University of Denver and Exempla Healthcare Study Finds Patient Distress Screenings Practical, Helpful 

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Nearly half of patients who identified distress indicated a level of 5 [out of 10] or greater.

—Christine DeVore, MA

Researchers at the University of Denver and Exempla Healthcare found that multiple distress screenings per patient over the course of cancer treatment informs health-care providers about emotional distress patterns and supportive needs over time. The information gathered allows providers to improve quality of life, satisfaction with medical care and support services, treatment compliance, and even survival rates. The study also found that distress screenings could be successfully administered at community cancer centers.1

Little research has been published in peer-reviewed journals about the trajectory of distress over the cancer continuum. The project tied for Best Program at the 10th Annual Conference of the American Psychosocial Oncology Society (APOS), held recently in Huntington Beach, California.

Study Rationale

The purpose of the study was “to increase understanding and awareness of patterns in distress, the stated needs, and patients’ willingness to complete multiple psychosocial screenings in an outpatient cancer center.” Despite recommendations by the Institute of Medicine, many patients with cancer are not screened for distress, including those patients being treated at comprehensive cancer centers.

Cancer is a journey consisting of many ups and downs that cannot be measured by one distress screening. The researchers believe that patients need to be screened throughout the progression of their disease to receive the best possible care.

Approximately 1,500 cancer patients were screened over a 6-month period. In total, over 3,000 screens were collected. Patients completed the questionnaire, which was offered in both Spanish and English, at multiple appointments over the course of their treatment. The purpose of the questionnaire was to identify patients who required greater support services. As a result of this project, 1,074 psychosocial oncology referrals were made.

Notable Findings

“Nearly half of patients who identified distress indicated a level of 5 [out of 10] or greater,” said doctoral psychology intern and lead researcher Christine DeVore, MA. “To meet guidelines, it is essential that cancer centers have adequate psychosocial resources and staffing to provide the appropriate follow-up clinical interventions.”

This particular screen offered respondents the option of consulting with a psychologist, social worker, dietitian, spiritual care provider, or pharmacist. An oncology dietitian was most frequently requested. Patients were also asked to rate four domains of symptoms and concerns: health, social, practical, and emotional. The individuals polled were most concerned about their health, including fatigue, weight management, nausea, and sleep.

“Physical and medical complaints are a major source of distress reported by the patients sampled,” Ms. DeVore said. “It is important that psychosocial oncology providers assess these concerns with patients and triage services when appropriate.”

Moving forward, the researchers plan to conduct further research, particularly analyzing distress patterns over time. They plan to improve data collection and analysis processing so that monthly reporting of distress is more feasible. Ms. DeVore hopes that the study will serve as a model for program guidance and evaluation. ■

Disclosure: Ms DeVore reported no potential conflicts of interest.


1. DeVore C, Lomax JB, Aoyagi M, et al: Psychosocial distress screening in a community cancer center: A descriptive study of distress over the course of treatment. 2013 American Psychosocial Oncology Society Annual Conference. Abstract P2-14. Presented February 16, 2013.