The International Endorsement of US Distress Screening and Psychosocial Guidelines in Oncology: A Model for Dissemination

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The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Distress Management have, since 1997, called for routine screening of distress in patients with cancer. Following the example of pain as the fifth vital sign, the case for using the concept of distress as the sixth vital sign was made by leading psycho-oncologists in 2007. Cancer care organizations in Canada and the International Psycho-Oncology Society have adopted the NCCN Guidelines for Distress Management and have named distress screening as the sixth vital sign, thereby encouraging cancer care clinicians to think of screening for distress when they screen for pain and other vital signs. Using the evidence integration triangle, this article explores the dissemination of the notion of distress as the sixth vital sign in an international context. This exploration shows that NCCN and similar organizations can adopt the evidence integration triangle in its next phase of moving toward full implementation of the NCCN Guidelines for Distress Management.

Correspondence: Mark Lazenby, PhD, RN, Yale University, 100 Church Street South, New Haven, CT 06536-0740. E-mail: mark.lazenby@yale.edu
  • 1.

    Glasgow R, Vinson C, Chambers D. National institutes of health approaches to dissemination and implementation science: current and future directions. Am J Public Health 2012;102:12741281.

    • Search Google Scholar
    • Export Citation
  • 2.

    Holland J, Andersen B, Breitbart W. Distress management. J Natl Compr Canc Netw 2013;11:190209.

  • 3.

    Zabora J, BrintzenhofeSzoc K, Curbow B. The prevalence of psychological distress by cancer site. Psychooncology 2001;10:1928.

  • 4.

    Bultz B, Carlson L. Emotional distress: the sixth vital sign in cancer care. J Clin Oncol 2005;23:64406441.

  • 5.

    Aziz NM, Rowland JH. Trends and advances in cancer survivorship research: challenge and opportunity. Semin Radiat Oncol 2003;13:248266.

  • 6.

    Pirl WF, Muriel A, Hwang V. Screening for psychosocial distress: a national survey of oncologists. J Support Oncol 2007;5:499504.

  • 7.

    Sollner W, DeVries A, Steixner E. How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 2001;84:179185.

    • Search Google Scholar
    • Export Citation
  • 8.

    Institute of Medicine. Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington, DC: The National Academies Press; 2008.

    • Search Google Scholar
    • Export Citation
  • 9.

    Jacobsen PB, Donovan KA, Vadaparampil ST, Small BJ. Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue. Health Psychol 2007;26:660667.

    • Search Google Scholar
    • Export Citation
  • 10.

    Valdimarsdottir U, Helgason AR, Furst CJ. The unrecognised cost of cancer patients’ unrelieved symptoms: a nationwide follow-up of their surviving partners. Br J Cancer 2002;86:15401545.

    • Search Google Scholar
    • Export Citation
  • 11.

    DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000;160:21012107.

    • Search Google Scholar
    • Export Citation
  • 12.

    Prieto JM, Blanch J, Atala J. Psychiatric morbidity and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. J Clin Oncol 2002;20:19071917.

    • Search Google Scholar
    • Export Citation
  • 13.

    Hjerl K, Andersen EW, Keiding N. Depression as a prognostic factor for breast cancer mortality. Psychosomatics 2003;44:2430.

  • 14.

    Steel JL, Geller DA, Gamblin TC. Depression, immunity, and survival in patients with hepatobiliary carcinoma. J Clin Oncol 2007;25:23972405.

    • Search Google Scholar
    • Export Citation
  • 15.

    Roth AJ, Kornblith AB, Batel-Copel L. Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study. Cancer 1998;82:19041908.

    • Search Google Scholar
    • Export Citation
  • 16.

    Jacobsen PB, Donovan KA, Trask PC. Screening for psychologic distress in ambulatory cancer patients. Cancer 2005;103:14941502.

  • 17.

    Worden JW, Weisman AD. Do cancer patients really want counseling? Gen Hosp Psychiatry 1980;2:100103.

  • 18.

    Worden JW, Weisman AD. Preventive psychosocial intervention with newly diagnosed cancer patients. Gen Hosp Psychiatry 1984;6:243249.

  • 19.

    Velikova G, Booth L, Smith AB. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 2004;22:714724.

    • Search Google Scholar
    • Export Citation
  • 20.

    Von Essen L, Larsson G, Oberg K, Sjoden PO. ‘Satisfaction with care’: associations with health-related quality of life and psychosocial function among Swedish patients with endocrine gastrointestinal tumours. Eur J Cancer Care 2002;11:9199.

    • Search Google Scholar
    • Export Citation
  • 21.

    Velikova G. Patient benefits from psychosocial care: screening for distress and models of care. J Clin Oncol 2010;28:48714873.

  • 22.

    Detmar SB, Muller MJ, Schornagel JH. Health-related quality-of-life assessments and patient-physician communication: a randomized controlled trial. JAMA 2002;288:30273034.

    • Search Google Scholar
    • Export Citation
  • 23.

    Adler NE, Page A, eds. Cancer care for the whole patient [electronic resource]: meeting psychosocial health needs/Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting, Board on Health Care Services. Washington, DC: National Academies Press; 2008.

    • Search Google Scholar
    • Export Citation
  • 24.

    Fallowfield L, Ratcliffe D, Jenkins V, Saul J. Psychiatric morbidity and its recognition by doctors in patients with cancer. Br J Cancer 2001;84:10111015.

    • Search Google Scholar
    • Export Citation
  • 25.

    Donovan K, Jacobsen P. Progress in the implementation of NCCN guidelines for distress management by member institutions. J Natl Compr Canc Netw 2013;11:223226.

    • Search Google Scholar
    • Export Citation
  • 26.

    Jacobsen PB, Ransom S. Implementation of NCCN distress management guidelines by member institutions. J Natl Compr Canc Netw 2007;5:99103.

    • Search Google Scholar
    • Export Citation
  • 27.

    Glasgow R, Green L, Taylor M, Stange K. An evidence integration triangle for aligning science with policy and practice. Am J Prev Med 2012;42:646654.

    • Search Google Scholar
    • Export Citation
  • 28.

    Victoria (Australia) Department of Health. Victoria’s Cancer Action Plan 2008-2011. Available at: http://docs.health.vic.gov.au/docs/doc/Victorias-Cancer-Action-Plan-2008-2011-complete-document---Dec-2008. Accessed July 8, 2013.

    • Search Google Scholar
    • Export Citation
  • 29.

    Accreditation Canada. Cancer care and oncology services standards, 2008, 2009. Available at: www.accreditation.ca/cancer-care-and-oncology-services.

    • Search Google Scholar
    • Export Citation
  • 30.

    Rebalance Focus Action Group. A position paper: screening key indicators in cancer patients—pain as a 5th vital sign and emotional distress as a 6th vital sign. Canadian Strategy for Cancer Control Bulletin 2005;7(Suppl):4.

    • Search Google Scholar
    • Export Citation
  • 31.

    Bultz BD, Groff SL, Fitch M. Implementing screening for distress, the 6th vital sign: a canadian strategy for changing practice. Psychooncology 2011;20:463469.

    • Search Google Scholar
    • Export Citation
  • 32.

    International Psycho-Oncology Society. IPOS international standard of quality cancer care. Standards of Care News. http://ipos-society.org/about/news/standards_news.aspx. Updated 2013. Accessed May 21, 2013.

    • Search Google Scholar
    • Export Citation
  • 33.

    American College of Surgeons. Cancer program standards (CPS) 2011 project. Available at: http://www.facs.org/cancer/coc/cps2011.html. Accessed September 1, 2011.

    • Search Google Scholar
    • Export Citation
  • 34.

    Jacobsen P, Kadlubek P. Changes over time in quality of psychosocial care: results from the Quality Oncology Practice Initiative (QOPI). J Clin Oncol 2010;28(Suppl):15s.

    • Search Google Scholar
    • Export Citation
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