Distress is common among people diagnosed with cancer. It ranges from normal feelings of vulnerability to sadness and fears. Distress is the sixth vital sign in cancer care, after temperature, respiration, heart rate, blood pressure and pain.
While distress may decrease over time for some people with cancer, it may persist or even increase over time for others. Therefore, routine screening and management of distress is a critical component of person centred cancer care.
Why is distress screening important?
Screening for distress aims to identify the concerns of patients in a timely manner, so those concerns can be addressed and managed at the earliest point in time.
Early detection and management of distress may lead to better adherence to treatment and improved quality of life. No two individuals will respond in exactly the same manner. All, however, will feel some degree of distress. (Bultz et al., 2009)
How do we measure distress?
Distress can be measured in various ways, such as through observation and self-report, and can be used in the overall assessment of the client.
The NCCN Thermometer and Problem List (NCCN Guidelines) is a well validated screening tool. The self - report scale asks patients to rate 'how much distress you have been experiencing in the past week, including today'.
Clients also tick 'problem areas' across 5 domains on the 39 item Problem List. It is a quick and accurate way of screening patients for high psychological distress.
In 2013, our regional support services began using the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List ("DT"). The "DT" has been validated among patients with different types of cancer including, breast cancer, lung cancer, prostate cancer, intracranial tumours and colorectal cancer.
A score of 4 or more indicates the person is experiencing elevated distress and may require additional support. It is essential that distress screening is followed up with psychosocial support, information and referral targeted to the needs of the patient. Along with other vital signs, distress should be monitored routinely.
When does Cancer Council WA carry out distress screening?
We carry out distress screening via our Cancer Support Coordinator interactions with patients and our 13 11 20 calls.
For cancer information and support call our Cancer Nurses on 13 11 20.
Learn more about the support services we provide here.