The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial
The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial
复制标题
多学科心理社会护理对癌症患者社会经济问题的影响：整群随机试验
DOI：
10.1007/s00520-017-4024-x
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发表时间：
2018
影响因子：
3.1
通讯作者：
H. Danker
中科院分区：
文献类型：
--
作者：
S. Singer;J. Roick;J. Meixensberger;F. Schiefke;S. Briest;A. Dietz;K. Papsdorf;J. Mössner;T. Berg;J. Stolzenburg;D. Niederwieser;Annette Keller;A. Kersting;H. Danker
PurposeWe研究是否多学科的阶梯式心理社会护理减少经济问题，提高了癌症patients.MethodsIn一所大学医院，病房随机分配到阶梯式或标准护理。分级护理包括检查经济问题、医生和病人之间的协商以及提供社会服务。结果是基线后半年< 65岁的患者出院和重返工作时的经济问题。分析采用混合效应多元回归modeling.Results13病房随机和1012例患者参加（n= 570在阶梯护理和n = 442在标准护理）。那些在基线时报告财务问题的人在接受阶梯式护理后出院时出现财务问题的可能性较小（比值比（OR）0.2，95%置信区间（CI）0.1，0.7;p= 0.01）。没有证据表明分级护理对基线时没有经济问题的患者的经济问题有影响（OR 1.1，CI 0.5，2.6;p= 0.82）。基线时未退休的< 65岁患者399例。在这一组中，没有证据表明阶梯式护理对基线后半年被雇用的影响（OR 0.7，CI 0.3，2.0;p= 0.52）。Trial registrationNCT 01859429 ConclusionsFinancial problems can be avoided more effectively with multi-disciplinary stepped psycho-social care than with standard care in patients who have such problems.
PurposeWe examined whether multi-disciplinary stepped psycho-social care decreases financial problems and improves return-to-work in cancer patients.MethodsIn a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for financial problems, consultation between doctor and patient, and the provision of social service. Outcomes were financial problems at the time of discharge and return-to-work in patients < 65 years old half a year after baseline. The analysis employed mixed-effect multivariate regression modeling.ResultsThirteen wards were randomized and 1012 patients participated (n= 570 in stepped care andn= 442 in standard care). Those who reported financial problems at baseline were less likely to have financial problems at discharge when they had received stepped care (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.1, 0.7;p= 0.01). There was no evidence for an effect of stepped care on financial problems in patients without such problems at baseline (OR 1.1, CI 0.5, 2.6;p= 0.82). There were 399 patients < 65 years old who were not retired at baseline. In this group, there was no evidence for an effect of stepped care on being employed half a year after baseline (OR 0.7, CI 0.3, 2.0;p= 0.52).Trial registrationNCT01859429ConclusionsFinancial problems can be avoided more effectively with multi-disciplinary stepped psycho-social care than with standard care in patients who have such problems.