Psycho-Oncology Service and Department Consultation-Liaison Psychiatry, Calvary Mater Newcastle, Australia; Centre for Brain and Mental Health, University of Newcastle, NSW, Australia.
Psychooncology. 2012 Nov;21(11):1149-57. doi: 10.1002/pon.2020. Epub 2011 Jul 21.
To describe the change in pain and distress over time to demonstrate the effectiveness of the QUICATOUCH program in an outpatient oncology population.
Descriptive study of the first 29 months of the QUICATOUCH program (13 736 assessments for 5775 patients). A longitudinal cohort design was used to examine the patients with three or more assessments (8129 assessments for 1778 patients). Effectiveness of this complex intervention (repeated assessment, clinician report and referral to speciality psycho-oncology service) was examined using: reduction in proportion over threshold for pain and distress, predictors of mean pain and distress scores and comparison of the number of new patients treated by the psycho-oncology service during the study and in the preceding 29 months.
Pain and distress declined during the study. The risk of being over threshold at endpoint was reduced for pain (odds ratio (OR) 0.70, confidence interval (CI) 95% 0.60-0.81) and for distress (OR 0.58 CI 95% 0.49-0.68) with baseline as referent level. Three variables predicted the mean pain: clinic type, current radiotherapy treatment and distress score; and five predicted mean distress: time, gender, clinic type, age and pain score. There was an increase of 40% (533v747) in new patients treated by the psycho-oncology service.
The QUICATOUCH assessment for pain and distress was implemented into usual clinical practice with reasonable coverage of patients for modest cost. It was effective in monitoring the patients over time, contributed to a reduction in pain and distress, whilst appropriately increasing the number of new patients reaching psychological treatment as part of the clinical service.
描述疼痛和痛苦随时间的变化，以证明 QUICATOUCH 计划在门诊肿瘤患者中的有效性。
对 QUICATOUCH 计划的前 29 个月（5775 名患者的 13736 次评估）进行描述性研究。采用纵向队列设计，对接受三次或三次以上评估的患者（1778 名患者的 8129 次评估）进行研究。使用以下方法检查这种复杂干预措施（重复评估、临床医生报告和转介至专业心理肿瘤学服务）的有效性：疼痛和痛苦超过阈值的比例减少、平均疼痛和痛苦评分的预测因素以及比较研究期间和之前 29 个月接受心理肿瘤学服务治疗的新患者数量。
研究期间疼痛和痛苦减轻。与基线作为参考水平相比，终点时疼痛（比值比（OR）0.70，95%置信区间（CI）0.60-0.81）和痛苦（OR 0.58，95%CI 0.49-0.68）超过阈值的风险降低。三个变量预测平均疼痛：诊所类型、当前放疗治疗和痛苦评分；五个变量预测平均痛苦：时间、性别、诊所类型、年龄和疼痛评分。接受心理肿瘤学服务治疗的新患者增加了 40%（533 例比 747 例）。
QUICATOUCH 用于疼痛和痛苦的评估已被纳入常规临床实践，患者的覆盖范围合理，费用适中。它在监测患者随时间的变化方面是有效的，有助于减轻疼痛和痛苦，同时适当增加新患者接受心理治疗的数量，作为临床服务的一部分。
