Systematic screening for distress in oncology practice using the Distress Barometer: the impact on referrals to psychosocial care

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This study evaluates how patterns of psychosocial referral of patients with elevated distress differ in a ‘systematic screening for distress’ condition versus a ‘usual practice’ condition in ambulatory oncology practice.


The psychosocial referral process in a 2-week usual practice (N= 278) condition was compared with a 2-week ‘using the Distress Barometer as a screening instrument’ (N= 304) condition in an outpatient clinic with seven consulting oncologists.


Out of all distressed patients in the usual practice condition, only 5.5% of patients detected with distress were actually referred to psychosocial counselling, compared with 69.1% of patients detected with distress in the condition with systematic screening using the Distress Barometer. Only 3.7% of patients detected with distress in the usual practice condition finally accepted this referral, compared with 27.6% of patients detected with distress in the screening condition.


Using the Distress Barometer as a self-report screening instrument prior to oncological consultation optimises detection of elevated distress in patients, and this results in a higher number of performed and accepted referrals, but cannot by itself guarantee actual psychosocial referral or acceptance of referral. There is not only a problem of poor detection of distress in cancer patients but also a need for better decision-making and communication between oncologists and patients about this issue. Copyright © 2014 John Wiley & Sons, Ltd.

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