Rynar Lauren, Kaplan Jonathan, Fank Patricia
Supportive Oncology, Rush MD Anderson Cancer Center, 1725 W Harrison Street, Suite 950, Chicago, IL, 60612, USA.
Support Care Cancer. 2025 Apr 23;33(5):407. doi: 10.1007/s00520-025-09418-5.
Best practice regarding screening for cancer-related distress includes timely follow-up with psychosocial services to address identified needs. Cancer centers frequently struggle to identify distress via systematized, low-burden workflows and link patients to high-quality, evidenced-based care. Models of psychological and psychiatric consultation can address several known challenges of attending to patient and provider need and can be designed with varying resources and levels of integration. Consultation can be offered in inpatient and outpatient settings and function independently or within existing supportive care departments.
This review summarizes four models of consultation including 1) inpatient psychological consultation, 2) outpatient psychological consultation, 3) integrated and tiered psychiatric consultation, and 4) integration of behavioral health providers into subspecialty teams. We present data on utilization of each model, as well as patient clinical outcomes and satisfaction measures and provider satisfaction.
Consultation models are utilized and offer an effective approach to optimizing timely and accessible care. Utilizing this model of care between July 2020 and June 2021, we managed more than 1200 inpatient referrals for consultation and responded to more than 1600 outpatients with positive distress screens. Programs should consider strengths and limitations of implementing consultation models, with an emphasis on available staffing and institutional investment in supportive care for cancer survivors.
癌症相关痛苦筛查的最佳实践包括及时跟进心理社会服务以满足已确定的需求。癌症中心常常难以通过系统化、低负担的工作流程识别痛苦，并将患者与高质量的循证护理联系起来。心理和精神科会诊模式可以应对关注患者和医护人员需求方面的几个已知挑战，并且可以根据不同的资源和整合水平进行设计。会诊可以在住院和门诊环境中提供，并且可以独立运作或在现有的支持性护理部门内进行。
本综述总结了四种会诊模式，包括1）住院心理会诊、2）门诊心理会诊、3）综合分层精神科会诊以及4）将行为健康提供者纳入亚专科团队。我们展示了每种模式的使用数据，以及患者的临床结局、满意度指标和医护人员满意度。
会诊模式得到了应用，并为优化及时且可及的护理提供了一种有效方法。在2020年7月至2021年6月期间采用这种护理模式，我们处理了1200多例住院会诊转诊，并对1600多名筛查出痛苦阳性的门诊患者做出了回应。各项目应考虑实施会诊模式的优势和局限性，重点关注现有人员配备以及对癌症幸存者支持性护理的机构投入。
