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Program helps cancer patients overcome severe distress

January 8, 2015

Alberta pioneers a global standard of care that’s improving overall well-being

CALGARY— Fewer Alberta cancer patients are experiencing severe distress as a result of their illness and treatment since the launch of a program developed at the Tom Baker Cancer Centre.

Screening for Distress helps front-line staff to identify issues that are negatively affecting cancer patients throughout various points of their journey, so solutions can be developed to improve their overall well-being. The program, funded by the Alberta Cancer Foundation, was implemented in the province’s 17 cancer centres two years ago.

More than 1,000 patients were assessed as part of a recent evaluation of the program. Results showed Screening for Distress reduced the number of cancer patients who worried about their appearance by 72 per cent, and reduced the number of cancer patients who reported feeling a burden to others by 60 per cent. More than half of all patients reported less frustration and anger after participating in the program.

“While the physical symptoms of cancer are routinely addressed with medical treatment, the psychosocial and practical impact of the disease can go unattended,” says Linda Watson, Lead of Person-Centred Care Integration for Alberta Health Services. “Screening for Distress allows the patient to identify issues so meaningful support can be provided across the entire cancer journey.”

Distress is classified as an unpleasant emotional experience ranging from vulnerability and sadness, to disabling problems, such as anxiety and depression. It can also include eating difficulties, fatigue, financial worries or family concerns.

Unaddressed and untreated, distress can interfere with a patient’s ability to cope effectively with cancer, its physical and psychosocial symptoms, and its treatment.

Patients are asked to complete a brief screening for distress questionnaire at various points throughout their cancer treatment. Responses are then gathered and front-line staff work with individuals who are experiencing severe distress and develop an action plan to mitigate or eliminate the cause(s) of distress.

“The program has helped to change the approach of health care professionals and how we treat our patients,” says Watson. “It opens up meaningful conversations, allowing patients to talk with front-line staff about what is causing them the most distress.”

High River resident Meredith Hodges completed the Screening for Distress questionnaire following her breast cancer diagnosis, and Hodges’s responses indicated she was becoming increasingly concerned her illness was damaging her marriage.

“The closeness my husband and I shared for so long was not there anymore and I didn’t know how to approach my husband,” recalls Hodges.

“The screening talk allowed me to open up about the distress I was feeling. The nurse I spoke with knew how to help and she recommended a program that was right for me and my situation. It helped me understand my own situation and brought me closer to my husband, and he to me. We were ready to face the world again as just the two of us, in a much closer way.”

Screening for Distress was conceived in the late 1990s at the Tom Baker Cancer Centre by a team led by Dr. Barry Bultz, Clinical Lead of Psychosocial Oncology, Supportive Care and Patient Experience.

Today, distress is now endorsed by more than 75 international organizations and societies, including the Union for International Cancer Control, as the “sixth vital sign” in cancer care, following temperature, pulse, blood pressure, breathing rate and pain.

“Alberta is a champion of whole patient care which promises better patient outcomes and a more targeted and efficient use of limited resources,” says Dr. Bultz. “We pioneered Screening for Distress in our province and it is now a global standard of care that’s improving patient outcomes around the world and here at home.”

The Alberta Cancer Foundation provided funds to develop the program and implement it provincewide.

“We know that in order to improve patient outcomes, all aspects of care must be addressed, including the emotional and mental well-being of a patient,” says Alberta Cancer Foundation CEO Myka Osinchuk. “We’re thrilled to know all Albertans facing cancer across this province have access to such an important tool.”

About 16,000 cancer cases are diagnosed every year in Alberta.

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

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