Aim
To determine if cancer related distress can be identified through Supportive Care Screening (SCS) and mitigated through referrals to appropriate services.
Method
A mixed method descriptive cohort study using retrospective medical file audit data and self-report client questionnaires. Inclusion criteria: all patients receiving SCS from 20 December 2011 to 12 November 2015. Audit data recorded levels of distress as measured by a Distress Thermometer (DT) and associated causal issues. All living audited patients free from end stage palliation were mailed a questionnaire. Outcomes variables included current level of distress, satisfaction with the cancer service, attendance rates to supportive services and Quality of Life (EORTC QOL-C 30).
Results
Audit data showed a high distress (DT score of ≥ 4) rate of 40% (n=242) with peaks at diagnosis and end of treatment. High distress referral rates were low (n=28, 11.57%) amid overall low referral rates (n=80, 33%). Screening over time showed that high distress was not mitigated through referral to service providers.
Two hundred participants were sent the questionnaire, 104 responded (53% response rate). High distress was found in 32% (n=32). Patients self-reported high rates of service use. This was incongruent with the rate of referrals documented in the audit.
Men were more likely to be older; visited the health service more frequently; reported lower QoL measures; less satisfaction with the information provided about cancer; unlikely to see any positive benefits to having cancer; less likely to seek support groups and received lower numbers of referrals than women.
Conclusion
SCS accurately detects high distress. Overall referral rates are low, not predicted by distress and have not shown to mitigate high distress in this cohort. Timely referrals to the ambulatory cancer service are now sought, thus offering early intervention to ensure improved survivorship with an increased sensitivity to gender variance.