Development and implementation of a comprehensive psychosocial screening program in a Brazilian cancer center

Abstract

Objective

International guidelines recommend routine screening for distress as part of care practices. Accordingly, a Brazilian cancer center developed and implemented a Distress Screening Program (DS) in 2007, which was enhanced in 2009 through the inclusion of a Psychosocial Care Meeting Group (DS + PCM) regarding patients' psychosocial needs. The current paper will provide an overview of the development and pilot implementation of this program, initial analyses to assess patient outcomes, and report initial results to extend international research on this key aspect of cancer care.

Method

Patients were assessed for distress, anxiety/depression, and in the DS + PCM phase for quality of life at the first day of chemotherapy infusion, at mid-point, and at treatment end. We compared data from program phases (DS vs. DS + PCM), with a sequential cohort design and mixed effects modeling.

Results

Clinical and demographic characteristics were similar between groups. Patients receiving DS + PCM showed significantly lower distress and depression/anxiety upon chemotherapy initiation (ps < .001). While both groups reported significantly lowered distress and total depression/anxiety scores across time (ps < .003), patients receiving DS + PCM maintained the lowest distress and total anxiety/depression at all assessments. Patients from DS + PCM group also reported improvements in quality of life over time.

Conclusions

The current study provides preliminary evidence that a multi-disciplinary structured screening program utilizing validated measures and team meetings is associated with reduced impairment in patients' psychological well-being. This program provided more opportunities for collaboration among providers with increased multi-disciplinary meetings, enabled patients to more easily report problems, and ensured rapid access to relevant resources. This article is protected by copyright. All rights reserved.

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