Document Type


Publication Date

Spring 2024

Date of Final Presentation


Committee Chair

Katherine Doyon, PhD, MEd, RN, CHPN

Committee Member

Marilyn O'Mallon, PhD, RN

Coordinator/ Chair of DNP Program

April Howell, DNP, RN

Abstract/ Executive Summary

Of the nearly 2 million new cancer cases projected to occur in the United States in 2022, up to 65% of patients may be hospitalized in the first year of their diagnosis. Hospitalized oncology patients have been documented to experience psychological distress during their hospitalization related to physical and emotional challenges related to their disease. In ***, a tertiary hospital located in ***, Oregon, hospitalized cancer patients with hematologic malignancies and aggressive or advanced solid cancers have verbalized distress, including depression, anxiety, feelings of isolation, and fatigue during prolonged hospital stays. According to the National Comprehensive Cancer Network (NCCN), distress in cancer patients is exceedingly common. It is associated with significant reductions in a patient's emotional and physical well-being, decreased quality of life, longer hospital length of stays, higher likelihood of hospital readmissions, and increased healthcare costs. Evidence-based oncology literature suggests that multidisciplinary palliative interventions that emphasize patient education and mental, physical, and psychological strategies effectively combat patient distress in the hospital. Observational and translational studies suggest that nurses who are educated in identifying patient distress contribute to better referral rates to psychosocial oncology services and play critical roles in patient decision-making and intervention implementation. Furthermore, ***’s Distress Management Policy and national cancer associations specify that all new cancer patients have "access to psychosocial distress screening at their first new patient visit," which may occur in the inpatient setting for the population specified above.

This scholarly project aimed to assess *** inpatient oncology nurses' knowledge regarding distress in the oncology population and to design an educational intervention that supports nurses' ability to identify distress, improve distress screening, and intervene in the hospital setting. This project integrated the National Comprehensive Cancer Network’s (NCCN) distress thermometer into inpatient patient care areas and presented the opportunity to screen for distress during the patient’s initial hospital stay. Furthermore, this project utilized institution- approved strategies and educational resources to address multiple facets of what contributes to patients’ distress. Finally, this project assessed the impact of the offered distress education on oncology nursing knowledge, skills, and attitudes regarding distress.

The topics and resources covered in the distress education included the definition of oncological distress, the rationale for distress screening, the national guidelines for distress screening and management, the distress screening policy of ***, the NCCN distress thermometer and problem list, a compendium of printed and electronic cancer, and distress related outpatient resources, and nursing interventions to address patients in distress. One hour of continuing nursing education was offered for completing this education.

At the completion of this scholarly project, oncology nurses reported increased efficacy in identifying distress, increased intention in using the NCCN distress thermometer and discussing distress with their patients, and increased confidence in discussing distress and distress-related interventions. During the five-month implementation period of this project, there was a notable increase in distress screening during the patient's hospitalization and increased referral rates to outpatient oncology social workers before hospital discharge.

Included in

Nursing Commons