Identifying and Addressing Distress in Cancer Care: A Study of Screening Outcomes and Referrals in Australian Oncology Outpatients.

IF 3.9 2区医学 Q2 ONCOLOGY

Psycho‐Oncology Pub Date : 2026-08-01 DOI:10.1002/pon.70584

E Matthews, K Webber, C Parker, C Feola, T Gencarelli, P Koe-Leong, J F Wiley

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Abstract

Objective: Psychological distress is highly prevalent among oncology patients and represents an important unmet supportive care need. Yet referrals made following routine distress screening remain poorly understood. This study examined referrals following routine distress screening in outpatient oncology to assess how screening supports patient care, especially for psychological concerns.

Methods: All outpatient medical oncology distress screenings at a major metropolitan Victorian hospital from 1 December 2023 to 31 May 2024 were extracted from medical records. Screening was conducted with the NCCN distress thermometer (DT), problem list and additional custom items. Patient characteristics, screening uptake, and referral following screening were analysed.

Results: Of 850 distress screening encounters offered to 773 patients, 82 (9.6%) were declined, leaving 768 completed screening encounters. Among respondents, 53.6% reported clinically significant distress (DT ≥ 4) and 60.4% reported psychological concerns. 35.8% (n = 275) of screenings resulted in at least one referral. Patients with more distress and greater patient-reported need for support were more likely to be referred (both p < 0.001). However, only a small proportion of referrals following screening targeted psychological concerns directly, with just five directed to specialist mental health services.

Conclusions: Distress and psychological concerns are highly prevalent in outpatient oncology, yet referral following screening often does not align with concerns reported. Most referrals are made to external services, limiting integration with oncology care. Improving referral pathways and enhancing access to mental health services within oncology settings are critical steps towards better meeting patients' psychological needs and ensuring that distress screening translates into meaningful, patient-centred care.

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识别和解决痛苦的癌症护理：筛选结果和转诊在澳大利亚肿瘤门诊病人的研究。

目的：心理困扰在肿瘤患者中非常普遍，是一个重要的未满足的支持性护理需求。然而，人们对常规的痛苦筛查后的转诊仍然知之甚少。本研究检查了门诊肿瘤患者常规痛苦筛查后的转诊，以评估筛查如何支持患者护理，特别是心理问题。方法：从医疗记录中提取2023年12月1日至2024年5月31日在维多利亚州一家主要大都会医院进行的所有门诊肿瘤窘迫筛查。使用NCCN痛苦温度计（DT）、问题清单和其他自定义项目进行筛查。分析了患者特征、筛查吸收情况和筛查后转诊情况。结果：在773名患者提供的850次痛苦筛查中，82次（9.6%）被拒绝，剩下768次完成了筛查。在受访者中，53.6%的人报告有临床意义的痛苦（DT≥4），60.4%的人报告有心理问题。35.8% （n = 275）的筛查结果至少有一次转诊。结论：焦虑和心理问题在门诊肿瘤患者中非常普遍，但筛查后的转诊往往与所报告的担忧不一致。大多数转介到外部服务，限制了与肿瘤护理的整合。改善转诊途径和在肿瘤学环境中增加获得精神卫生服务的机会，是更好地满足患者心理需求和确保将痛苦筛查转化为有意义的、以患者为中心的护理的关键步骤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.