Wenckebach Institute, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Department of Psychology, University of Groningen, Department of Psychology, Groningen, the Netherlands.
PLoS One. 2018 Jun 14;13(6):e0198722. doi: 10.1371/journal.pone.0198722. eCollection 2018.
This observational clinical study investigated patients' experiences with and opinions on the Dutch 'Screening of Distress and Referral Need' (SDRN) process implemented in oncology practice. Insight into these can guide improvement of the SDRN process.
Patients from hospitals that had implemented SDRN for at least a year completed questions on experiences with essential SDRN process steps (1: completion of the Distress Thermometer and Problem List as screening instrument (DT&PL), 2: information on SDRN+DT&PL, 3: information on referral options, 4: discussing DT&PL responses, 5: referral when needed), and on opinions about SDRN and DT&PL. Descriptive and univariate analyses were conducted.
Of the 498 participants (response = 54%), 81% completed a DT&PL, of whom 86-87% was exposed to steps 2-3 and 76% discussed responses; only three needing care were not offered referral. Sixty-one percent encountered all SDRN steps and 78% would recommend SDRN to others. Recommending SDRN is related to more frequent DT&PL completion (t = -2.5; p≤0.01), receipt of information on SDRN+DT&PL and referral options (X2 = 4.9; p≤0.05 and X2 = 5.9; p≤0.05 respectively), discussion of responses (X2 = 10.2; p≤0.001), and fuller exposure to SDRN process steps (X2 = 14.8; p≤0.01). Percentages (strongly) agreeing were highest on the DT&PL being useful (90%) and suitable (88%), and lowest on burdensome (31%) and time-consuming (28%).
The majority of participating patients encountered the steps of the SDRN process considered essential, with 3/5 having encountered all steps. Referral is largely targeted to patients' need. Patients' perceived benefit of SDRN increases with fuller exposure to all process steps. Therefore, improvements, particularly in DT&PL completion and discussion of responses should be made.
本观察性临床研究调查了患者对荷兰“筛查痛苦和转介需求”（SDRN）在肿瘤学实践中实施的过程的体验和看法。深入了解这些问题可以指导 SDRN 流程的改进。
在实施 SDRN 至少一年的医院中，患者完成了对基本 SDRN 流程步骤（1：完成痛苦温度计和问题清单作为筛查工具（DT&PL），2：SDRN+DT&PL 的信息，3：转介选项的信息，4：讨论 DT&PL 响应，5：需要时转介）的体验以及对 SDRN 和 DT&PL 的看法的问题。进行了描述性和单变量分析。
在 498 名参与者中（应答率=54%），81%完成了 DT&PL，其中 86-87%接触了步骤 2-3，76%讨论了反应；只有 3 名需要护理的患者未被提供转介。61%的患者遇到了所有 SDRN 步骤，78%的患者会向他人推荐 SDRN。推荐 SDRN 与更频繁地完成 DT&PL 相关（t = -2.5；p≤0.01），接受 SDRN+DT&PL 和转介选项的信息（X2 = 4.9；p≤0.05 和 X2 = 5.9；p≤0.05 分别），讨论反应（X2 = 10.2；p≤0.001），以及更全面地接触 SDRN 流程步骤（X2 = 14.8；p≤0.01）。对 DT&PL 有用性（90%）和适用性（88%）的认同率最高，对负担（31%）和耗时（28%）的认同率最低。
大多数参与的患者都遇到了被认为是基本的 SDRN 流程步骤，其中 3/5 的患者遇到了所有步骤。转介主要针对患者的需求。患者对 SDRN 的感知益处随着对所有流程步骤的更全面接触而增加。因此，应该进行改进，特别是在 DT&PL 完成和反应讨论方面。
