Queensland University of Technology, Brisbane, Australia.
BMC Cancer. 2011 Feb 1;11:48. doi: 10.1186/1471-2407-11-48.
Despite evidence that up to 35% of patients with cancer experience significant distress, access to effective psychosocial care is limited by lack of systematic approaches to assessment, a paucity of psychosocial services, and patient reluctance to accept treatment either because of perceived stigma or difficulties with access to specialist psycho-oncology services due to isolation or disease burden. This paper presents an overview of a randomised study to evaluate the effectiveness of a brief tailored psychosocial Intervention delivered by health professionals in cancer care who undergo focused training and participate in clinical supervision.
METHODS/DESIGN: Health professionals from the disciplines of nursing, occupational therapy, speech pathology, dietetics, physiotherapy or radiation therapy will participate in training to deliver the psychosocial Intervention focusing on core concepts of supportive-expressive, cognitive and dignity-conserving care. Health professional training will consist of completion of a self-directed manual and participation in a skills development session. Participating health professionals will be supported through structured clinical supervision whilst delivering the Intervention. In the stepped wedge design each of the 5 participating clinical sites will be allocated in random order from Control condition to Training then delivery of the Intervention. A total of 600 patients will be recruited across all sites. Based on level of distress or risk factors eligible patients will receive up to 4 sessions, each of up to 30 minutes in length, delivered face-to-face or by telephone. Participants will be assessed at baseline and 10-week follow-up. Patient outcome measures include anxiety and depression, quality of life, unmet psychological and supportive care needs. Health professional measures include psychological morbidity, stress and burnout. Process evaluation will be conducted to assess perceptions of participation in the study and the factors that may promote translation of learning into practice.
This study will provide important information about the effectiveness of a brief tailored psychological Intervention for patients with cancer and the potential to prevent development of significant distress in patients considered at risk. It will yield data about the feasibility of this model of care in routine clinical practice and identify enablers and barriers to its systematic implementation in cancer settings.
ACTRN12610000448044.
尽管有证据表明多达 35%的癌症患者经历着显著的痛苦，但由于缺乏系统的评估方法、缺乏心理社会服务以及患者由于认为存在污名化或由于隔离或疾病负担而难以获得专科心理肿瘤学服务而不愿意接受治疗，因此获得有效的心理社会护理受到限制。本文介绍了一项随机研究的概述，该研究评估了由接受过重点培训并参与临床监督的癌症护理卫生专业人员提供的简短定制心理社会干预的有效性。
方法/设计：护理、职业治疗、言语病理学、营养学、物理治疗或放射治疗等学科的卫生专业人员将参加培训，以提供侧重于支持性表达、认知和尊严保护护理核心概念的心理社会干预。卫生专业人员培训将包括完成自我指导手册和参加技能发展课程。在提供干预的过程中，参与的卫生专业人员将通过结构化临床监督得到支持。在阶梯式楔形设计中，将按照随机顺序从对照条件分配给 5 个参与临床站点中的每一个，然后是培训，最后是干预的实施。总共将在所有站点招募 600 名患者。根据焦虑程度或风险因素，符合条件的患者将接受最多 4 次每次 30 分钟的面对面或电话治疗。参与者将在基线和 10 周随访时进行评估。患者结局指标包括焦虑和抑郁、生活质量、未满足的心理和支持性护理需求。卫生专业人员指标包括心理发病率、压力和倦怠。将进行过程评估以评估对参与研究的看法以及可能促进将学习转化为实践的因素。
这项研究将提供有关癌症患者简短定制心理干预有效性的重要信息，并有可能预防被认为有风险的患者出现明显的痛苦。它将提供有关在常规临床实践中实施这种护理模式的可行性的数据，并确定在癌症环境中系统实施的促进因素和障碍。
ACTRN12610000448044。
