Educational intervention in cancer outpatient clinics on routine screening for emotional distress: an observational study

Purpose : To examine the possible effect of an educational model on distress screening in newly diagnosed cancer patients referred to Psycho‐oncology service (POS). Methods : We examined the differences in distress and problems among newly diagnosed cancer patients referred to POS by cancer care professionals' according to their clinical judgement (2‐year period; Study‐1) and after an educational intervention on the Distress Thermometer (DT) and Problem List (PL), with referral to those reporting cut‐off scores indicative of ‘caseness’ (DT>4) (1‐year period; Study‐2). Results : In Study‐1, 153 (6.7%) of 2268 new patients were referred and seen by the POS, which submitted each patient to the DT/PL. About one‐third of the patients (31%) were not DT‐cases (scores < 4) and showed lower levels of emotional and relational problems than those who resulted DT‐cases. In Study‐2, of all newly diagnosed cancer patients ( n = 1107), 583 (52.6%) were administered to the DT/PL by nurses. Two‐hundred and eighty‐four (52.2%) resulting DT‐cases were referred to POS and, of these, 133 (12% of all new patients; 22.81% of those screened; 46.8% of cases) were seen by the POS. There were significant differences in problems between not referred (DT‐non‐cases) and referred patients (DT‐cases). Conclusions : Because of the observational nature of the study, the conclusions should be drawn with caution. The implementation of the routine use of DT/PL seemed to determine a higher (79% increase) and more accurate referral of patients but the rate of acceptance was not high, confirming that more effort is necessary in implementing optimal psychosocial care in oncology. Copyright © 2011 John Wiley & Sons, Ltd.