a Department of Oncology, Cumming School of Medicine , University of Calgary , Calgary , AB , Canada.
b Department of Psychology , University of Calgary , Calgary , AB , Canada.
J Psychosoc Oncol. 2019 Jan-Feb;37(1):5-21. doi: 10.1080/07347332.2018.1521490. Epub 2018 Dec 28.
Routine distress screening in United States oncology clinics has been mandatory since 2015.
This study was the first to assess distress in a geographically diverse sample of cancer patients following mandated distress screening implementation by oncology social workers.
Sites were self-selected via social workers who applied to participate in the Association of Oncology Social Work's Project to Assure Quality Cancer Care, advertised through their social media outlets and conference. Electronic screening records were collected from 55 cancer treatment centers in the United States and Canada. Cases required cancer diagnoses and Distress Thermometer (DT) scores to be included. Distress rates and rates by age, sex, cancer type, and ethnicity were examined.
Of 4664 cases, 46% (2157) experienced significant distress (DT score ≥ 4). Being female, age 40-59, and having diagnoses of pancreatic or lung cancer was associated with increased likelihood of distress. Half of cases experience clinically-significant distress, though this need was not evenly distributed across patient or cancer types.
Identifying those at risk for distress may help inform optimal resource allocation. Methods to address needs of distressed patients in cases of limited resources are discussed.
自 2015 年以来，美国肿瘤学诊所的常规痛苦筛查已成强制性要求。
本研究首次评估了在肿瘤学社会工作者实施强制性痛苦筛查之后，在具有地理多样性的癌症患者样本中出现的痛苦情况。
通过社会工作者进行了站点的自我选择，他们通过其社交媒体渠道和会议申请参加了肿瘤社会工作协会的确保癌症护理质量项目。从美国和加拿大的 55 个癌症治疗中心收集了电子筛查记录。病例需要癌症诊断和痛苦温度计（DT）评分才能被纳入。检查了痛苦率以及按年龄、性别、癌症类型和种族划分的比率。
在 4664 例病例中，有 46%（2157 例）经历了明显的痛苦（DT 评分≥4）。女性、40-59 岁、患有胰腺癌或肺癌与痛苦发生率增加相关。尽管这种需求在患者或癌症类型中没有均匀分布，但仍有一半的病例存在临床显著的痛苦。
识别出有痛苦风险的人可能有助于为最佳资源分配提供信息。讨论了在资源有限的情况下解决痛苦患者需求的方法。
