Purpose: This project was created to expand the psychosocial distress screening program at VA Palo Alto Health Care System (VAPAHCS) to explore the levels of distress experienced by Veterans’ caregivers. Caregiver distress and burden can have a far-reaching impact on patient care, health care costs, and clinical outcomes. VAPAHCS has had a procedure in place to measure Veteran cancer patient distress levels since 2013. Clinical experiences administering distress screens in our outpatient oncology clinics suggested that caregivers accompanying Veterans to appointments may be experiencing elevated levels of distress. Thus, a program evaluation project was conducted in order to measure caregiver distress and compare distress between Veterans and caregivers.
Methods: Veterans recently diagnosed with cancer were screened for distress by a psychologist, social worker, or psychology trainee during regularly scheduled oncology appointments using the National Comprehensive Cancer Network Distress Thermometer and Symptom Checklist. Beginning in January 2016, the Distress Thermometer question was also administered verbally to any caregivers present during the Veteran’s screen.
Data Analysis: Descriptive statistics were used to explore the level of distress by Veterans and caregivers. An independent samples t test was conducted to compare overall level of distress between the two groups.
Results: A total of 483 Veterans and 93 caregivers completed distress screening during the program evaluation period (January 2016-June 2017). Average level of distress for caregivers was 3.45 (0 = no distress, 10 = extreme distress). Average level of distress for caregivers was 5.09 (0 = no distress, 10 = extreme distress). T test was found to be clinically significant, t (574)= 5.19, P < .0001. 63% of caregivers were a spouse, partner, or significant other, 22% children, and 15% ‘other’.
Implications: These results indicate that caregivers endorse, on average, distress levels above the suggested cutoff for clinically significant distress (> 4), whereas Veterans are endorsing, on average, distress below the cutoff. This suggests that additional resources for caregiver distress are warranted in our clinics. Future directions include the development of additional caregiver support programs within the VAPAHCS and improved facilitation of referrals to caregiver support outside of the VAPAHCS system.
