Cancer diagnosis and its treatments often lead to the experience of physical symptoms. Unrelieved physical symptoms are distressing, potentially leading to poor long-term psychological well-being. Current guidelines recommend regular symptom screening and appropriate interventions, enabling affected cancer patients to self-manage their symptoms. However, there is no routine systematic symptom distress screening and management protocol offered in local oncology centres in HKSAR’s health care systems.
With a donation from The Hong Kong Jockey Club Charities Trust, the LKS Faculty of Medicine, HKU has recently established the Jockey Club Institute of Cancer Care (JCICC) to develop and pilot an evidence-based care model for implementing structured symptom assessment and management in routine cancer care. In the pilot program, using the modified Edmonton Symptom Assessment System (ESAS-r), patients screening positive for moderate-to-severe symptom distress were referred to a nurse-led community-based symptom-management programme. A nursing case manager triaged patients to stepped-care symptom/psychosocial management interventions and carried out follow-up assessments at 3-months and 9-months thereafter. The results showed that nurse-led symptom distress screening programs with well-structured referral pathways to community-based services and continued monitoring are feasible and acceptable in cancer patients and may help in reducing symptom distress. We intend next to develop optimal strategies for implementation and referral within routine cancer care services.
This implementation study aims to develop implementation strategies to enhance the adoption and acceptance of symptom distress screening in local settings.
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