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Show Distress Screening and Oncology Nursing Practice Youngbeen Shamo, BSN, OCN, DNP Student Ana Sanchez-Birkhead, PhD, APRN, WHNP-BC Key Findings: This study identified oncology inpatient nurses’ perceived barriers to distress screening and improved their knowledge, confidence, and practice regarding distress screening via a Distress Education Module. Background Figure 1. Changes in Level of Knowledge Results Patients with cancer commonly experience psychosocial distress. About 40% report significant distress. Over 60% (presurvey n=27; postsurvey n=19) of the eligible nurses participated in the study. Many researchers reported the failure to optimally manage psychiatric disorders and psychosocial needs in patients with cancer due to underdetection of distress. Of these, 85.2% (n=23) identified a lack of access to validated tools as a moderate to extreme barrier to distress screening, followed by time constraint (n=16) and a lack of clinical policies (n=15). Systematic distress screening is endorsed to improve the accurate and timely identification but, there is no routine distress screening practice in inpatient units of a cancer hospital, located in SLC, Utah. A Mann-Whitney U test indicated that DEM improved nurses’ knowledge (U=174.000, p=0.000), beliefs (U=174.000, p=0.033) and confidence (U=155.000, p=0.013). There were no statistically significant gains in attitudes but some percentage increases were noted. The purpose of this DNP project was to improve nurses’ knowledge, attitudes, and perceived confidence in addressing distress screening among cancer patients. Methods A Theory of Planned Behavior (TPB) was used as guide to the development of this project. Pre-intervention: A presurvey assessed nurses’ knowledge, attitudes, beliefs, confidence, and barriers to distress screening. Intervention: A Distress Education Module (DEM) was developed and implemented via PowerPoint presentation, handouts, and a recorded video. Post-intervention: The postsurvey was conducted 4-6 weeks after the intervention. The effectiveness of DEM was evaluated by measuring changes in nurses’ responses in the pre- and postsurveys. Figure 2. Changes in Level of Practice Nurses reported that both the frequency of distress screening (U=169.000, p=0.038) and the usage of validated tool (U=173.500, p=0.047) have increased after the DEM. Conclusions This project provided the groundwork for future implementations of distress screening by identifying nurses’ perceived barriers and improving their knowledge, beliefs, and confidence. The improvement in knowledge, attitudes, beliefs, and confidence levels could develop into actual practice changes. Further quality improvement projects are recommended to address identified barriers at the organizational level and to implement the formal distress screening and management protocol. COLLEGE OF NURSING |
