Supporting Resilience and Case Finding

With this trial we want to improve psychosocial care for patients with cancer and adequately detect psychological distress in these patients. To achieve this, oncologists and nurses will receive a training aimed at communicating about emotions, including emphatically ending a conversation about emotions, and at targeted referral. Furthermore, based on predefined risk factors, patients will be divided into two groups: (a) patients with a low risk of developing psychological distress, and (b) patients with a high risk of developing psychological distress. Patients at high risk for distress will be monitored closely and care needs will be evaluated regularly. All adult cancer patients will be asked to participate, excluding patients participating in interfering trials, patients who are referred to our hospital for a second opinion and patients with a life expectancy of less than three months.

To evaluate the diagnostic accuracy (distress recognition) of the new procedure for detecting psychological distress in patients with cancer

3 months after start treatment

Based on empirically derived predictors of poor resilience (‘yellow flags’), patients are divided into (I) a group with an elevated risk of experiencing psychological distress, and (II) a group with a normal risk.

Group I

(i) Within group I oncologists and nurses provide basic support in dealing with emotional and mental challenges inherent to illness and treatment, as well as supporting existing resilience and optimizing coping strategies. Training in counseling and supervision are provided to medical and nursing staff.

(ii) The oncologist and oncology nurse are alert to possible psychological distress (case finding): the patient’s psychological state is an explicit topic of conversation. The ‘Lastmeter’ and the PHQ4 are available to facilitate detection of psychological distress.

(iii) In case of psychological distress, the oncologist and/or oncology nurse explores the severity and nature of the problem, using the ‘Lastmeter’. The most appropriate assistance is determined, in deliberation with the patient.



Group II
(i) Within group II oncologists and nurses provide support (analogous to group I).

(ii) Oncologist and nurses rely on the usual approach in regular visits to detect psychological distress. The ‘Lastmeter’ and the PHQ4 are available to facilitate detection of psychological distress.

(iii) The most appropriate assistance is determined (analogous to group I).