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Promoting quality breast cancer care: Psychosocial distress screening

Published online by Cambridge University Press:  29 October 2013

M. Tish Knobf*
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
Maureen Major-Campos
Affiliation:
Women's Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut
Anees Chagpar
Affiliation:
Yale School of Medicine, Department Surgery and The Breast Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut
Andrea Seigerman
Affiliation:
Department of Social Work and the Breast Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut
Ruth Mccorkle
Affiliation:
Yale University School of Nursing, New Haven, Connecticut
*
Address correspondence and reprint requests to: M. Tish Knobf, Yale University School of Nursing, 100 Church Street South, New Haven, CT. 06536-0740. E-mail: [email protected]

Abstract

Objective:

To evaluate the feasibility of implementing psychosocial distress screening in a breast center of a comprehensive cancer center, using a model of structure (personnel, resources), process (screening), and outcome (number of patients screened, number referred).

Methods:

The first step in the project was to establish administrative support, educate and engage breast center staff, identify stakeholders and persons with expertise in the conduct of evidence based initiatives. A two-phase implementation approach was agreed upon with Phase I being screening of new patients in surgical oncology and Phase II being screening women in medical oncology.

Results:

A total of 173 patients were screened. The new patients screened in surgical oncology reported higher average distress scores compared to patients in medical oncology (5.7 vs. 4.0). However, a greater number of patients in medical oncology reported scores >4 compared to the new patients screened in surgery (54% vs. 35%). Psychological distress was the most commonly reported distress for patients in surgery. In contrast, 60% of scores >4 in medical oncology were symptom related, managed by the nurse or physician.

Significance of results:

Nurse led implementation of psychosocial distress screening is feasible, addressing this important quality indicator of patient-centered care.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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