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Usefulness of the nurse-assisted screening and psychiatric referral program
Article first published online: 15 MAR 2005
Copyright © 2005 American Cancer Society
Volume 103, Issue 9, pages 1949–1956, 1 May 2005
How to Cite
Shimizu, K., Akechi, T., Okamura, M., Oba, A., Fujimori, M., Akizuki, N. and Uchitomi, Y. (2005), Usefulness of the nurse-assisted screening and psychiatric referral program. Cancer, 103: 1949–1956. doi: 10.1002/cncr.20992
- Issue published online: 18 APR 2005
- Article first published online: 15 MAR 2005
- Manuscript Accepted: 30 DEC 2004
- Manuscript Revised: 21 DEC 2004
- Manuscript Received: 2 JUN 2004
- Japanese Ministry of Health, Labor, and Welfare
- referral and consultation;
- major depression;
- adjustment disorders
Major depression and adjustment disorders are common psychiatric disorders in patients with cancer, but they are often overlooked in clinical oncology settings. The nurse-assisted screening and psychiatric referral program (NASPRP) has been introduced in clinical practice to facilitate psychiatric treatment for major depression and adjustment disorders. This study assessed the usefulness of the NASPRP and compared it with usual practice.
The program consists of two stages. In the first stage, consecutive patients newly admitted to the Oncology/Hematology Unit are administered the Distress and Impact Thermometer (DIT) by nurses as a brief screening tool for major depression and adjustment disorders. In the second stage, the nurses recommend psychiatric referral to patients with scores above the cutoff point. Patients' records were reviewed for a 3-month period before the start of the program and during the 3-month period after the start of the program. These records were then compared.
Of 157 patients newly admitted during the program period, 86.0% (135/157) completed the DIT and results were positive in 49.6% (67/135), but only 28.2% (19/67) accepted psychiatric referral. Ultimately, 11.5% (18/157) of patients newly admitted were diagnosed with major depression or adjustment disorders and treated by psychiatric service, a significantly higher proportion than during the preceding 3-month period, before the program was begun (2.5%; P = 0.001).
The NASPRP enabled identification of major depression and adjustment disorders in patients with cancer and introduced them to psychiatric treatment. Nevertheless, there is room for improvement in the program. Cancer 2005. © 2005 American Cancer Society.