What is screening for distress?
Many people with cancer report feelings of sadness, fear and loneliness — as well as depression, anxiety and panic. In fact, research indicates that 35% to 40% of cancer patients feel enough distress that they would benefit from additional support services.
While common, this distress can make coping with cancer diagnosis and treatment that much more difficult. Following heart rate, blood pressure, respiratory rate, temperature and pain, distress is recognized as the sixth vital sign. It can often be detected through dialogue with patients and the use of simple, consistent tools, such as a checklist that records an individual’s level of pain, depression, anxiety and fatigue.
Progress to date
From 2007 to 2008, Screening for Distress was endorsed by Accreditation Canada and five professional and patient organizations. The Partnership works with jurisdictions to develop and implement resources to support screening for distress. Important steps are being made to implement wide programs that identify distress proactively to determine people’s individual needs for further assessment or referral.
- A practitioners’ toolkit and guidelines were piloted in British Columbia, Ontario, Quebec and Nova Scotia, and more than 1,000 patients were screened between April 2009 and March 2010.
- Northeastern Ontario, the Quebec City Supra Region, Cancer Care Nova Scotia and the British Columbia Cancer Agency began collaboration with the Partnership to implement distress-screening programs, and trained more than 200 front-line staff and volunteers to use consistent checklists to support coordinated distress-screening efforts.
- These four jurisdictions formed a national Implementation Group to share strategies and identify knowledge gaps in the implementation and management of screening for distress.
- Developed in collaboration with the Canadian Association of Psychosocial Oncology, A Pan-Canadian Clinical Practice Guideline: Assessment of Psychosocial Health Care Needs of the Adult Cancer Patient was finalized and distributed in October 2009. The guideline provides access to comprehensive evidence that helps ensure the physical, psychological and informational needs of patients are understood by practitioners.
- Work continues on creating practice standards for specific distress symptoms to increase consistency in the quality and level of service cancer patients receive across the country. An education module was developed for front-line staff engaged in screening for distress and will be made available online to health-care providers.
For patients, expected benefits of Screening for Distress include better quality of life, fewer gaps in support needs and a more integrated approach to patient care. Continuing expansion of distress-screening programs to more jurisdictions will be accompanied by ongoing evaluation of the changes in practice that result from these programs.
 Zabora J, Brintzenhofe-Szoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychosocial distress by cancer site. Psycho-oncology 2001;10(1):19-28.