title: Guiding Lay Navigation in Geriatric Patients With Cancer Using a Distress Assessment Tool.
abstract: There is growing interest in psychosocial care and evaluating distress in patients with cancer. As of 2015, the Commission on Cancer requires cancer centers to screen patients for distress, but the optimal approach to implementation remains unclear.
  
  
  
  We assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014.
  
  
  
  Of the 5,121 patients enrolled in our lay patient navigation program, 4,520 (88%) completed at least one assessment using a standardized distress tool (DT). Navigators used the tool to structure both formal and informal distress assessments. Of all patients, 24% reported distress scores of 4 or greater and 5.5% reported distress scores of 8 or greater. The most common sources of distress at initial assessment were pain, balance/mobility difficulties, and fatigue. Minority patients reported similar sources of distress as the overall program population, with increased relative distress related to logistical issues, such as transportation and financial/insurance questions. Patients were more likely to ask for help with questions about insurance/financial needs (79%), transportation (76%), and knowledge deficits about diet/nutrition (76%) and diagnosis (66%) when these items contributed to distress.
  
  
  
  Lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|Hematology and Oncology, University of Alabama at Birmingham School of Medicine
authors.forename: Gabrielle B
authors.initials: GB
authors.lastname: Rocque
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|Preventive Medicine, University of Alabama at Birmingham School of Medicine
authors.forename: Richard A
authors.initials: RA
authors.lastname: Taylor
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|University of Alabama at Birmingham School of Nursing
authors.forename: Aras
authors.initials: A
authors.lastname: Acemgil
authors.affiliation: University of Alabama at Birmingham School of Nursing
authors.forename: Xuelin
authors.initials: X
authors.lastname: Li
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|University of Alabama at Birmingham School of Nursing
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
authors.affiliation: University of Alabama at Birmingham School of Nursing
authors.forename: Kelly
authors.initials: K
authors.lastname: Kenzik
authors.affiliation: Preventive Medicine, University of Alabama at Birmingham School of Medicine
authors.forename: Bradford E
authors.initials: BE
authors.lastname: Jackson
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center
authors.forename: Karina I
authors.initials: KI
authors.lastname: Halilova
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|Preventive Medicine, University of Alabama at Birmingham School of Medicine
authors.forename: Karen
authors.initials: K
authors.lastname: Meneses
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|University of Alabama at Birmingham School of Nursing
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Li
authors.affiliation: University of Alabama at Birmingham School of Nursing
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Martin
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center
authors.forename: Carol
authors.initials: C
authors.lastname: Chambless
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|University of Alabama at Birmingham School of Nursing
authors.forename: Nedra
authors.initials: N
authors.lastname: Lisovicz
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|University of Alabama at Birmingham School of Nursing
authors.forename: Mona
authors.initials: M
authors.lastname: Fouad
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center
authors.forename: Edward E
authors.initials: EE
authors.lastname: Partridge
authors.affiliation: University of Alabama at Birmingham Comprehensive Cancer Center|Birmingham VA Medical Center, Birmingham, Alabama
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Kvale
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005791:Patient Care; D062526:Patient Navigation / Q000379:methods; D013315:Stress, Psychological