Department of Psychology, The Hospital for Sick Children, Toronto, Canada.
Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
Pediatr Blood Cancer. 2018 Dec;65(12):e27429. doi: 10.1002/pbc.27429. Epub 2018 Aug 29.
Although systematic psychosocial screening has been established as a standard of psychosocial care in pediatric oncology, this is not yet widely implemented in clinical practice. Limited information is available regarding the reasons behind this. In this study, we investigated perceptions of psychosocial screening by health care providers (HCPs) involved in pediatric cancer care.
Using purposeful sampling, 26 HCPs (11 oncologists, 8 nurses, and 7 social workers) from a large North American pediatric cancer center participated in semistructured interviews. Interviews were recorded and transcribed verbatim. Themes were then derived using content analysis.
The themes were organized into perceived benefits of and barriers to psychosocial risk screening, and practical issues regarding implementation. Perceived benefits of screening included obtaining concise documentation of family psychosocial risk, identifying psychosocial factors important to medical treatment, starting a conversation, and triaging patients to psychosocial services. Barriers included perceived limited institutional support, commitment, and resources for psychosocial services, limited knowledge and appreciation of existing evidence-based validated tools, concerns about diverse family cultural backgrounds regarding psychosocial issues and language proficiency, and HCPs' personal values regarding psychosocial screening. Finally, practical issues of implementation including training in psychosocial risk screening, when and how to screen were discussed.
These findings highlight the importance of addressing HCPs' perceptions of benefits, barriers, and practical issues regarding implementing psychosocial risk screening.
尽管系统的心理社会筛查已被确立为儿科肿瘤学心理社会护理的标准，但这在临床实践中尚未得到广泛实施。关于这一现象背后的原因，目前的信息有限。在这项研究中，我们调查了参与儿科癌症护理的医疗保健提供者（HCP）对心理社会筛查的看法。
我们使用目的性抽样，从一家大型北美儿科癌症中心招募了 26 名 HCP（11 名肿瘤学家、8 名护士和 7 名社会工作者）参与半结构化访谈。访谈内容被录音并逐字转录。然后使用内容分析得出主题。
这些主题分为心理社会风险筛查的感知益处和障碍，以及实施过程中的实际问题。筛查的感知益处包括：获得简明扼要的家庭心理社会风险记录，确定对医疗治疗重要的心理社会因素，开启对话，并将患者分诊到心理社会服务部门。障碍包括：感知到机构对心理社会服务的支持、承诺和资源有限，对现有基于证据的验证工具的知识和理解有限，对不同家庭文化背景的心理社会问题和语言能力的担忧，以及 HCP 对心理社会筛查的个人价值观。最后，还讨论了实施过程中的实际问题，包括心理社会风险筛查的培训、何时以及如何进行筛查。
这些发现强调了必须解决 HCP 对实施心理社会风险筛查的感知益处、障碍和实际问题的看法。
