Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands; Department of Health Services Research, CAPHRI School for Public Health and Primary, Maastricht University, Maastricht, The Netherlands.
Patient Educ Couns. 2013 Nov;93(2):289-97. doi: 10.1016/j.pec.2013.06.015. Epub 2013 Aug 28.
This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication.
A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention.
Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (P<0.01). No effects were observed for numbers of referred patients, or for improved patient-radiotherapist communication.
Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients.
Psychosocial screening can be enhanced by effective radiotherapist-patient communication.
本研究旨在检验使用筛查工具是否能提高向心理社会照护提供者（如心理学家）转介的比例，并促进患者与放射治疗师之间的沟通。
采用了一项整群随机对照试验。14 名放射治疗师被随机分配到实验组或对照组，他们的 568 名患者按照其放射治疗师所属的组接受治疗。实验组的患者在放射治疗开始前和结束时被要求完成一项筛查工具。所有患者在第一次就诊后被要求完成关于医患沟通的问卷，并在干预后 3 个月和 12 个月完成关于心理社会照护的问卷。
完成筛查工具的患者比未完成的患者更早被转介给社工（P<0.01）。但在转介患者的数量或改善患者与放射治疗师的沟通方面，未观察到任何效果。
我们的结果表明，简单的筛查程序对于及时治疗患者的心理社会问题可能是有价值的。未来的努力应致力于确定适当的筛查时机，并提高医生识别、讨论和治疗癌症患者心理社会问题的意识。
有效的放射治疗师-患者沟通可以增强心理社会筛查。
