Attachment D_Measure info

	NAME	BRIEF DESCRIPTION	CONSTRUCT	TARGET POPULATION	INSTRUMENT / REFERENCE MANUSCRIPT
1	Psycho-oncology Screening Tool (POST)	T Distress Measurement Initiative (GEM-DM) Instrument Information he Psycho-oncology Screening Tool (POST) is a brief, self-administered screening instrument that was designed to evaluate emotional and physical distress, depressive symptoms and social concerns in cancer patients and survivors.	Anxiety and depression	Cancer patients and survivors	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1796
2	Cancer Needs Questionnaire (CNQ) Short Form	Thirty-two item self-administered questionnaire that assesses five domains of need: 1) Psychological; 2) Health information; 3) Physical and daily living; 4) Patient care and support; 5) Interpersonal communication.	Cancer needs	Cancer survivors	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1598
3	Prostate Cancer Needs Assessment (PCNA)	This is a 135-item survey that assessed both the Importance and Unmet Needs for three domains: 1) Information; 2) Information; 3) Support and care delivery; Need score was calculated for each item, incorporating both the Importance and the degree to which the need was unmet. Surveys (n = 500) were distributed in four geographically distinct areas, with a response rate of 46%.	Cancer needs	Prostate cancer survivors	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1778
4	Prostate Cancer Needs Questionnaire Version 2 (PCNQv2)	This is a revision of the Prostate Cancer Needs Questionnaire (PCNQ). The PCNQ was constructed in two parts with Part 1 measuring needs at diagnosis and initial treatment and Part 2 measuring current needs.	Cancer needs	Prostate cancer survivors	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1779
5	Psychosocial Needs Assessment Survey (PNAS)	A 34-item psychosocial needs assessment survey was developed to assess 4 categories of need: Informational, Practical, Supportive, and Spiritual.	Cancer needs	Ethnic minority and underserved cancer survivors	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1780
6	Cancer Rehabilitation Evaluation System (CARES)	Find how cancer affects psychosocial, physical and behaviors.	Coping	Cancer patients	http://www.cancer.ucla.edu/Index.aspx?page=1221
7	Cancer Rehabilitation Evaluation System - Short Form (CARES-SF)	Self-report measure assessing the day-to-day problems and rehabilitation needs of patients with cancer. 59 items (not all items completed by all patients: minimum, 38 items; maximum, 57 items): patients rate extent to which item applies to them; scale ranges from 0 (does not apply) to 4 (very much); global CARES-SF score and five higher-order factors: physical, psychologic, medical interaction, marital, sexual, and other problems.	Coping	-	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1596
8	PROMIS Emotional Distress (Depression) Short Form	The purpose of this study is to validate the PROMIS Emotional Distress (Depression and Anxiety) Short Forms (SFs) for use with cervical cancer patients.	Depression	Cancer survivors	http://www.artcbt.com/files/PROMISDepressionForm.pdf
9	Patient Needs Assessment Tool (PNAT)	The Patient Needs Assessment Tool (PNAT) is an interviewer-rated scale that may be completed through a simple structured interview and screens cancer patients for potential problems in physical and psychosocial functioning. The instrument provides separate scores for physical, psychological, and social status, and can potentially clarify the types of interventions needed to address specific areas of dysfunction.	Functioning	-	http://www.ncbi.nlm.nih.gov/pubmed/8635168
10	Brief Symptom Inventory (BSI) short form (BSI-18)	Brief screening measure for psychologic distress and psychiatric disorders in patients with cancer. 53 item self-report measure that assess symptoms in the following domains: Scales Symptom Scales SOM - Somatization O-C - Obsessive-Compulsive I-S - Interpersonal Sensitivity DEP - Depression ANX - Anxiety HOS - Hostility PHOB - Phobic Anxiety PAR - Paranoid Ideation PSY - Psychoticism BSI-18 Shortened form that measures distress in medical and community populations Symptom Scales SOM - Somatization DEP - Depression ANX – Anxiety Both scales have a global score	Psychological distress	Adult survivors	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1441
11	Psychosocial Needs Inventory (PNI)	Assesses practical, childcare, support networks, emotional and spiritual, information, health professional, and identity needs. 48 items: patient rates the importance of the need over the past few weeks (scale ranges from 1 ‘not important’ to 5 ‘very important’) as well as satisfaction of that need; The items were grouped into seven needs categories: those related to health professionals (nine items); information needs (five items); needs related to support networks (five items); identity needs (five items); emotional and spiritual needs (15 items); practical needs (eight items); child care need (one item).	Psychological distress	Adult cancer patients	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1587
12	Cancer problems in living scale (CPILS)	29-item inventory of problems faced by individuals with cancer	Quality of life	Cancer patients / survivors	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1405
13	Problems Checklist	This 16-item tool assesses the daily living, relationship, emotion, and economic problems of patients with cancer Patients rate the extent to which they had difficulties or worries recently; scale ranges from 0 (no difficulty) to 3 (severe difficulty).	Social support	-	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1590
14	Supportive Care Needs Survey (SCNS)	This 59-item tool assesses the physical and daily living, psychologic, health system and information, sexuality, and patient care and support needs of patients with cancer. Patients rate their level of need in the past month; scale ranges from 1 (no need/not applicable) to 5 (high need)	Social support	-	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1591
15	Supportive Care Needs Survey-Short Form (SCNS-SF34)	This 34-item tool assesses the physical and daily living, psychologic, health system and information, sexuality, patient care and support needs of patients with cancer. Patients rate their level of need in the past month; scale ranges from 1 (no need/not applicable) to 5 (high need).	Unmet needs	Adults diagnosed with cancer	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1592
16	CancerSupportSource	CancerSupportSource (CSS) is the first comprehensive distress screening program developed for community-based hospitals, physician practices and advocacy organizations to integrate screening, referral and follow-up care, through a single, streamlined, program. CancerSupportSourceSM can be used in any cancer care setting. CancerSupportSourceSM is designed with the community practice setting in mind, where 85% of cancer patients are treated. CSS allows health care teams to thoroughly assess and address needs of patients identified with distress. CSS integrates institutional and community programs to provide the necessary support resources improving overall quality of care, patient satisfaction and institutional efficiency. In less than 10 minutes, patients can complete a 25-item screening tool on any computer or tablet (at home or in office) with a standard browser. CancerSupportSourceSM provides the patient with a Personal Support Care Plan with information and referrals for support services which can be emailed or printed. Providers receive a Patient Distress Management Report—a summary score of a patient’s results, including actionable clinical alerts to help staff triage a response. CancerSupportSourceSM enables patients to not only rate their concerns but to identify what specific assistance is needed. As a complete program offering automated screening, referral and follow-up for busy oncology settings, reports are instantly generated including resource fact sheets that can be customized for any institution. CSS is HIPAA compliant and can be linked to the EHR using HL7 and web services interface. CancerSupportSource is ready and available for implementation. It has been validated against standardized measures and pilot tested in multiple sites.	Stress/distress	Adults with cancer	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1795
17	Distress Thermometer	Together with five distress domains, the DT is the main distress management measure recommended by the National Comprehensive Cancer Network (NCCN). The DT is a simple, self-report, pencil and paper measure consisting of a line with a 0-to-10 scale anchored at the zero point with “No Distress” and at scale point 10 with “Extreme Distress.” Patients are asked to answer the question “How distressed have you been during the past week on a scale of 0 to 10?” by marking their answer on the scale. The recommended cutoff was 4 versus 5, but in 2007 was revised to 3 versus 4.	Stress/distress	Adults; survivors; palliative	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1118
18	James Supportive Care Screening	The James Supportive Care Screening (SCS) is a distress screening instrument including six factors (i) emotional concerns, (ii) physical symptoms, (iii) social/practical problems, (iv) spiritual concerns, (v) cognitive concerns, and (vi) healthcare decision-making/communication. The James SCS was validated in three phases: content validation, factor analysis, and measure validation. The SCS has good to excellent internal consistency, test-retest reliability and convergent, divergent and predictive validity. Specificity of individual items was 0.90 and 0.87, respectively, for identifying patients with DSM-IV-TR diagnoses of major depression and generalized anxiety disorder. The James SCS can be used to quickly detect the most frequent and distressing symptoms and concerns of cancer patients. It is an efficient, reliable and valid clinical and research outcomes measure.	Stress/distress	Cancer patients at all phases	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1797
19	Life Stress Scale	Life Stress Scale is a 19-item measure assess degree of stress on multiple life contexts e.g., family life. Each item is scored on a scale from 1 (extreme stress) to 5 (no stress) and the scores are averaged to form the total Life Stress Score. The Cronbach's alpha ranged from 0.86-.88 in studies with multiethnic samples of BCS. The measure is available in Spanish and demonstrates excellent reliability (0.77- 0.86) in multiethnic studies (Ashing-Giwa et al., 2004; 2012)	Stress/distress	-	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1789
20	Needs Assessment for Advanced Cancer Patients (NA-ACP)	The NA-ACP is one of the first multi-dimensional instruments specifically designed to assess the needs of patients with advanced, incurable cancer.	Unmet needs	Cancer patients with advanced, incurable cancer	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1610
21	Needs Assessment for Advanced Lung Cancer Patients (NA-ALCP)	The original Needs Assessment for Advanced Cancer Patients (NA-ACP) is a 132-item self-report measure designed to assess the perceived needs of patients with advanced, incurable cancer. However, the average time to completion (76 minutes) was too long for patients with advanced disease. The current scale (NA-ALCP) is a shorted 38-item version and assesses the same 7 needs domains as the original NA-ACP: (1) medical communication/information, (2) psychological/emotional, (3) daily living, (4) financial, (5) symptom, (6) spiritual, and (7) social. However, internal consistency for the spiritual scale was very low (Schofield et al., 2012), so it is advised to drop the spiritual scale. Individuals respond to items on a four-point scale (no need, low need, moderate need, and high need).	Unmet needs	Patients diagnosed with inoperable (terminal) lung cancer	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1612
22	Needs Assessment Tool: (NAT) or (PC-NAT) or (NAT: PD-C)	The NAT or NAT:PD-C or PC-NAT is a one-page assessment tool meant for use by health professionals who work with advanced cancer patients. The tool assesses palliative care needs of the patient based on assessment of the complexity and severity of the patient's physical and psychosocial needs. This is to be used in both generalist and specialist settings. There are 5 sections of the original PC-NAT (2008) 1. 3 items assessing absence of caregiver, patient/caregiver request for specialist palliative care services (SPCS), and health professional's needs for assistance 2. 7 items that assess patient's well-being (physical, functional status, psychological, information, spiritual/existence, health beliefs/cultural, and financial/legal) 3. 5 items to asses the ability of the caregiver/family to care for patient 4. 2 items to assess the caregiver's well being 5. 1 item to asses whether the health professional thought the patient needed assessment by a SPCS. However, in a follow-up study in 2010 revised the NAT to include four sections: 1. 3 items assessing: presence/ absence of caregiver, patient/caregiver request for specialist palliative care services (SPCS) referral, and health professional's needs for assistance 2. 7 items that assess patient's well-being (physical, functional status, psychological, information, spiritual/existence, health beliefs/cultural, and financial/legal) 3. 5 items to assess the ability of the caregiver/family to care for patient 4. 2 items to assess the caregiver's well being	Unmet needs	Health professionals who work with cancer patients	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1615
23	Needs Evaluation Questionnaire (NEQ)	Tamburini et al. (2000) This is a 23-item scale that measures unmet needs for cancer patients. Items are grouped into four subscales: a. informative needs about diagnosis/prognosis b. informative needs about exam/treatments c. communicative needs d. relational needs Annunziata et al. (2009) conducted additional exploratory factor analyses and confirmatory factor analyses and found evidence for 5 factors/subscales: a. informative needs b. needs related to assistance/care c. relational needs d. needs for psychoemotional support e. material needs	Unmet needs	Cancer patients / survivors	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1614
24	Needs Near the End of Life Scale (NEST)	This is a multi-dimensional scale designed for those who are terminally ill to assess their experiences and perspectives regarding their care.	Unmet needs	Terminally ill patients	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1613
25	Problems and Needs in Palliative Care (PNPC)	The PNPC was constructed as a comprehensive checklist of the problems patients experience in palliative care, and their needs for care (addressed as their desire for (more) professional attention). Assesses the physical/daily living, psychologic, social, spiritual, information, financial, sexuality, caregiver/family, quality of care, and general practitioner/specialist needs of patients with cancer in palliative setting.	Unmet needs	-	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1588
26	Problems and Needs in Palliative Care-short version (PNPC-sv)	The original Problems and Needs in Palliative Care questionnaire (PNPC) instrument is a comprehensive checklist of problems and needs for palliative care. With its 90 items, however, it is not always practical. Thus it was abridged to a short version with 33 items. This tool assesses the physical/daily living, autonomy, psychologic, social, spiritual, information, and financial needs of patients with cancer in palliative setting. The patient rates the degree of problem; scale ranges from 1 (yes) to 2 (somewhat) to 3 (no). Patient also rates desire for professional attention for each problem; scale ranges from 1 (yes, more) to 2 (as much as now) to 3 (no)	Unmet needs	-	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1589
27	Screen for Palliative and End-of-Life Care Needs in the Emergency Department (SPEED)	This 13-item health professional–completed screening tool assesses the physical, spiritual, social, therapeutic, and psychologic needs of patients with cancer receiving palliative care admitted to the emergency department The patient rates the level of need; scale ranges from 0 (not at all) to 10 (a great deal)	Unmet needs	Patients with cancer in the emergency department	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1594
28	Sheffield Profile for Assessment and Referral to Care (SPARC-45)	SPARC is a multi-dimensional screening questionnaire, which gives a profile of needs to identify patients who could benefit from additional supportive or palliative care, regardless of diagnosis. This 45-item screening tool assesses communication and information, physical symptom, psychologic, religious and spiritual, independence and activity, family, social, and treatment needs of patients with advanced cancer. The patient rates level of need on a scale ranging from 0 (not at all) to 3 (very much) and desire for help from health team on a yes/no scale.	Unmet needs	-	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1595
29	Supportive Needs Screening Tool (SNST)	This 40-item tool assesses physical, social, psychologic, information, spiritual needs for use in an outpatient oncology setting. Patients rate the presence of need experienced on a yes/no scale; time periods defined for specific needs based on evidence and clinician-defined usefulness (e.g., pain experienced in last week, emotions experienced in last 2 weeks)	Unmet needs	-	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1593
30	Survivors Unmet Needs Survey	The Survivors Unmet Needs Survey is a 89-item measure designed to assess the unmet needs of adult cancer survivors who are 1 or more years post-diagnosis. This survey consists of 5 subscales: 1) Emotional health needs, 2) Access and continuity of care needs, 3) Relationships, 4) Financial concerns, and 5) Information needs.	Unmet needs	Cancer survivors	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1389
31	Hospital Anxiety and Depression Scale	This 14-item measure assesses anxiety and depressive symptoms. Item content is intended to minimize somatic symptoms, to facilitate use with medical patients. Cut-off scores are available to assist interpretation.	Anxiety and depression	Adults	https://www.gem-beta.org/Public/DownloadMeasure.aspx?mid=1177
32	Patient Health Questionnaire (PHQ-9)	A 9-item scale using each of the 9 DSM-IV criteria with self-reported frequency of “0” (not at all) to “3” (nearly every day). One of the most widely used instruments to assess depression, PHQ-9 scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe, and severe depression, respectively.	Depression	adults; primary care patients	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1096
33	Cancer and Treatment Distress (CTXD) Scale	The CTXD is designed to assess distress specific to cancer and its treatment, as distinct from general anxiety or depression.	Stress/distress	Adults with cancer	https://www.gem-beta.org/public/DownloadMeasure.aspx?mid=1417

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