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头颈癌患者自杀风险筛查:一项实施研究。

Suicide Risk Screening for Head and Neck Cancer Patients: An Implementation Study.

作者信息

Kansara Bhargav, Basta Ameer, Mikhael Marian, Perkins Randa, Reisman Phillip, Hallanger-Johnson Julie, Rollison Dana E, Nguyen Oliver T, Powell Sean, Gilbert Scott M, Turner Kea

机构信息

Department of Oncological Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States.

Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, Florida, United States.

出版信息

Appl Clin Inform. 2024 Mar;15(2):404-413. doi: 10.1055/s-0044-1787006. Epub 2024 May 22.

Abstract

OBJECTIVES

There is limited research on suicide risk screening (SRS) among head and neck cancer (HNC) patients, a population at increased risk for suicide. To address this gap, this single-site mixed methods study assessed oncology professionals' perspectives about the feasibility, acceptability, and appropriateness of an electronic SRS program that was implemented as a part of routine care for HNC patients.

METHODS

Staff who assisted with SRS implementation completed (e.g., nurses, medical assistants, advanced practice providers, physicians, social workers) a one-time survey ( = 29) and interview ( = 25). Quantitative outcomes were assessed using previously validated feasibility, acceptability, and appropriateness measures. Additional qualitative data were collected to provide context for interpreting the scores.

RESULTS

Nurses and medical assistants, who were directly responsible for implementing SRS, reported low feasibility, acceptability, and appropriateness, compared with other team members (e.g., physicians, social workers, advanced practice providers). Team members identified potential improvements needed to optimize SRS, such as hiring additional staff, improving staff training, providing different modalities for screening completion among individuals with disabilities, and revising the patient-reported outcomes to improve suicide risk prediction.

CONCLUSION

Staff perspectives about implementing SRS as a part of routine cancer care for HNC patients varied widely. Before screening can be implemented on a larger scale for HNC and other cancer patients, additional implementation strategies may be needed that optimize workflow and reduce staff burden, such as staff training, multiple modalities for completion, and refined tools for identifying which patients are at greatest risk for suicide.

摘要

目的

对头颈癌(HNC)患者这一自杀风险增加的人群进行自杀风险筛查(SRS)的研究有限。为填补这一空白,这项单中心混合方法研究评估了肿瘤学专业人员对一项电子SRS项目的可行性、可接受性和适宜性的看法,该项目作为HNC患者常规护理的一部分实施。

方法

协助实施SRS的工作人员(如护士、医疗助理、高级执业提供者、医生、社会工作者)完成了一项一次性调查(n = 29)和访谈(n = 25)。使用先前验证的可行性、可接受性和适宜性指标评估定量结果。收集了额外的定性数据,为解释分数提供背景信息。

结果

与其他团队成员(如医生、社会工作者、高级执业提供者)相比,直接负责实施SRS的护士和医疗助理报告的可行性、可接受性和适宜性较低。团队成员确定了优化SRS所需的潜在改进措施,如招聘额外人员、改善员工培训、为残疾个体提供不同的筛查完成方式,以及修订患者报告结果以改善自杀风险预测。

结论

工作人员对将SRS作为HNC患者常规癌症护理一部分实施的看法差异很大。在对HNC和其他癌症患者进行更大规模的筛查之前,可能需要额外的实施策略来优化工作流程并减轻工作人员负担,如员工培训、多种完成方式以及完善识别哪些患者自杀风险最高的工具。

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