Sewell K

Purpose: To create and evaluate psychosocial distress screening procedures for patients diagnosed with cancer at the VA Palo Alto Health Care System (VAPAHCS).

Relevant Background/Problem: A program development and evaluation project was conducted at VAPAHCS in order to implement psychosocial distress screening according to the Cancer Program Standards (Standard 3.2) of the American College of Surgeon’s Commission on Cancer.

Methods: Veterans recently diagnosed with cancer were screened for distress by a psychologist, social worker, or psychology trainee during one of their regularly scheduled oncology appointments using the National Comprehensive Cancer Network Distress Thermometer and Symptom Checklist. Data were abstracted from CPRS for distress screens conducted from January 2015-April 2016. The number of new cancer cases at VAPAHCS during the same time period was obtained from the cancer registry.

Data Analysis: The number of distress screens conducted was compared to cancer registry data of total new cases of cancer. Descriptive statistics were used to explore the level of distress and frequency of biopsychosocial symptoms endorsed by veterans in this sample.

Results: A total of 372 veterans completed distress screening during the program evaluation period. During the same time period, 920 veterans were newly diagnosed with cancer at VAPAHCS. Average level of distress was 3.3 (0 = no distress, 10 = extreme distress). Forty-one percent (n = 152) of veterans scored above the clinical cut-off for significant distress (4/10). The most commonly endorsed symptoms were fatigue (n = 97; 26.0%), worry (n = 93; 25.0%), pain (n = 92; 24.7%), sleep (n = 78; 21.0%), and skin dry/itchy (n = 78; 21.0%).

Implications: The discrepancy between number of new cases of cancer and number of distress screenings conducted during the program evaluation period suggests that modifications to current procedures are necessary to ensure that all cancer patients at VAPAHCS are screened for distress. Over 40% of veterans screened endorsed clinically significant levels of distress and over 20% of veterans endorsed problems with fatigue, worry, pain, sleep and/or skin issues. Future directions for care include introducing psychosocial interventions in the oncology clinic to reduce distress and cope with commonly reported symptoms/side effects.

Purpose: To create and evaluate psychosocial distress screening procedures for patients diagnosed with cancer at the VA Palo Alto Health Care System (VAPAHCS).

Relevant Background/Problem: A program development and evaluation project was conducted at VAPAHCS in order to implement psychosocial distress screening according to the Cancer Program Standards (Standard 3.2) of the American College of Surgeon’s Commission on Cancer.

Methods: Veterans recently diagnosed with cancer were screened for distress by a psychologist, social worker, or psychology trainee during one of their regularly scheduled oncology appointments using the National Comprehensive Cancer Network Distress Thermometer and Symptom Checklist. Data were abstracted from CPRS for distress screens conducted from January 2015-April 2016. The number of new cancer cases at VAPAHCS during the same time period was obtained from the cancer registry.

Data Analysis: The number of distress screens conducted was compared to cancer registry data of total new cases of cancer. Descriptive statistics were used to explore the level of distress and frequency of biopsychosocial symptoms endorsed by veterans in this sample.

Results: A total of 372 veterans completed distress screening during the program evaluation period. During the same time period, 920 veterans were newly diagnosed with cancer at VAPAHCS. Average level of distress was 3.3 (0 = no distress, 10 = extreme distress). Forty-one percent (n = 152) of veterans scored above the clinical cut-off for significant distress (4/10). The most commonly endorsed symptoms were fatigue (n = 97; 26.0%), worry (n = 93; 25.0%), pain (n = 92; 24.7%), sleep (n = 78; 21.0%), and skin dry/itchy (n = 78; 21.0%).

Implications: The discrepancy between number of new cases of cancer and number of distress screenings conducted during the program evaluation period suggests that modifications to current procedures are necessary to ensure that all cancer patients at VAPAHCS are screened for distress. Over 40% of veterans screened endorsed clinically significant levels of distress and over 20% of veterans endorsed problems with fatigue, worry, pain, sleep and/or skin issues. Future directions for care include introducing psychosocial interventions in the oncology clinic to reduce distress and cope with commonly reported symptoms/side effects.

Purpose: To create and evaluate psychosocial distress screening procedures for patients diagnosed with cancer at the VA Palo Alto Health Care System (VAPAHCS).

Relevant Background/Problem: A program development and evaluation project was conducted at VAPAHCS in order to implement psychosocial distress screening according to the Cancer Program Standards (Standard 3.2) of the American College of Surgeon’s Commission on Cancer.

Methods: Veterans recently diagnosed with cancer were screened for distress by a psychologist, social worker, or psychology trainee during one of their regularly scheduled oncology appointments using the National Comprehensive Cancer Network Distress Thermometer and Symptom Checklist. Data were abstracted from CPRS for distress screens conducted from January 2015-April 2016. The number of new cancer cases at VAPAHCS during the same time period was obtained from the cancer registry.

Data Analysis: The number of distress screens conducted was compared to cancer registry data of total new cases of cancer. Descriptive statistics were used to explore the level of distress and frequency of biopsychosocial symptoms endorsed by veterans in this sample.

Results: A total of 372 veterans completed distress screening during the program evaluation period. During the same time period, 920 veterans were newly diagnosed with cancer at VAPAHCS. Average level of distress was 3.3 (0 = no distress, 10 = extreme distress). Forty-one percent (n = 152) of veterans scored above the clinical cut-off for significant distress (4/10). The most commonly endorsed symptoms were fatigue (n = 97; 26.0%), worry (n = 93; 25.0%), pain (n = 92; 24.7%), sleep (n = 78; 21.0%), and skin dry/itchy (n = 78; 21.0%).

Implications: The discrepancy between number of new cases of cancer and number of distress screenings conducted during the program evaluation period suggests that modifications to current procedures are necessary to ensure that all cancer patients at VAPAHCS are screened for distress. Over 40% of veterans screened endorsed clinically significant levels of distress and over 20% of veterans endorsed problems with fatigue, worry, pain, sleep and/or skin issues. Future directions for care include introducing psychosocial interventions in the oncology clinic to reduce distress and cope with commonly reported symptoms/side effects.