Distress management (DM) (screening and response) is an essential component of cancer care across the treatment trajectory. Effective DM has many benefits, including improving patients' quality of life; reducing distress, anxiety, and depression; contributing to medical cost offsets; and reducing emergency department visits and hospitalizations. Unfortunately, many distressed patients do not receive needed services. There are several multilevel barriers that represent key challenges to DM and affect its implementation. The Consolidated Framework for Implementation Research was used as an organizational structure to outline the barriers and facilitators to implementation of DM, including: 1) individual characteristics (individual patient characteristics with a focus on groups who may face unique barriers to distress screening and linkage to services), 2) intervention (unique aspects of DM intervention, including specific challenges in screening and psychosocial intervention, with recommendations for resolving these challenges), 3) processes for implementation of DM (modality and timing of screening, the challenge of triage for urgent needs, and incorporation of patient-reported outcomes and quality measures), 4) organization—inner setting (the context of the clinic, hospital, or health care system); and 5) organization—outer setting (including reimbursement strategies and health-care policy). Specific recommendations for evidence-based strategies and interventions for each of the domains of the Consolidated Framework for Implementation Research are also included to address barriers and challenges.

中文翻译：

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应对压力管理挑战：来自美国心理社会肿瘤学会和肿瘤社会工作协会共识小组的建议

痛苦管理 (DM)（筛查和反应）是整个治疗过程中癌症护理的重要组成部分。有效的 DM 有很多好处，包括改善患者的生活质量；减少痛苦、焦虑和抑郁；为医疗费用抵消做出贡献；减少急诊就诊和住院。不幸的是，许多陷入困境的患者没有得到所需的服务。有几个多层次的障碍代表 DM 面临的主要挑战并影响其实施。实施研究综合框架被用作组织结构，以概述实施 DM 的障碍和促进因素，包括：1) 个体特征（个体患者特征，重点关注可能面临痛苦筛查和服务联系的独特障碍的群体），2）干预（DM 干预的独特方面，包括筛查和心理社会干预方面的具体挑战，以及解决问题的建议）这些挑战），3）实施 DM 的过程（筛查的方式和时间，紧急需求分类的挑战，以及合并患者报告的结果和质量措施），4）组织——内部环境（诊所的背景） 、医院或医疗保健系统）；和 5) 组织——外部环境（包括报销策略和医疗保健政策）。