Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, United Kingdom.
Cancer. 2012 Dec 15;118(24):6260-9. doi: 10.1002/cncr.27648. Epub 2012 Jun 6.
There is considerable uncertainty regarding the acceptability of routine distress screening.
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).
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.
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.
常规痛苦筛查的可接受性存在很大的不确定性。
在一项未获得资金支持的实施研究中，作者要求 50 名临床医生（化疗护士和治疗放射技师/放射技术员）在常规护理中实施痛苦筛查计划，并在每次临床接触后记录他们的反馈。共有 379 名患者接受了简单的纸笔版痛苦温度计和情绪温度计（ET）筛查。
在所有筛查应用中，临床医生认为在 43%的评估中筛查是有用的，在 35.9%的评估中是无用的，在 21.1%的评估中是不确定或中立的。该筛查计划的应用在 41.9%的评估后帮助工作人员改变了他们的临床意见，临床医生认为筛查计划在超过 50%的评估中有助于沟通。然而，37.5%的人认为筛查在常规使用中不切实际，而且化疗护士比放射技师更认为筛查计划“无用”。在多变量分析中，有 3 个变量与工作人员对筛查的高度满意度相关，即接受过先前的培训、与患者谈论心理社会问题以及更好地发现心理问题。对筛查的正面看法也与临床意见的改变有关。
癌症临床医生对常规痛苦筛查的看法喜忧参半：约 33%的人认为筛查无用/不切实际，而超过 50%的人认为筛查促进了良好的沟通和/或有助于识别。对筛查更积极的临床医生在沟通和识别方面从筛查中获得了更大的益处。
