Implementation of screening for unmet psychosocial needs: long-term follow up of screening rates, patient needs, referrals and continued barriers to patient screening. — ASN Events
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  2. IPOS Symposium - Integration of psychosocial support throughout cancer care: Perspectives from around the globe
  3. Implementation of screening for unmet psychosocial needs: long-term follow up of screening rates, patient needs, referrals and continued barriers to patient screening.

Implementation of screening for unmet psychosocial needs: long-term follow up of screening rates, patient needs, referrals and continued barriers to patient screening. (#295)

Sibilah J Breen 1 2 , Sanchia K Aranda 1 2 3
  1. Nursing & Supportive Care Research, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
  2. Department of Nursing, University of Melbourne, Parkville, VIC, Australia
  3. Division of Cancer Services & Information, Cancer Institute NSW, Alexandria, NSW, Australia

Background: The Victorian Cancer Action Plan stipulates that 50% of new patients be screened for psychosocial needs by 2012. The Supportive Needs Screening Tool (SNST) is a validated paper-based form completed by patients/nurses to document, physical, emotional, information, and support needs/referrals. Forms are scanned, data stored electronically and a summary of needs/referrals displayed in the electronic medical record

Aims: To determine: patient screening rates for 2011; the most common needs/referrals and to describe barriers to screening.

Methods: Descriptive statistics for screening rates; unmet needs/referrals were calculated from electronic SNST data. Barriers to screening are those raised at monthly SNST working-group meetings.

Results: The screening rate for 2011 was 46%(range 33-55% per month; 1271 forms). The majority of patients screened had urological(28%) or gastrointestinal(27%) cancers with localized(26%) or unknown/unreported(35%) disease. Most common needs included:  information about disease/treatment(54%); worry/anxiety(42%); fatigue and being slowed down/sluggish(41%); worrying thoughts(35%); sleep problems/practical/financial needs and ability to only complete light exercise(31%). Most common referrals were: social work(31%); nutrition(16%); psychology/psychiatry(10%); nursing(9%) and occupational therapy (OT)/physiotherapy (7%). Most commonly accepted referrals were: social work/nutrition/nursing(91%); OT/physiotherapy(85%) with psychology/psychiatry having much lower acceptance(57%). Lowered mood/anxiety accounted for one-third of psychology/psychiatry referrals whilst adjustment issues/psychosocial assessment/counseling comprised 44% referrals to social work. Screening barriers included: nurse time, clinic space, form distribution; technical/time issues with scanning, staff change/training.

Conclusions: Sustainability and increased screening rates may be improved via training of additional nurses to undertake screening and the use of fully electronic screening mechanisms to decrease administrative loads (eg internet/mobile-phone technology as trialled in the research setting). Further exploration of reasons behind high refusal rates for some referrals is required alongside long-term follow-up of referral attendances. Linkage of screening data with other hospital datasets may assist in predicting patients at risk of not attending referrals and/or future adverse outcomes enabling targeted interventions/improved care.

Abstract submitted for planned symposium entitled: 'Integration of Psychosocial Support Throughout Cancer Care: Perspectives from Around the Globe'.