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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