How Feasible Is Implementation of Distress Screening by Cancer Clinicians in Routine Clinical Care?

被引:61
|
作者
Mitchell, Alex J. [1 ]
Lord, Karen [2 ]
Slattery, Jo [3 ]
Grainger, Lorraine [2 ]
Symonds, Paul [1 ]
机构
[1] Univ Leicester, Dept Canc Studies & Mol Med, Leicester, Leics, England
[2] Leicester Natl Hlth Serv Trust, Univ Hosp, Dept Chemotherapy, Leicester, Leics, England
[3] Leicester Natl Hlth Serv Trust, Univ Hosp, Dept Radiotherapy, Leicester, Leics, England
关键词
distress; depression; screening; satisfaction; implementation; cancer; diagnosis; QUALITY-OF-LIFE; PSYCHOLOGICAL DISTRESS; BREAST-CANCER; PATIENT; DEPRESSION; COMMUNICATION; WELL; FEASIBILITY; ONCOLOGISTS; RECOGNITION;
D O I
10.1002/cncr.27648
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: There is considerable uncertainty regarding the acceptability of routine distress screening. METHODS: In an unfunded implementation study, the authors asked 50 clinicians (chemotherapy nurses and treatment radiographers/radiation technologists) to implement a screening program for distress as part of routine care and to record their feedback after each clinical encounter. In total, 379 patients were screened using a simple paper-and-pencil versions of distress thermometer and the emotion thermometer (ET). RESULTS: Across all screening applications, clinicians believed that screening was useful during 43% of assessments and was not useful during 35.9% of assessments, and they were unsure or neutral in 21.1% of assessments. The application of the screening program assisted staff in changing their clinical opinion after 41.9% of assessments, and clinicians believed that the screening program helped with communication in >50% of assessments. However, 37.5% believed that screening was impractical for routine use, and more chemotherapy nurses than radiographers rated the screening program as "not useful." On multivariate analysis, 3 variables were associated with high staff satisfaction with screening, namely, receipt of prior training, talking with the patient about psychosocial issues, and improved detection of psychological problems. A favorable perception of screening also was linked to a change in clinical opinion. CONCLUSIONS: Opinions of cancer clinicians regarding routine distress screening were mixed: Approximately 33% considered screening not useful/impractical, whereas >50% n believed promoted good communication and/or helped with recognition. Clinicians who were more positive about screening gained greater benefits from screening in terms of communication and recognition. Cancer 2012; 118:6260-9. (C) 2012 American Cancer Society.
引用
收藏
页码:6260 / 6269
页数:10
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