From CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.
J Natl Compr Canc Netw. 2016 Oct;14(10):1259-1266. doi: 10.6004/jnccn.2016.0135.
Although published studies report that screening for distress (SFD) improves the quality of care for patients with cancer, little is known about how SFD impacts healthcare professionals (HCPs).
This quality improvement project examined the impact of implementing the SFD intervention on HCPs' confidence in addressing patient distress and awareness of person-centered care.
This project involved pre-evaluation and post-evaluation of the impact of implementing SFD. A total of 254 HCPs (cohort 1) were recruited from 17 facilities across the province to complete questionnaires. SFD was then implemented at all cancer care facilities over a 10-month implementation period, after which 157 HCPs (cohort 2) completed post-implementation questionnaires. At regional and community care centers, navigators supported the integration of SFD into routine practice; therefore, the impact of navigators was examined.
HCPs in cohort 2 reported significantly greater confidence in managing patients' distress and greater awareness about person-centered care relative to HCPs in cohort 1. HCPs at regional and community sites reported greater awareness in person-centeredness before and after the intervention, and reported fewer negative impacts of SFD relative to HCPs at tertiary sites. Caring for single or multiple tumor types was an effect modifier, with effects observed only in the HCPs treating multiple tumors.
Implementation of SFD was beneficial for HCPs' confidence and awareness of person-centeredness. Factors comprising different models of care, such as having site-based navigators and caring for single or multiple tumors, influenced outcomes.
尽管已发表的研究报告表明,对患者的痛苦状况进行筛查(SFD)可以提高癌症患者的护理质量,但人们对 SFD 如何影响医疗保健专业人员(HCPs)知之甚少。
本质量改进项目研究了实施 SFD 干预措施对 HCPs 处理患者痛苦和关注以患者为中心的护理的信心的影响。
该项目涉及实施 SFD 前后的影响评估。共从全省 17 个机构招募了 254 名 HCPs(队列 1)来完成问卷调查。在 10 个月的实施期内,在所有癌症护理机构实施 SFD 后,有 157 名 HCPs(队列 2)完成了实施后的问卷调查。在区域和社区护理中心,导航员支持将 SFD 纳入常规实践;因此,考察了导航员的影响。
与队列 1 相比,队列 2 的 HCPs 在管理患者痛苦方面的信心显著增强,对以患者为中心的护理的认识也显著增强。区域和社区站点的 HCPs 在干预前后对以患者为中心的认识更高,并且报告 SFD 的负面影响相对较少与三级站点的 HCPs 相比。照顾单个或多个肿瘤类型是一个调节因素,仅在治疗多个肿瘤的 HCPs 中观察到效果。
实施 SFD 对 HCPs 的信心和以患者为中心的意识有益。不同的护理模式构成因素,如基于站点的导航员和照顾单个或多个肿瘤,都影响了结果。