At KF-SYSCC, we have been screening all newly diagnosed cancer patients with the Distress Thermometer (DT) for psychosocial distress since 2007. The optimal cutoff was set at DT>=4 (1). For the patients who are detected to be significantly distressed and wish to be assisted by the psychosocial care team, our social workers will make telephone or personal contacts with them. If needed, they will also be referred for psychiatric evaluation.
The goal of this study was to retrospectively assess to what extent the distressed patients had actually had contacts with the psychosocial care team.
All newly diagnosed cancer patients, who fit the following criteria and received treatment at KF-SYSCC between 2007 and 2010, were included in this study:
1. Major cancer type, of which the total number of patients were more than 100 from this time period;
2. Age 18 or older; and
3. DT screening done within 90 days after the diagnoses.
Information of contacts with the psychosocial care team was retrieved from the computerized data bases.
Five thousand three hundred and thirty five (5335) newly diagnosed cancer patients of 12 major cancer types, seen between Jan. 1, 2007 and Dec. 31, 2010, were included in this study. Over all, 1771 (33.20%) were assessed to be significantly distressed. Among these distressed patients, 628(36%) had had contacts with the psychosocial care team: 422 (24%) with the social worker, 276 (16%) with the psychiatric staff, and 70 (4%) with both the social worker and the psychiatric staff.
Vast majority of these patients, up to 88 %, had the contacts with the social worker within 30 days after the screening, as the social worker had made the initial contacts. The visits to the psychiatric staff were spread out to a year with only 52% within the first three months.
Routine screening for psychosocial distress in newly diagnosed cancer patients has led to 36% of those identified as distressed to have contacts with the psychosocial care team. Most of such patients were reached by the social workers within one month after the screening. However, only half of the first psychiatric visits were made within the first three months.
Routine screening for psychosocial distress should be continued. Patient’s follow-up contacts with the psychosocial care team, especially with the psychiatric staff, should be closely monitored to facilitate timely intervention.
Further studies are needed to assess the outcome of the psychosocial intervention for these highly vulnerable patients.
1. Wang GL, et al. The HADS and the DT for screening psychosocial distress of cancer patients in Taiwan. Psych-Oncology 20: 639-646 (2011).