Scialla Michele A, Canter Kimberly S, Chen Fang Fang, Kolb E Anders, Sandler Eric, Wiener Lori, Kazak Anne E
Nemours Alfred I duPont Hospital for Children, Nemours Center for Cancer and Blood Disorders, Wilmington, Delaware.
Nemours Children's Health System, Nemours Center for Healthcare Delivery Science, Wilmington, Delaware.
Pediatr Blood Cancer. 2017 Nov;64(11). doi: 10.1002/pbc.26634. Epub 2017 May 19.
Fifteen evidence-based Standards for Psychosocial Care for Children with Cancer and Their Families (Standards) were published in 2015. The Standards cover a broad range of topics and circumstances and require qualified multidisciplinary staff to be implemented. This paper presents data on the availability of psychosocial staff and existing practices at pediatric oncology programs in the United States, providing data that can be used to advocate for expanded services and prepare for implementation of the Standards.
Up to three healthcare professionals from 144 programs (72% response rate) participated in an online survey conducted June-December 2016. There were 99 pediatric oncologists with clinical leadership responsibility (Medical Director/Clinical Director), 132 psychosocial leaders in pediatric oncology (Director of Psychosocial Services/Manager/most senior staff member), and 58 administrators in pediatric oncology (Administrative Director/Business Administrator/Director of Operations). The primary outcomes were number and type of psychosocial staff, psychosocial practices, and identified challenges in the delivery of psychosocial care.
Over 90% of programs have social workers and child life specialists who provide care to children with cancer and their families. Fewer programs have psychologists (60%), neuropsychologists (31%), or psychiatrists (19%). Challenges in psychosocial care are primarily based on pragmatic issues related to funding and reimbursement.
Most participating pediatric oncology programs appear to have at least the basic level of staffing necessary to implement of some of the Standards. However, the lack of a more comprehensive multidisciplinary team is a likely barrier in the implementation of the full set of Standards.
2015年发布了15项针对癌症患儿及其家庭的循证心理社会护理标准（以下简称“标准”）。这些标准涵盖了广泛的主题和情况，需要合格的多学科工作人员来实施。本文介绍了美国儿科肿瘤项目中心理社会工作人员的配备情况及现有实践的数据，这些数据可用于倡导扩大服务范围，并为标准的实施做准备。
2016年6月至12月，来自144个项目（回复率72%）的多达三名医疗保健专业人员参与了一项在线调查。其中有99名承担临床领导职责的儿科肿瘤学家（医学主任/临床主任）、132名儿科肿瘤领域的心理社会服务负责人（心理社会服务主任/经理/最高级工作人员）以及58名儿科肿瘤领域的行政人员（行政主任/业务管理员/运营主任）。主要结果包括心理社会工作人员的数量和类型、心理社会护理实践以及在提供心理社会护理过程中发现的挑战。
超过90%的项目配备了为癌症患儿及其家庭提供护理的社会工作者和儿童生活专家。配备心理学家（60%）、神经心理学家（31%）或精神科医生（19%）的项目较少。心理社会护理方面的挑战主要基于与资金和报销相关的实际问题。
大多数参与调查的儿科肿瘤项目似乎至少具备实施部分标准所需的基本人员配置水平。然而，缺乏更全面的多学科团队可能是全面实施整套标准的一个障碍。
