Aims: We examined effects of a psychosocial screening procedure on patients’ distress, quality of life (QoL) and satisfaction with care versus no screening procedure.
Methods: A sequential cohort design was used. Cohort1 consisted of all cancer patients consecutively visiting out-patient clinics in 6 hospitals in North-East Netherlands during a 2-4 weeks period. Participants completed the Distress Thermometer (DT) and Dutch Problem List (PL), EORTC measuring 6 QoL domains and the Patient Satisfaction Questionnaire assessing four satisfaction with care domains. No feedback was given to patients/clinicians. Approximately 1-2 years later a psychosocial screening procedure was implemented in which DT/PL’s were completed by patients, results were discussed with nurses and referrals were offered if indicated. Consequently, Cohort2 was approached as cohort1, and completed the same questionnaires. X2 and t-tests compared the two groups.
Results: Of 680 cancer patients approached for Cohort1, 359 (53%) participated, as did 302/550 (55%) approached for Cohort2. No significant between-group differences were found for age, marital status, education, treatment phase, or treatment type. More women participated in Cohort2 (87%) than in Cohort1 (80%) (X2=6.07, p<.05) and more patients having breast cancer (Cohort1=67%, Cohort2=79%, X2 =8.69,p<.01). Cohort2 respondents reported experiencing significantly fewer problems in the physical (t=2.04, p<.05), practical (t=2.20, p<.05), emotional (t=2.59, p<.01) and spiritual PL domains (t=1.98, p=.05), and more satisfaction with accessibility/waiting times in the hospital (t=2.10, p<.05) than Cohort1 respondents did. No significant differences were found in DT scores; in EORTC physical, role, emotional, social, and cognitive functioning and overall QoL; or in medical specialists’ technical qualities, interpersonal behavior, and general satisfaction with care received.
Conclusion: Psychosocial screening of cancer patients with discussion of results appears associated with reduced severity of problems, marginally with satisfaction with care, but not with reported DT scores or QoL.