watson said. “It has been our experience that using a tool that helps patients to specify their particular area of concern facilitates meaningful interventions,” she added.

The study authors noted that the presence of site-based navigators and caring for patients diagnosed with a different tumor types also influenced outcomes. The benefits of the SFD was more noticeable among HCPs taking care of multiple tumor types, which the authors note suggests that such intervention is well adopted by physicians who practice a more generalist model of care.

They added that on the other hand, physicians from larger centers tend to be single-tumor specialists at hospitals that do not employ patient navigation programs; these participants reported lower awareness in person-centeredness in general, and the SFD intervention potentially posed an additional workload.

“Patient distress has received little attention from clinicians, but can have a large impact on patient quality of life,” said Jimmie C. Holland, MD, in a statement. Holland is the Wayne R. Chapman Chair in Psychiatric Oncology, Memorial Sloan Kettering Cancer Center, and Chair of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Distress Management. “As such, screening for distress will become increasingly important in clinical practices, so information on its implementation is useful for practitioners.”

Tamagawa R, Groff S, Anderson J, et al. Effects of a provincial-wide implementation of screening for distress on healthcare professionals’ confidence and understanding of person-centered care in oncology. J Natl Compr Canc Netw. 2016;14(10):1259-1266.