School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.
Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.
Asia Pac J Clin Oncol. 2022 Jun;18(3):303-310. doi: 10.1111/ajco.13604. Epub 2021 Jun 29.
Patient-centered cancer care includes emotional, informational, and practical support that is personalised to the needs of patients and inclusive of family and friends. However, when supportive care referrals are offered in hospital settings, distressed patients and carers do not consistently act on those referrals, which can prolong patient suffering. The degree to which sub-optimal referral uptake also occurs in Australian telephone support services is unknown.
To report, among a sample of distressed patients and caregivers who called a cancer information and support service: 1) the types of services used; 2) proportion who received and actioned a referral (uptake); 3) associations between referral to a service and callers' characteristics); and, 4) associations between uptake of a referred service and callers' characteristics.
This study used cross-sectional data collected at 3-month post-baseline from control participants (usual care group) enrolled in the Structured Triage and Referral by Telephone (START) trial. The START trial recruited distressed adult cancer patients and caregivers from the Cancer Council Information and Support Service (CIS). A research assistant conducted a 30-45 min telephone interview with participants, which included recall of referrals provided by CIS staff and reported uptake of referral(s) to the offered service types.
Most patients (98%) and caregivers (97%) reported receiving a referral to a service. For patients and caregivers respectively, information materials (71%, 77%), CIS call-back (51%, 43%), practical services (52%, 45%), and group peer support (49%, 51%) were the services most frequently offered. For callers receiving a referral, uptake was highest for information materials (91%) and CIS call-backs (89%) and lowest for specialist psychological services (30%). Significant association was found between older age and reduced uptake of services (p = 0.03).
The high uptake rate of CIS call-backs suggests it is a potentially more acceptable form of support compared to specialist psychological services. Efforts to reduce the barriers to telephone-based psychological services are required. Specifically, older age peoples' and caregivers' preferences for support and priorities who may benefit from a referral coordinator.
以患者为中心的癌症护理包括针对患者需求提供的个性化情感、信息和实际支持，同时还包括患者家属和朋友的支持。然而，在医院环境中提供支持性护理转介时，苦恼的患者和护理人员并不总是接受这些转介，这可能会延长患者的痛苦。在澳大利亚的电话支持服务中，转介接受程度不理想的程度尚不清楚。
报告在一个拨打癌症信息和支持服务的苦恼患者和护理人员样本中：1）使用的服务类型；2）接受和实施转介（接受率）的比例；3）转介服务与呼叫者特征之间的关联；4）接受转介服务与呼叫者特征之间的关联。
本研究使用了横断面数据，这些数据是从参与结构化电话分诊和转介（START）试验的对照组（常规护理组）在基线后 3 个月收集的。START 试验招募了来自癌症委员会信息和支持服务（CIS）的苦恼成年癌症患者和护理人员。一名研究助理与参与者进行了 30-45 分钟的电话访谈，其中包括回忆 CIS 工作人员提供的转介，并报告了对提供的服务类型的转介接受情况。
大多数患者（98%）和护理人员（97%）报告收到了服务转介。对于患者和护理人员来说，信息材料（71%，77%）、CIS 回电（51%，43%）、实际服务（52%，45%）和团体同伴支持（49%，51%）是最常提供的服务类型。对于接受转介的呼叫者，信息材料（91%）和 CIS 回电（89%）的接受率最高，而专科心理服务（30%）的接受率最低。年龄较大与服务接受率降低之间存在显著关联（p=0.03）。
CIS 回电的高接受率表明，与专科心理服务相比，它是一种更能被接受的支持形式。需要努力减少对电话心理服务的障碍。具体而言，需要了解年龄较大的人和护理人员对支持的偏好以及他们可能从转介协调员中受益的优先级。
