Psychosocial Distress Screening: Application of the Oncology Standard to HCT

Topic Significance & Study Purpose/Background/Rationale Maintaining a standardized process for psychosocial distress screening (PDS) for cancer patients is a 2015 standard for Commission on Cancer accredited hospitals.1 While many patients undergoing hematopoietic cell transplantation (HCT) have a cancer diagnosis, there are distinctions between the HCT process and oncology care, including the significant role of the HCT caregiver and the treatment of non-cancer diseases. These variations require modification of PDS processes to fit the HCT setting. The objective was to develop and implement a phone-based PDS process for patients and caregivers pre-HCT. Methods, Intervention, & Analysis An evidence based approach was used to apply an oncology-based PDS standard to HCT. This approach included: 1) review literature on PDS practices for HCT; 2) select and modify a screening tool; 3) develop a pilot program and evaluation plan; and 4) use preliminary results to guide program changes. Findings & Interpretation The literature review resulted in 359 abstracts (PubMed, 2009 – 2014); 41 relevant articles were synthesized. From among 16 screening tools, the Distress Thermometer was selected with associated problem lists and referral plans tailored to HCT.2 An implementation plan for the phone-based PDS pilot was developed. Program objectives were to: 1) design a standard process for PDS in HCT; 2) determine average PD score of pilot participants; and 3) provide participants with appropriate resources and/or referrals to address psychosocial needs. Preliminary results will be presented including: 1) baseline data for developing goals around number of PDS completed and referrals made; 2) mean PD score of pilot participants, 3) perceived helpfulness of PDS (staff); and 4) overall satisfaction with program (staff). Discussion & Implications These results will inform the comprehensive formative evaluation plan. Lessons learned from this evidence-based pilot program will provide relevant insight to nurses and social workers adapting this standard to their practice. 1. American College of Surgeons Commission on Cancer. Cancer Program Standards 2012, Version 1.1: Ensuring Patient-Centered Care. Available at: http://www.facs.org/cancer/coc/programstandards2012.html. Accessed February 20, 2014. 2. Ransom, S., Jacobsen, P. B., & Booth-Jones, M. (2006). Validation of the Distress Thermometer with bone marrow transplant patients. Psycho-Oncology, 15(7), 604–612.