Date of Submission

Summer 8-9-2021

Document Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Nancy Selix

Second Advisor

Cynthia Huff


Background: Routine oncology visits failed to identify 50-94% of patient’s distress, which creates a considerable burden, impairs emotional well-being and reduces patients’ quality of life. Limited in-person visits during the COVID-19 pandemic have reduced access to care for many patients, further adding to their emotional distress. Untreated distress also leads to elevated stress levels, systemic inflammation, non-compliance with treatment, and higher mortality rates. Early distress screening and multidisciplinary care are recommended to reduce the impacts of distress.

Objectives: To identify the best outpatient practices to address newly diagnosed cancer patients’ unique needs due to distress.

Methods: Databases searched including CINAHL® Complete, Joanna Briggs Institute EBP Database, APA PsycINFO®, PubMed, and Cochrane Database of Systematic Reviews. Studies had to be written in English or Chinese, published in a peer-reviewed journal, and included individuals aged 18 years or older. The initial search yielded 371 articles.

Findings: Research highlighted the need to assess patients’ pre-existing life events, culture, beliefs, and other personal characteristics for optimal distress management. The screening should identify high-risk patients and provide early intervention. Investing in telehealth practice and psycho-oncology education is more cost-effective compared to face-to-face interventions.