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Validated Distress Screening Tools Items Time (min) Brief Symptom Inventory (BSI-18) 18 3–5 CancerSupportSourceSM 25 5-10 Distress Thermometer (DT) & Problem List 1 2–3 Distress and problems related to the distress Edmonton Symptom Assessment System 9 2-3 Symptoms Hospital Anxiety and Depression Scale (HADS) 14 5–10 Symptoms of clinical depression and anxiety PHQ-9 9 5-10 Anxiety and depression Psychological Distress Inventory 13 5-10 Psychological functioning (incl. coping) Psychosocial Screen for Cancer (PSSCAN) 21 10-15 General Distress SupportScreen 53 15-20 Psychosocial needs Zung Self-Rating Depression Scale 20 5–10 Symptoms of depression Constructs Measured Somatization, depression, general distress anxiety, “Distress extends along a continuum, ranging from common normal feelings of vulnerability and sadness to problems that can be disabling, such as depression, anxiety, panic, social isolation and existential and spiritual crisis.” National Comprehensive Cancer Network: 1999, 2001, 2004, 2007, 2010 Prevalence rates for significant levels of distress in patients with cancer range from 22% to 58% NCI’s Adjustment to Cancer: Anxiety and Distress (PDQ®) Distress Management Goals & Outcomes • Reduce/eliminate barriers that impact treatment adherence • Enhance satisfaction with care and quality of life • Improve staff-patient communication/trust • Reduce unnecessary telephone calls/visits • Better treatment outcomes as fewer patients become distressed to the point of interrupting treatment Psychosocial Distress Screening Process Summary • Choose or create a screening tool(s) and delivery method • Establish a threshold/cutoff and use screening results to triage patients for further evaluation and care • Distribute resources and information to all patients • Document gaps in resources & determine the options for addressing those gaps (Std 3.1) • Designate the healthcare team available to do a full assessment for those who fall above the threshold/cutoff • Assess, intervene & follow-up on those patients in need & document their care and follow-up • Psychosocial Service Representative reports to the cancer committee and discusses the screening and care delivery process with surveyor