Psychosocial Screening and Evaluation in Palliative and Oncology Settings

Psychosocial Screening and Evaluation in Palliative and Oncology Settings

Psychosocial screening and evaluation are essential steps in providing adequate care to cancer patients and their families. Psychosocial problems can affect not only the quality of life, but also the course and outcome of the disease. Therefore, it is important to identify and address the emotional, psychological, social, and existential aspects of cancer and its treatment.

Psychosocial screening is the process of identifying patients who may have psychosocial distress or disorders, using standardized tools or instruments. Psychosocial evaluation is the process of assessing the nature, severity, and impact of the psychosocial problems, using more specific and comprehensive methods. Both screening and evaluation should be done regularly throughout the cancer trajectory, from diagnosis to palliative care.

Psychosocial screening can be done by using simple tools, such as the Distress Thermometer (DT), which measures the level of distress on a scale from 0 to 10, or the Hospital Anxiety and Depression Scale (HADS), which measures anxiety and depression symptoms. These tools can help to identify patients who need further evaluation or intervention. However, they are not sufficient to capture the complexity and diversity of psychosocial issues in cancer patients.

Psychosocial evaluation requires a more in-depth and multidimensional approach, which can be done by using structured or semi-structured interviews, such as the Diagnostic Criteria for Psychosomatic Research (DCPR), which assesses different psychosocial dimensions, such as demoralization, health anxiety, maladaptive coping, dysfunctional attachment, etc. These interviews can help to understand the underlying causes and consequences of the psychosocial problems, as well as to plan appropriate interventions.

Psychosocial screening and evaluation should be tailored to the individual needs and preferences of each patient, taking into account their cultural background, language, ethnicity, race, religion, etc. These factors can influence how patients perceive and cope with their illness, as well as how they communicate their distress or needs. Therefore, it is important to use culturally sensitive and competent methods, as well as to involve family members or caregivers when appropriate.

Psychosocial screening and evaluation are not only beneficial for patients, but also for health care providers. They can help to improve the quality of care, enhance patient satisfaction, reduce burnout, and increase collaboration among different disciplines. Moreover, they can contribute to the advancement of research and knowledge in the field of psycho-oncology and palliative care.

References:

– Grassi L., Caruso R., Sabato S., Massarenti S., Nanni M.G., The UniFe Psychiatry Working Group Coauthors (2015). Psychosocial screening and assessment in oncology and palliative care settings. Frontiers in Psychology 5: 1485. https://doi.org/10.3389/fpsyg.2014.01485
– Holland J.C., Bultz B.D., National Comprehensive Cancer Network (NCCN) (2007). The NCCN guideline for distress management: a case for making distress the sixth vital sign. Journal of the National Comprehensive Cancer Network 5: 3-7.
– Mitchell A.J., Kaar S., Coggan C., Herdman J. (2008). Acceptability of common screening methods used to detect distress and related mood disorders-preferences of cancer specialists and non-specialists. Psycho-Oncology 17: 226-236. https://doi.org/10.1002/pon.1213
– Porcelli P., Sonino N., eds (2007). Psychological Factors Affecting Medical Conditions: A New Classification for DSM-V. Basel: Karger.