Systematic screening for distress in oncology practice using the Distress Barometer: the impact on referrals to psychosocial care.
OBJECTIVE
This study evaluates how patterns of psychosocial referral of patients with elevated distress differ in a 'systematic screening for distress' condition versus a 'usual practice' condition in ambulatory oncology practice.


METHODS
The psychosocial referral process in a 2-week usual practice (N=278) condition was compared with a 2-week 'using the Distress Barometer as a screening instrument' (N=304) condition in an outpatient clinic with seven consulting oncologists.


RESULTS
Out of all distressed patients in the usual practice condition, only 5.5% of patients detected with distress were actually referred to psychosocial counselling, compared with 69.1% of patients detected with distress in the condition with systematic screening using the Distress Barometer. Only 3.7% of patients detected with distress in the usual practice condition finally accepted this referral, compared with 27.6% of patients detected with distress in the screening condition.


CONCLUSIONS
Using the Distress Barometer as a self-report screening instrument prior to oncological consultation optimises detection of elevated distress in patients, and this results in a higher number of performed and accepted referrals, but cannot by itself guarantee actual psychosocial referral or acceptance of referral. There is not only a problem of poor detection of distress in cancer patients but also a need for better decision-making and communication between oncologists and patients about this issue.
Dienst Supportieve en Palliatieve Zorg, Universitair Ziekenhuis Brussel, Brussel, Belgium; Dienst Klinische Psychologie, Universitair Ziekenhuis Brussel, Brussel, Belgium.
Sabien
S
Bauwens
Catherine
C
Baillon
Willem
W
Distelmans
Peter
P
Theuns
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008495:Medical Oncology / Q000592:standards; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires
cancer; distress; oncology; psychosocial needs; referral