Pirl William F, Muriel Anna, Hwang Vivian, Kornblith Alice, Greer Joseph, Donelan Karen, Greenberg Donna B, Temel Jennifer, Schapira Lidia
Department of Psychiatry, Massachusetts General Hospital Cancer Center, Boston, Massachusetts 02114, USA.
J Support Oncol. 2007 Nov-Dec;5(10):499-504.
Little is known about the dissemination and uptake of National Comprehensive Cancer Network (NCCN) guidelines for psychosocial distress in oncology practice. This study surveyed oncologists about their awareness of NCCN guidelines on psychosocial distress and their methods of screening patients for distress. In all, 1,000 oncologists practicing in the United States who were members of the American Society of Clinical Oncology were asked to complete an anonymous questionnaire. Predictors of routine screening for distress were identified using logistic regression. Overall, 46% (448/965) of the oncologists responded. Almost two thirds (63.4%) practiced in the community, 27.2% practiced in cancer centers, and 6.9% practiced in hospitals. Less than one-third (32.3%) reported being at least somewhat familiar with NCCN guidelines. Two-thirds (65.0%; 95% confidence interval, 60.6-69.4) reported screening patients for distress routinely, but only 14.3% used a screening instrument. Independent predictors for screening patients for distress included availability of mental health services, knowledge of NCCN guidelines, experience, lack of time, uncertainty about identifying distress, and female gender of the practitioner. NCCN guidelines for psychosocial distress do not appear to be widely disseminated. Whereas the majority of oncologists reported routinely screening patients for distress, only a small percentage followed the guidelines by using a screening instrument. Future efforts should focus on the dissemination and validation of the NCCN guidelines.
关于国家综合癌症网络（NCCN）肿瘤学实践中社会心理困扰指南的传播和应用情况，人们了解甚少。本研究对肿瘤学家进行了调查，询问他们对NCCN社会心理困扰指南的知晓情况以及筛查患者困扰的方法。总共邀请了1000名在美国执业且为美国临床肿瘤学会会员的肿瘤学家填写一份匿名问卷。使用逻辑回归确定困扰常规筛查的预测因素。总体而言，46%（448/965）的肿瘤学家做出了回应。近三分之二（63.4%）在社区执业，27.2%在癌症中心执业，6.9%在医院执业。不到三分之一（32.3%）的人表示至少对NCCN指南有所了解。三分之二（65.0%；95%置信区间，60.6 - 69.4）的人报告常规筛查患者的困扰，但只有14.3%使用筛查工具。筛查患者困扰的独立预测因素包括心理健康服务的可及性、对NCCN指南的了解、经验、时间不足、识别困扰的不确定性以及从业者的女性性别。NCCN社会心理困扰指南似乎并未得到广泛传播。虽然大多数肿瘤学家报告常规筛查患者的困扰，但只有一小部分人按照指南使用筛查工具。未来的努力应集中在NCCN指南的传播和验证上。
