Yale University School of Nursing, New Haven, Connecticut.
Women's Center, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut.
Palliat Support Care. 2014 Feb;12(1):75-80. doi: 10.1017/S147895151300059X. Epub 2013 Oct 29.
To evaluate the feasibility of implementing psychosocial distress screening in a breast center of a comprehensive cancer center, using a model of structure (personnel, resources), process (screening), and outcome (number of patients screened, number referred).
The first step in the project was to establish administrative support, educate and engage breast center staff, identify stakeholders and persons with expertise in the conduct of evidence based initiatives. A two-phase implementation approach was agreed upon with Phase I being screening of new patients in surgical oncology and Phase II being screening women in medical oncology.
A total of 173 patients were screened. The new patients screened in surgical oncology reported higher average distress scores compared to patients in medical oncology (5.7 vs. 4.0). However, a greater number of patients in medical oncology reported scores >4 compared to the new patients screened in surgery (54% vs. 35%). Psychological distress was the most commonly reported distress for patients in surgery. In contrast, 60% of scores >4 in medical oncology were symptom related, managed by the nurse or physician.
Nurse led implementation of psychosocial distress screening is feasible, addressing this important quality indicator of patient-centered care.
评估在综合癌症中心的乳腺中心实施心理困扰筛查的可行性，使用结构（人员、资源）、过程（筛查）和结果（筛查患者数量、转介患者数量）模型。
该项目的第一步是建立行政支持，对乳腺中心的工作人员进行教育和参与，确定利益相关者和具有循证举措实施专业知识的人员。商定了两阶段实施方法，第一阶段是对外科肿瘤学的新患者进行筛查，第二阶段是对内科肿瘤学的女性进行筛查。
共筛查了 173 名患者。与内科肿瘤学的患者相比，外科肿瘤学新筛查患者的平均困扰评分更高（5.7 对 4.0）。然而，与外科新筛查患者相比，内科肿瘤学中有更多的患者报告评分>4（54%对 35%）。心理困扰是手术患者最常报告的困扰。相比之下，内科肿瘤学中>4 的评分有 60%与症状相关，由护士或医生管理。
护士主导的心理困扰筛查实施是可行的，解决了以患者为中心的护理的这一重要质量指标。
