A cancer diagnosis is associated with a range of physical, psychological, social, and existential challenges. For some individuals, their personal or situational resources are not sufficient to manage these challenges, which in turn contribute to an array of adverse effects, including psychological distress.1 Psychological distress is a generic term that encompasses the spectrum of feelings from worry, vulnerability, and sadness, to depression, anxiety, and panic.2 Between 20% and 66% of patients with cancer report high levels of distress.3,4 Early identification and treatment of emotional distress are important given its potential negative effects on patients’ short- and long-term illness adjustment.5,6 Although distress is recognized internationally as the sixth vital sign, it often goes unrecognized because of health care professionals’ lack of time and confidence in assessing distress.2
Throughout the past decade, much attention has been given to implementing routine distress screening programs in cancer care as a way of improving the management of distress. Routine distress screening at periods of increased vulnerability is now an integral part of international cancer control plans7,8 and best practice guidelines in psychosocial cancer care.2,4 Research increasingly supports the effectiveness of distress screening programs in identifying patients with adjustment disorders5,7,8 and of follow-up psychosocial care in improving psychological and physical functioning.7,9,10 However, despite the availability of psychosocial services, many patients who screen positive for distress do not accept referrals for further assessment or psychosocial services.3,5,8 These low rates of referral uptake often raise concerns among health care professionals that patients are not receiving optimal cancer care.
To inform the development and implementation of potentially successful models of distress screening, a qualitative study was undertaken to better understand the preferences for psychosocial care of distressed women diagnosed with a gynecologic cancer, including perceptions of distress screening and women’s motives for accepting (or refusing) subsequent referrals to available psychosocial services.
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