Systematic screening for distress in oncology practice using the Distress Barometer: the impact on referrals to psychosocial care
Menée sur 582 patients atteints d'un cancer, cette étude évalue, par rapport aux pratiques usuelles, l'intérêt d'utiliser un outil d'auto-évaluation pour détecter de manière systématique et efficace le niveau de détresse psychologique des patients avant une consultation oncologique
Purpose : This study evaluates how patterns of psychosocial referral of patients with elevated distress differ in a ‘systematic screening for distress’ condition versus a ‘usual practice’ condition in ambulatory oncology practice. Methods : The psychosocial referral process in a 2-week usual practice (N = 278) condition was compared with a 2-week ‘using the Distress Barometer as a screening instrument’ (N=304) condition in an outpatient clinic with seven consulting oncologists. Results : Out of all distressed patients in the usual practice condition, only 5.5% of patients detected with distress were actually referred to psychosocial counselling, compared with 69.1% of patients detected with distress in the condition with systematic screening using the Distress Barometer. Only 3.7% of patients detected with distress in the usual practice condition finally accepted this referral, compared with 27.6% of patients detected with distress in the screening condition. Conclusions : Using the Distress Barometer as a self-report screening instrument prior to oncological consultation optimises detection of elevated distress in patients, and this results in a higher number of performed and accepted referrals, but cannot by itself guarantee actual psychosocial referral or acceptance of referral. There is not only a problem of poor detection of distress in cancer patients but also a need for better decision-making and communication between oncologists and patients about this issue.