title: Promoting quality breast cancer care: psychosocial distress screening.
abstract: OBJECTIVE
  To evaluate the feasibility of implementing psychosocial distress screening in a breast center of a comprehensive cancer center, using a model of structure (personnel, resources), process (screening), and outcome (number of patients screened, number referred).
  
  
  METHODS
  The first step in the project was to establish administrative support, educate and engage breast center staff, identify stakeholders and persons with expertise in the conduct of evidence based initiatives. A two-phase implementation approach was agreed upon with Phase I being screening of new patients in surgical oncology and Phase II being screening women in medical oncology.
  
  
  RESULTS
  A total of 173 patients were screened. The new patients screened in surgical oncology reported higher average distress scores compared to patients in medical oncology (5.7 vs. 4.0). However, a greater number of patients in medical oncology reported scores >4 compared to the new patients screened in surgery (54% vs. 35%). Psychological distress was the most commonly reported distress for patients in surgery. In contrast, 60% of scores >4 in medical oncology were symptom related, managed by the nurse or physician.
  
  
  CONCLUSIONS
  Nurse led implementation of psychosocial distress screening is feasible, addressing this important quality indicator of patient-centered care.
authors.affiliation: Yale University School of Nursing, New Haven, Connecticut.
authors.forename: M Tish
authors.initials: MT
authors.lastname: Knobf
authors.affiliation: Women's Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut.
authors.forename: Maureen
authors.initials: M
authors.lastname: Major-Campos
authors.affiliation: Yale School of Medicine, Department Surgery and The Breast Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut.
authors.forename: Anees
authors.initials: A
authors.lastname: Chagpar
authors.affiliation: Department of Social Work and the Breast Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut.
authors.forename: Andrea
authors.initials: A
authors.lastname: Seigerman
authors.affiliation: Yale University School of Nursing, New Haven, Connecticut.
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D000223:Adaptation, Psychological; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000451:nursing* / Q000523:psychology; D001943:Breast Neoplasms / Q000451:nursing* / Q000523:psychology*; D003237:Connecticut; D003299:Cooperative Behavior; D003866:Depressive Disorder / Q000175:diagnosis* / Q000451:nursing* / Q000523:psychology; D055318:Evidence-Based Nursing; D005260:Female; D006284:Health Plan Implementation; D006293:Health Promotion / Q000458:organization & administration*; D064946:Hospice and Palliative Care Nursing; D006801:Humans; D033183:Interdisciplinary Communication; D008403:Mass Screening / Q000451:nursing* / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D011594:Psychometrics / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D015203:Reproducibility of Results; D012803:Sick Role; D011795:Surveys and Questionnaires