Journal ArticleDOI
The NCCN Guideline for Distress Management: A Case for Making Distress the Sixth Vital Sign
Jimmie C. Holland,Barry D. Bultz +1 more
TLDR
A simple question to ask patients about psychosocial concerns was found to be the best umbrella word to represent the range of emotional concerns patients with cancer experience and that it did not carry the stigma of other words sometimes used for emotional symptoms.Abstract:
Psychosocial care of patients has traditionally been seen as separate from routine medical care and has been criticized as being “soft” and lacking evidence. This traditional perspective continues in many settings, despite the fact that patients and families, when asked, state that emotional care is highly valued. The question of how to integrate psychosocial care into routine cancer care has also been an issue, partly because of the stigma associated with cancer. In 1997, the National Comprehensive Cancer Network (NCCN) established a multidisciplinary panel to examine this problem. 1 Because patient and physician attitudes toward pain can pose similar barriers to care as with distress, the panel used as a model the rating system for assessing pain that resulted in successful improvement of pain management in the United States. The rating system’s success seemed partly based on routinely using a single question to assess a patient’s pain: “How is your pain on a scale of 0 to 10?” The system uses a score of 5 or higher as the indication to reassess pain medications or refer the patient for more expert management. This system is widely used, and patient self-report of subjective symptoms is now accepted as appropriate and reliable. Pain has become the fifth vital sign, after pulse, respiration, blood pressure, and temperature, ensuring that it is evaluated as part of routine care. Drawing on this experience, the NCCN panel recommended a simple question to ask patients about psychosocial concerns. They found that distress was the best umbrella word to represent the range of emotional concerns patients with cancer experience and that it did not carry the stigma of other words sometimes used for emotional symptoms. Several studies have now validated the approach of asking, “How is your distress on a scale of 0 to 10?” and using a score of 4 or above as the trigger for further questions and possible referral to a psychosocial service. 2,3 In 2004, the Canadian Federal Government’s public health agency, Health Canada‐Canadian Strategy for Cancer Control, approved “Emotional Distress as the 6th Vital Sign.” 4 We propose that this system should also be considered in the United States to ensure that psychosocial distress is routinely assessed as part of cancer care and managed according to the NCCN distress management guidelines. This commentary outlines the potential benefits that can accrue for patients, families, and the health care system. Over 2 years beginning in 1997, the NCCN’s multidisciplinary panel deread more
Citations
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Journal ArticleDOI
Screening for Distress and Unmet Needs in Patients With Cancer: Review and Recommendations
TL;DR: Involving all stakeholders and frontline clinicians when planning screening for distress programs is recommended, and continuing to rigorously evaluate outcomes, including PROs, process of care, referrals, and economic costs and benefits is essential.
Journal ArticleDOI
Distress management: Clinical practice guidelines in Oncology™
Jimmie C. Holland,Barbara L. Andersen,William Breitbart,Luke O. Buchmann,Bruce E. Compas,Teresa L. Deshields,Moreen M. Dudley,Stewart B. Fleishman,Caryl D. Fulcher,Donna B. Greenberg,Carl B. Greiner,Rev George F. Handzo,Laura Hoofring,Charles Hoover,Paul B. Jacobsen,Elizabeth Kvale,Michael H. Levy,Matthew Loscalzo,McAllister-Black Randi McAllister-Black,Karen Y. Mechanic,Oxana Palesh,Janice P. Pazar,Michelle Riba,Kristin Roper,Alan D. Valentine,Lynne I. Wagner,Michael A. Zevon,Nicole R. McMillian,Deborah A. Freedman-Cass +28 more
TL;DR: These NCCN Clinical Practice Guidelines in Oncology for Distress Management discuss the identifica tion and treatment of psychosocial problems in patients with cancer to assist oncology teams identify patients who require referral to psychossocial resources and to give oncological teams guidance on interventions for patients with mild distress.
Journal ArticleDOI
Screening and referral for psychosocial distress in oncologic practice: use of the Distress Thermometer.
TL;DR: The objectives of this study were to validate the Distress Thermometer in the Netherlands and to examine its correspondence with a 46‐item Problem List, possible risk factors, and the wish for a referral.
Journal ArticleDOI
Screening for Distress in Lung and Breast Cancer Outpatients: A Randomized Controlled Trial
TL;DR: Routine online screening for distress is feasible in a large cancer center and may help to reduce future distress levels, particularly when coupled with uptake of appropriate resources.
Journal ArticleDOI
[German S3-Guideline "Diagnosis and Treatment of Esophagogastric Cancer"]
Markus Moehler,Se-E. Al-Batran,T. Andus,M. Anthuber,Jann Arends,Dirk Arnold,Daniela Aust,P. Baier,Gustavo B. Baretton,J. Bernhardt,H. Boeing,E. Böhle,Carsten Bokemeyer,Jan Bornschein,W. Budach,E. Burmester,K. Caca,Wa A. Diemer,Cf F. Dietrich,MP Ebert,A. Eickhoff,C. Ell,J. Fahlke,H. Feußner,Rainer Fietkau,Wolfgang Fischbach,W. Fleig,Michael Flentje,He E. Gabbert,Pr R. Galle,M. Geissler,Ines Gockel,U. Graeven,Lars Grenacher,S. Groß,Jt T. Hartmann,M. Heike,Volker Heinemann,B. Herbst,Thomas Herrmann,S. Höcht,Rd D. Hofheinz,Heinz Höfler,T. Höhler,Ah H. Hölscher,Markus Horneber,J. Hübner,J. R. Izbicki,R. Jakobs,Christian Jenssen,Stephan Kanzler,M. Keller,Ralf Kiesslich,G. Klautke,J. Körber,Bj J. Krause,C. Kuhn,Frank Kullmann,H. Lang,Hartmut Link,Florian Lordick,K. Ludwig,Manfred P. Lutz,R. Mahlberg,Peter Malfertheiner,S. Merkel,Helmut Messmann,Hj-J. Meyer,Stefan Mönig,P. Piso,Steffen Pistorius,R. Porschen,T. Rabenstein,P. Reichardt,K. Ridwelski,Christoph Röcken,I. Roetzer,P. Rohr,W. Schepp,Pm M. Schlag,RM Schmid,Heinz Schmidberger,Wh-H. Schmiegel,Hj-J. Schmoll,G. Schuch,Christoph Schuhmacher,Kerstin Schütte,W. Schwenk,Michael Selgrad,A. Sendler,J. Seraphin,T. Seufferlein,Michael Stahl,Hubert J. Stein,C. Stoll,Martin Stuschke,Andrea Tannapfel,R. Tholen,Peter C. Thuss-Patience,K. Treml,U. Vanhoefer,M Vieth,H. Vogelsang,D. Wagner,U. Wedding,A. Weimann,H. Wilke,Ch. Wittekind +107 more
TL;DR: Authors M. Moehler, S-E.
References
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Journal ArticleDOI
The prevalence of psychological distress by cancer site
TL;DR: The goal of this project was to determine the prevalence of psychological distress among a large sample of cancer patients and variations in distress among 14 cancer diagnoses.
Journal ArticleDOI
High levels of untreated distress and fatigue in cancer patients
Linda E. Carlson,M Angen,M Angen,J Cullum,Eileen Goodey,Jan Koopmans,Jan Koopmans,L Lamont,J H MacRae,J H MacRae,M Martin,Guy Pelletier,Guy Pelletier,John W. Robinson,John W. Robinson,J S A Simpson,J S A Simpson,Michael Speca,Michael Speca,L Tillotson,Barry D. Bultz,Barry D. Bultz +21 more
TL;DR: In this article, the authors assess a large representative sample of cancer patients on distress levels, common psychosocial problems, and awareness and use of psychOSocial support services, and conclude that distress is very common in cancer patients across diagnoses and across the disease trajectory.
Journal ArticleDOI
Screening for psychologic distress in ambulatory cancer patients
Paul B. Jacobsen,Kristine A. Donovan,Peter C. Trask,Stewart B. Fleishman,James Zabora,Frank Baker,Jimmie C. Holland +6 more
TL;DR: The authors sought to determine whether the single‐item Distress Thermometer (DT) compared favorably with longer measures currently used to screen for distress.
Journal ArticleDOI
Systematic Review of Psychological Therapies for Cancer Patients: Overview and Recommendations for Future Research
TL;DR: This review critically and systematically reviewed all identifiable publications about psychological therapies used by cancer patients to provide an objective and scientific evaluation of nontraditional therapies and suggests the specific therapies that should be considered for further investigation.
Journal ArticleDOI
Cancer fatalism: the state of the science
Barbara D. Powe,Ramona Finnie +1 more
TL;DR: Review of the studies suggests that cancer fatalism develops over time and is most frequently reported among medically underserved persons and those with limited knowledge of cancer.