Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine at the University Hospital, University of Cologne, Cologne, Germany.
Unit of Health Services Research in Childhood and Adolescence, Clinic of General Pediatrics, Neonatology and Pediatric Cardiology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
J Psychosoc Oncol. 2024;42(5):653-673. doi: 10.1080/07347332.2024.2318224. Epub 2024 Mar 14.
Since the COVID-19 pandemic, psycho-oncological care has increasingly been provided virtually and/or telephonically. We examined whether patients' therapeutic alliance (TA) - an essential processual outcome - differs due to altered modes of care delivery (MOCD) and assessed, if MOCD impacts patients' care satisfaction and patient reported outcomes.
Survey and documentation data from newly diagnosed cancer patients that were cared for in the new form of care 'isPO' in Germany, were analyzed. Patients were surveyed after completing the one-year psycho-oncological care program. MOCD was operationalized by the ratio of patients' face-to-face, telephonic or video-based consultations to all their consultations. Regression analyzes were conducted to determine a possible relationship between MOCD and TA, between MOCD and patients' care satisfaction ('subjective effectiveness' and 'satisfaction and needs-orientation') and patient reported outcomes (anxiety and depression, sense of coherence, global health status).
MOCD does not significantly influence TA. Regression models on the possible effect on subjective effectiveness and satisfaction and needs-orientation do not show statistical significance with only MOCD as the predictor. MOCD does not predict any of the patient reported outcomes.
During the pandemic, neither TA, care satisfaction nor patient reported outcomes were affected by the MOCD in the new form of care 'isPO'. Therefore, the MOCD didn't negatively affect quality of care, which indicates that telephone or video consultations seem to be useful alternatives for psycho-oncological care in Germany.
自 COVID-19 大流行以来，心理肿瘤学护理越来越多地通过虚拟和/或电话方式提供。我们研究了由于护理方式的改变（MOCD），患者的治疗联盟（TA）——一个重要的过程性结果——是否会有所不同，并评估了 MOCD 是否会影响患者的护理满意度和患者报告的结果。
对在德国以新的护理形式“isPO”接受护理的新诊断癌症患者的调查和记录数据进行了分析。患者在完成为期一年的心理肿瘤学护理计划后接受调查。MOCD 通过患者面对面、电话或基于视频的咨询与所有咨询的比例来操作化。进行回归分析以确定 MOCD 和 TA 之间、MOCD 和患者护理满意度（“主观效果”和“满意度和需求导向”）以及患者报告的结果（焦虑和抑郁、应对感、整体健康状况）之间可能存在的关系。
MOCD 不会显著影响 TA。仅 MOCD 作为预测因素的回归模型在对主观效果和满意度及需求导向的可能影响上不具有统计学意义。MOCD 不能预测任何患者报告的结果。
在大流行期间，新的护理形式“isPO”中的 MOCD 既没有影响 TA，也没有影响护理满意度或患者报告的结果。因此，MOCD 没有对护理质量产生负面影响，这表明电话或视频咨询似乎是德国心理肿瘤学护理的有用替代方式。
