Addressing Psychosocial Needs of Cancer Patients
Psychosocial distress is a significant problem for cancer patients, with up to 45% reporting measurable levels of psychosocial distress. As established by the National Comprehensive Cancer Network, clinical guidelines recommend routine screening for distress upon admission and at pivotal times over the course of the disease, but the accurate assessment of psychosocial distress is a clinical challenge. Nurses, who are on the frontline of cancer care, can play a crucial role in improving the recognition and management of cancer-related distress. This Commentary discusses the challenges of assessing and managing cancer-related distress, in addition to recommending assessment tools and further research.
One of the challenges in identifying cancer-related distress is that its signs and symptoms often mimic disease symptoms and treatment side effects. Fatigue, difficulty concentrating, and changes in appetite are symptoms of disease and treatment-related syndromes as well as psychological distress. Though assessment of distress is complicated, measurement tools are available that are both well-established and feasible for nurses working within time-constrained environments. For example, the Distress Thermometer – a thermometer-like diagram that rates a patient’s level of distress on a scale of 1 to 10 – has shown overall reliability and ease of administration for nurses. Despite such assessment tools, barriers remain. For example, as more cancer care is being delivered in outpatient settings, the time to address psychosocial needs is significantly reduced, as is communication with family caregivers. The author suggests research that will focus on the implementation of systems-based, organizational level change from a nursing perspective in order to provide nurses with the resources necessary to fully address the psychosocial needs of individuals facing cancer.
Abrahamson K. Nursing practice and cancer-related distress. American Journal of Nursing April 2010;110(4):67-69.
Dr. Abrahamson is part of HSR&D’s Center of Excellence on Implementing Evidence-Based Practice in Indianapolis, IN.