Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences



Major Advisor

Linda Cain


The landscape of cancer care has changed dramatically over the past several decades. An illness that was once often fatal, now represents both an acute life threatening illness and a chronic condition. While there have been tremendous advancements in the treatment of the physiological aspects of cancer, management of related psychosocial and emotional issues have not seen this same progress. Limited information exists related to both the evaluation and outcome metrics associated with the screening and management of psychiatric sequelae after referral to specialized psychiatric services in cancer patient populations. This capstone project focused on (a) implementation of consistent use of the Patient Health Questionnaire 9-item (PHQ-9) survey for patients seeing a provider in the Norton Cancer Institute Behavioral Oncology Program (NCIBOP) at each outpatient visit, (b) assessment of patient outcomes for changes in depression scores, (c) review of clinical interventions by providers, and (d) identification of opportunities for integration of psychiatric practice guidelines. Evidence-based practice guidelines were incorporated. The major findings were sequential assessment paired with evidence-based interventions lead to statistically significant reduction in PHQ-9 and Distress scores. Keywords: depression, distress, anxiety, coping, stress, cancer, psychosocial support, neoplasms, oncology, psychosocial support, psychotherapy, psychiatry, interventions, groups, quality of life, quality, outcomes, insurance, mental health