Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.
Faculty of Psychology and Sport Science, University of Innsbruck, Innsbruck, Austria.
Psychooncology. 2018 Apr;27(4):1312-1319. doi: 10.1002/pon.4675. Epub 2018 Mar 24.
In this retrospective investigation of patient pathways to psycho-oncological treatment (POT), we compared the number of POT referrals before and after implementation of electronic screening for POT needs and investigated psychosocial predictors for POT wish at a nuclear medicine department.
We extracted medical chart information about number of referrals and extent of follow-up contacts. During standard referral (November 2014 to October 2015), POT needs were identified by clinical staff only. In the screening-assisted referral period (November 2015 to October 2016), identification was supported by electronic screening for POT needs. Psychosocial predictors for POT wish were examined using logistic regression.
We analysed data from 487 patients during standard referral (mean age 56.4 years; 60.2% female, 88.7% thyroid carcinoma or neuroendocrine tumours) of which 28 patients (5.7%) were referred for POT. Of 502 patients in the screening-assisted referral period (mean age 57.0 years; 55.8% female, 86.6% thyroid carcinoma or neuroendocrine tumours), 69 (13.7%) were referred for POT. Of these, 36 were identified by psycho-oncological (PO) screening and 33 by clinical staff. After PO-screening implementation, referrals increased by a factor of 2.4. The strongest predictor of POT wish was depressive mood (P < .001). During both referral periods, about 15% of patients visited the PO outpatient unit additionally to inpatient PO consultations.
Our results provide evidence from a real-life setting that PO screening can foster POT referrals, reduce barriers to express the POT wish, and hence help to meet psychosocial needs of this specific patient group. Differences between patients' needs, wish, and POT uptake should be further investigated.
在这项对心理肿瘤治疗（POT）患者路径的回顾性研究中，我们比较了实施 POT 需求电子筛查前后 POT 转介的数量，并调查了核医学部门 POT 意愿的社会心理预测因素。
我们提取了有关转介数量和随访联系程度的医疗记录信息。在标准转介期间（2014 年 11 月至 2015 年 10 月），仅由临床工作人员确定 POT 需求。在筛查辅助转介期间（2015 年 11 月至 2016 年 10 月），通过电子筛查 POT 需求来支持识别。使用逻辑回归检查 POT 意愿的社会心理预测因素。
我们分析了标准转介期间 487 名患者的数据（平均年龄 56.4 岁；60.2%为女性，88.7%为甲状腺癌或神经内分泌肿瘤），其中 28 名患者（5.7%）被转介进行 POT。在筛查辅助转介期间，502 名患者（平均年龄 57.0 岁；55.8%为女性，86.6%为甲状腺癌或神经内分泌肿瘤）中，有 69 名（13.7%）被转介进行 POT。其中，36 名是通过心理肿瘤学（PO）筛查确定的，33 名是由临床工作人员确定的。实施 PO 筛查后，转介数量增加了 2.4 倍。POT 意愿的最强预测因素是抑郁情绪（P<0.001）。在这两个转介期间，大约 15%的患者除了住院 PO 咨询外，还额外到 PO 门诊就诊。
我们的结果提供了来自实际情况的证据，表明 PO 筛查可以促进 POT 转介，减少表达 POT 意愿的障碍，从而有助于满足这一特定患者群体的社会心理需求。应进一步研究患者需求、意愿和 POT 使用率之间的差异。
