1. Validated Distress Screening Tools Brief Symptom Inventory (BSI-18)
Items
Time (min) 
Constructs Measured 
Brief Symptom Inventory (BSI-18) 18
3–5
Somatization, depression, anxiety, general distress
CancerSupportSourceSM 25
5-10
Distress Thermometer (DT) & Problem List 1
2–3
Distress and problems related to the distress
Edmonton Symptom Assessment System 9
2-3
Symptoms
Hospital Anxiety and Depression Scale (HADS) 14
5–10
Symptoms of clinical depression and anxiety
PHQ-9
Anxiety and depression
Psychological Distress Inventory 13
Psychological functioning (incl. coping)
Psychosocial Screen for Cancer (PSSCAN) 21
10-15
General Distress
SupportScreen 53
 15-20
Psychosocial needs
Zung Self-Rating Depression Scale 20
Symptoms of depression
There is a need for research to study the efficacy of brief screening instruments.

3. “Distress extends along a continuum, ranging from common normal feelings of vulnerability and sadness to problems that can be disabling, such as depression, anxiety, panic, social isolation and existential and spiritual crisis.”
National Comprehensive Cancer Network: 1999, 2001, 2004, 2007, 2010

4. Prevalence rates for significant levels of distress in patients with cancer range from 22% to 58%
NCI’s Adjustment to Cancer: Anxiety and Distress (PDQ®)

5. Distress Management Goals & Outcomes
Reduce/eliminate barriers that impact treatment adherence
Enhance satisfaction with care and quality of life
Improve staff-patient communication/trust
Reduce unnecessary telephone calls/visits
Better treatment outcomes as fewer patients become distressed to the point of interrupting treatment

6. Psychosocial Distress Screening Process Summary
Choose or create a screening tool(s) and delivery method
Establish a threshold/cutoff and use screening results to triage patients for further evaluation and care
Distribute resources and information to all patients
Document gaps in resources & determine the options for addressing those gaps (Std 3.1)
Designate the healthcare team available to do a full assessment for those who fall above the threshold/cutoff
Assess, intervene & follow-up on those patients in need & document their care and follow-up
Psychosocial Service Representative reports to the cancer committee and discusses the screening and care delivery process with surveyor