Foster Kristin, Sadler Bethany, Conrad Amy L, Grafft Amanda
Department of Pediatrics, University of Iowa College of Nursing, Division of Hematology and Oncology, University of Iowa Stead Family Children's Hospital, Iowa City, IA 52242, USA.
Department of Pediatrics, Division of Hematology/Oncology, University of Iowa Stead Family Children's Hospital, Iowa City, IA 52242, USA.
Cancers (Basel). 2025 May 2;17(9):1550. doi: 10.3390/cancers17091550.
In January of 2019, the University of Iowa Stead Family Children's Hospital (UI SFCH) formalized their Pediatric Psychosocial Oncology Program by utilizing 15 evidence-based Standards for Psychosocial Care for Children with Cancer and Families as a foundation for program development. The psychosocial oncology clinical team members identified ongoing gaps in care and a need to improve progress toward achieving these standards. Reviewing and analyzing the Pediatric Psychosocial Standard of Care Institutional Assessment Tool further highlighted the need for program development but also demonstrated the need to design institutionally specific objective measures to monitor program improvements over time. The current project focused on the creation of a program evaluation system with objective measures specific to the UI SFCH practice setting. Barriers such as staffing and cost were identified and addressed. Additionally, a REDCap database using a structured chart review as its foundation was initiated, which permitted the comprehensive evaluation of the standards of care at UI SFCH. The Matrix and Guidelines included in the Pediatric Psychosocial Standard of Care Institutional Assessment Tool comprised the framework to develop institution specific objective measurements for each standard of care. The objective measures of interest were social work assessments and provider biopsychosocial assessments. Data were exported and uploaded to a statistical program for data analysis. The statistical significance of percentage changes was evaluated with a one-tailed -test; values < 0.05 were considered significant. The development of this REDCap database project allowed for the evaluation of the program's current efficiency in implementing the PSCPCC standards of care. Using the database in the future will allow psychosocial oncology team members to easily identify other areas for improvement and to ensure that all 15 standards of psychosocial care are being comprehensively addressed in the care of pediatric oncology patients and interactions with their families.
2019年1月，爱荷华大学斯特德家庭儿童医院（UI SFCH）通过采用15项基于证据的癌症患儿及家庭心理社会护理标准，将其儿科心理社会肿瘤项目正式化，以此作为项目发展的基础。心理社会肿瘤临床团队成员发现了护理方面持续存在的差距，以及改进以实现这些标准的必要性。对儿科心理社会护理标准机构评估工具进行审查和分析，不仅进一步凸显了项目发展的必要性，还表明需要设计针对机构的客观指标，以监测项目随时间的改进情况。当前项目专注于创建一个针对UI SFCH实际情况的具有客观指标的项目评估系统。确定并解决了人员配备和成本等障碍。此外，启动了一个以结构化图表审查为基础的REDCap数据库，这使得能够对UI SFCH的护理标准进行全面评估。儿科心理社会护理标准机构评估工具中包含的矩阵和指南构成了为每项护理标准制定机构特定客观指标的框架。感兴趣的客观指标是社会工作评估和提供者的生物心理社会评估。数据被导出并上传到一个统计程序进行数据分析。百分比变化的统计显著性用单尾检验进行评估；p值<0.05被视为具有显著性。这个REDCap数据库项目的开发使得能够评估该项目目前在实施PSCPCC护理标准方面的效率。未来使用该数据库将使心理社会肿瘤团队成员能够轻松识别其他需要改进的领域，并确保在儿科肿瘤患者护理及其与家人互动中全面涵盖所有15项心理社会护理标准。
