Suh Jina, Williams Spencer, Fann Jesse R, Fogarty James, Bauer Amy M, Hsieh Gary
University of Washington, USA and Microsoft Research, USA.
University of Washington, USA.
Proc ACM Hum Comput Interact. 2020 May;4(CSCW1). doi: 10.1145/3392843.
Depression is common but under-treated in patients with cancer, despite being a major modifiable contributor to morbidity and early mortality. Integrating psychosocial care into cancer services through the team-based Collaborative Care Management (CoCM) model has been proven to be effective in improving patient outcomes in cancer centers. However, there is currently a gap in understanding the challenges that patients and their care team encounter in managing co-morbid cancer and depression in integrated psycho-oncology care settings. Our formative study examines the challenges and needs of CoCM in cancer settings with perspectives from patients, care managers, oncologists, psychiatrists, and administrators, with a focus on technology opportunities to support CoCM. We find that: (1) patients with co-morbid cancer and depression struggle to navigate between their cancer and psychosocial care journeys, and (2) conceptualizing co-morbidities as separate and independent care journeys is insufficient for characterizing this complex care context. We then propose the as a conceptual design framework for characterizing challenges that patients and their care team encounter when cancer and psychosocial care journeys interact. We use the challenges discovered through the lens of this framework to highlight and prioritize technology design opportunities for supporting whole-person care for patients with co-morbid cancer and depression.
抑郁症在癌症患者中很常见，但治疗不足，尽管它是导致发病和早期死亡的一个主要可改变因素。通过基于团队的协作护理管理（CoCM）模式将心理社会护理纳入癌症服务，已被证明在改善癌症中心的患者治疗效果方面是有效的。然而，目前在理解患者及其护理团队在综合心理肿瘤护理环境中管理合并癌症和抑郁症时所遇到的挑战方面存在差距。我们的形成性研究从患者、护理经理、肿瘤学家、精神科医生和管理人员的角度审视了癌症环境中CoCM的挑战和需求，重点关注支持CoCM的技术机会。我们发现：（1）合并癌症和抑郁症的患者在其癌症和心理社会护理旅程之间难以导航，（2）将合并症概念化为单独且独立的护理旅程不足以描述这种复杂的护理背景。然后，我们提出[具体内容缺失]作为一个概念设计框架，用于描述患者及其护理团队在癌症和心理社会护理旅程相互作用时所遇到的挑战。我们利用通过这个框架发现的挑战，来突出并优先考虑支持合并癌症和抑郁症患者全人护理的技术设计机会。
