Authors (including presenting author) :
LEE PC, CHAN SC, Leung WY, LAU MK, LEE MH, CHAN MK, NG LK
Affiliation :
Department of Surgery, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Breast cancer has become the top malignant disease in women in Hong Kong since 2017. About twelve women were diagnosed with breast cancer everyday (Hong Kong Cancer Registry, 2019). Distress is very common in cancer patients across diagnoses and across the disease trajectory (Carlson, Angen & Cullum, 2004). Distress is an unpleasant experience of a mental, physical, social, or spiritual nature. It can occur at any point in time during one’s cancer journey. It may limit how well one’s function, interfere with their health decision and self-care, and worsen their health (NCCN Guidelines for Patients: Distress, 2017). Thus, a distress-screening tool is introduced to monitor cancer patient’s level of distress. It aims to alleviate the level of distress and finally improve their quality of life.
Objectives :
1. To provide a holistic approach in assessing and monitoring patient’s level of distress.
2. To provide a standard tool for assessment of patient distress during their cancer journey.
3. To provide timely management of distress.
4. To enhance patients’ comfort during their care journey.
Methodology :
1. Set up a task force workgroup with breast cancer nurses. (Apr, 2019)
2. Review literatures on the impact of distress on patient with breast cancer. (Apr, 2019)
3. Modify distress-screening tool “Holistic Need Assessment Form” from Royal Free Hospital to meet our target group of patients. (May, 2019)
4. Design patient opinion survey & staff satisfaction survey to evaluate the program. (May, 2019)
5. Pilot study to validate the modified “Holistic Need Assessment Form”. (June – July, 2019)
6. Implement the program. (Aug 2019)
7. Evaluate the effectiveness of the program. (Dec 2019)
Result & Outcome :
1. Patient’s distress level The distress level of patients in practical concerns was reduced from 50% to 25%, and the family concerns were reduced from 19% to 3%. Their concerns of emotion were reduced from 18% to 13%. However, their concerns in physical and spiritual issues remained the same. 2. Patient Satisfaction Survey 99% patients were satisfied with the usage of Holistic Needs Assessment. 87% patients suggested the printed information is useful and the assessment facilitate their expression in concerns. 78% agreed their concerns can be addressed and 73% agreed the level of distress can be minimized. 100% agreed the collaboration of health care professionals can relieve their stress level. 3. Staff Satisfactory Survey Staff satisfactory survey illustrated a positive attitude towards the Holistic Needs Assessments. About 90% nurses agreed the assessment able to facilitate the formulation of nursing care plan and management, and patient’s comfort was enhanced. 90% both concur the assessment provide a standard tool to assess and monitor patient’s distress level.
