title: Usefulness of the nurse-assisted screening and psychiatric referral program.
abstract: BACKGROUND
  Major depression and adjustment disorders are common psychiatric disorders in patients with cancer, but they are often overlooked in clinical oncology settings. The nurse-assisted screening and psychiatric referral program (NASPRP) has been introduced in clinical practice to facilitate psychiatric treatment for major depression and adjustment disorders. This study assessed the usefulness of the NASPRP and compared it with usual practice.
  
  
  METHODS
  The program consists of two stages. In the first stage, consecutive patients newly admitted to the Oncology/Hematology Unit are administered the Distress and Impact Thermometer (DIT) by nurses as a brief screening tool for major depression and adjustment disorders. In the second stage, the nurses recommend psychiatric referral to patients with scores above the cutoff point. Patients' records were reviewed for a 3-month period before the start of the program and during the 3-month period after the start of the program. These records were then compared.
  
  
  RESULTS
  Of 157 patients newly admitted during the program period, 86.0% (135/157) completed the DIT and results were positive in 49.6% (67/135), but only 28.2% (19/67) accepted psychiatric referral. Ultimately, 11.5% (18/157) of patients newly admitted were diagnosed with major depression or adjustment disorders and treated by psychiatric service, a significantly higher proportion than during the preceding 3-month period, before the program was begun (2.5%; P = 0.001).
  
  
  CONCLUSIONS
  The NASPRP enabled identification of major depression and adjustment disorders in patients with cancer and introduced them to psychiatric treatment. Nevertheless, there is room for improvement in the program.
authors.affiliation: Psychiatry Division, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Shimizu
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Masako
authors.initials: M
authors.lastname: Okamura
authors.forename: Akira
authors.initials: A
authors.lastname: Oba
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000223:Adaptation, Psychological; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D009741:Nursing Staff, Hospital; D012017:Referral and Consultation; D011795:Surveys and Questionnaires / Q000592:standards*