Abstract
Purpose
Cancer care team attitudes towards distress screening are key to its success and sustainability. Previous qualitative research has interviewed staff mostly around the startup phase. We evaluate oncology teams’ perspectives on psychosocial distress screening, including perceived strengths and challenges, in settings where it has been operational for years.
Methods
We conducted, transcribed, and analyzed semi-structured interviews with 71 cancer care team members (e.g., MDs, RNs, MSWs) at 18 Commission on Cancer-accredited cancer programs including those serving underrepresented populations.
Results
Strengths of distress screening identified by participants included identifying patient needs and testing provider assumptions. Staff indicated it improved patient-provider communication and other aspects of care. Challenges to distress screening included patient barriers (e.g., respondent burden) and lack of electronic system interoperability. Participants expressed the strengths of distress screening (n = 291) more than challenges (n = 86). Suggested improvements included use of technology to collect data, report results, and make referrals; complete screenings prior to appointments; longitudinal assessment; additional staff training; and improve resources to address patient needs.
Conclusion
Cancer care team members’ perspectives on well-established distress screening programs largely replicate findings of previous studies focusing on the startup phase, but there are important differences: team members expressed more strengths than challenges, suggesting a positive attitude. While our sample described many challenges described previously, they did not indicate challenges with scoring and interpreting the distress screening questionnaire. The differences in attitudes expressed in response to mature versus startup implementations provide important insights to inform efforts to sustain and optimize distress screening.
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Data availability
Research data are not shared.
Code availability
NVivo 12 qualitative data analysis software was used.
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Acknowledgements
We appreciate cancer center staff who participated in this study. The content of this publication does not necessarily reflect the views of the American Cancer Society.
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This study is intramurally funded by the American Cancer Society.
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The Sterling Institutional Review Board determines this study (IRBID: 6308) as exempt from IRB review because participant interview responses gathered during this study would not “reasonably place the subjects at risk of criminal or civil liability or be damaging to the subjects’ financial standing, employability, or reputation” in the unlikely event they were accidentally disclosed outside of research.
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Smith, T.G., Beckwitt, A.E., van de Poll-Franse, L.V. et al. Oncology team perspectives on distress screening: a multisite study of a well-established use of patient-reported outcomes for clinical assessment. Support Care Cancer 30, 1261–1271 (2022). https://doi.org/10.1007/s00520-021-06458-5
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DOI: https://doi.org/10.1007/s00520-021-06458-5