Butow, P., Price, M.A., Shaw, J.M., Turner, J., Clayton, J.M., Grimison, P., . . . Kirsten, L. (2015). Clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients: Australian guidelines. Psycho-Oncology, 24, 987–1001. 

DOI Link

Purpose & Patient Population

PURPOSE: To provide a clinical pathway for anxiety and depression in adult patients with cancer to guide best practice
 
TYPES OF PATIENTS ADDRESSED: Adult patients at any phase of care and type of cancer

Type of Resource/Evidence-Based Process

RESOURCE TYPE: Consensus-based guideline
 
PROCESS OF DEVELOPMENT: A review of existing guidelines and systematic reviews relevant to the purpose of the guideline was conducted. Structured interviews with 12 multidisciplinary staff from varied institutions were done, followed by an online Delphi process with 87 stakeholders representing multiple disciplines. Additional input was obtained from a multidisciplinary advisory panel.
 
DATABASES USED: Cochrane, Google, PubMed, Medline, PsycInfo, and CINAHL
 
KEYWORDS: not stated

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results Provided in the Reference

No information is provided regarding literature retrieved, quality of evidence, or how the evidence was used to develop the guidelines provided.

Guidelines & Recommendations

Outlines relevant healthcare provider roles. Identified the following assessment tools for use: Edmonton Symptom Assessment Scale, the NCCN's Distress Thermometer, and the Hospital Anxiety and Depression Scale. Provides a stepped path of interventions based on ongoing monitoring of symptoms and effectiveness of previous interventions. Recommendations for initial intervention are patient education (in-person or online) and brief emotional support. Ongoing interventions for those with cancer-related anxiety and depression include coping skills training, relaxation skills, communication skills, mindfulness, and a variety or psychological therapies.

Limitations

Despite an extensive review process for guidelines, as well as input from stakeholders, there is little information on the evidence base for the recommendations provided.

Nursing Implications

This guideline outlines recommended providers, and nurses are not specifically outlined as recommended providers in the written pathway other than as “other appropriately trained staff,” although nurses are identified as having roles in screening, assessment, and educational and counseling types of roles. This guideline provides no new information and does not directly provide the evidence base on which recommendations are based. The guideline suggests more limited roles for nurses than has been demonstrated in relevant research.