Implementing Routine Screening for Distress, the Sixth Vital Sign, for Patients With Head and Neck and Neurologic Cancers

This study examined the benefits of incorporating screening for distress as a routine part of care for patients with head and neck and neurologic cancers in a tertiary cancer center. Using a comparative 2-cohort pre-post implementation sequential design, consecutive outpatients with head and neck and neurologic cancers were recruited into 2 separate cohorts. Cohort 1 included patients attending clinics during April 2010, before the implementation of the screening program. The program was then implemented and patients completed the Screening for Distress Minimum Dataset (the Edmonton Symptom Assessment System [ESAS] and the Canadian Problem Checklist [CPC]) at each clinic visit. Cohort 2 included patients attending clinics during March 2011. Consenting patients completed screening and outcome measures (ESAS, CPC, and either the Functional Assessment of Cancer Illness Therapy – Brain  or the Functional Assessment of Cancer Illness Therapy – Head and Neck). A total of 146 patients (78 head and neck and 68 neurologic) provided data for Cohort 1, and 143 (81 head and neck and 62 neurologic) provided data for Cohort 2. Compared with Cohort 1, patients with neurologic cancers in Cohort 2 reported significantly higher scores on the Functional Assessment of Cancer Therapy: General total and emotional quality of life subscale; fewer high scores (≥4) on the ESAS breathlessness item; and fewer problems with fears/worries, frustration/anger, finding meaning in life, and worry about friends/family. Head and neck patients in Cohort 2 reported significantly higher emotional quality of life and fewer problems with eating and weight than those in Cohort 1. Although no definitive causal attributions can be made, patients exposed to routine screening for distress reported better well-being and fewer emotional, physical, and practical problems than historical controls.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Discuss the benefits that implementing a routine distress screening program had on patient-reported outcomes
  • Describe strategies to successfully implement screening for distress and ensure that services are provided to patients in response to concerns
Additional information
Supporters: 

No commercial support was received for this article.

Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
10/25/2013
Course expires: 
10/25/2014
Cost:
$0.00
Barry D. Bultz, PhD
Department of Psychosocial Resources, Tom Baker Cancer Centre
Department of Oncology, University of Calgary
Calgary, Alberta, Canada
Lisa Shirt
Department of Oncology, Tom Baker Cancer Center
University of Calgary
Calgary, Alberta, Canada
Amy Waller
Department of Psychosocial Resources, Tom Baker Cancer Centre
Department of Oncology, University of Calgary
Calgary, Alberta, Canada
Scott Blanchard
Department of Oncology, University of Calgary
Department of Oncology, Tom Baker Cancer Center
Calgary, Alberta, Canada
Paula Jones
Department of Psychosocial Resources, Tom Baker Cancer Centre
University of Calgary
Calgary, Alberta, Canada
Harold Lau
Department of Oncology, Tom Baker Cancer Center
University of Calgary
Calgary, Alberta, Canada
Johan Halland
Department of Psychosocial Resources, Tom Baker Cancer Centre
University of Calgary
Calgary, Alberta, Canada
Jacob Easaw
Department of Oncology, Tom Baker Cancer Center
University of Calgary
Calgary, Alberta, Canada
Jodi L. Cullum
Research and Evaluation Unit, Alberta Health Services
University of Calgary
Calgary, Alberta, Canada
Konrad Fassbender
Department of Oncology, Division of Palliative Care Medicine
University of Alberta
Edmonton, Alberta, Canada
Shannon Groff
Department of Psychosocial Resources, Tom Baker Cancer Centre
University of Calgary
Calgary, Alberta, Canada
Linda Carlson
Department of Psychosocial Resources, Tom Baker Cancer Centre
University of Calgary
Calgary, Alberta, Canada
Catriona Leckie
Department of Oncology, Tom Baker Cancer Center
University of Calgary
Calgary, Alberta, Canada

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
10/25/2013
Course expires: 
10/25/2014

Price

Cost:
$0.00
Please login or register to take this course.

Required Hardware/software

To access this activity, users will need:

  • A device with an Internet connection
  • Adobe Reader or other PDF reader software for article and certificate viewing/printing