Screening for Distress in Lung and Breast Cancer Outpatients: A Randomized Controlled Trial
Screening for Distress in Lung and Breast Cancer Outpatients: A Randomized Controlled Trial
复制标题
DOI：
10.1200/jco.2009.27.3698
复制
发表时间：
2010-11-20
影响因子：
45.3
通讯作者：
Bultz, Barry D.
中科院分区：
文献类型：
--
作者：
Carlson, Linda E.;Groff, Shannon L.;Bultz, Barry D.
目的 痛苦已被认为是癌症护理中的第六个生命体征，一些指南建议进行常规筛查。尽管如此，对痛苦的筛查却很少进行，也很少进行评估。方法对新的乳腺癌和肺癌患者实施了常规在线痛苦筛查计划。患者被随机分配到以下三种情况之一：（1）最低限度筛查：仅使用遇险温度计（DT）加上常规护理； (2) 全面筛查：DT、问题清单、癌症心理筛查C部分（测量焦虑和抑郁）、总结问题的个性化报告以及医疗档案报告； (3) 分诊：全面筛查加上可选的个性化电话分诊以及参考资源。所有病情的患者都会收到信息包，并在 3 个月后使用全面筛查电池进行重新评估。 结果 585 名乳腺癌患者和 549 名肺癌患者在基线时接受了评估（占所有患者的 89%），75.5% 保留进行随访。患者中基线痛苦的发生率很高。与其他两组相比，分诊中的肺癌患者在随访中持续感到高度痛苦的人数减少了 20%，而在全面筛查和分诊条件下的乳腺癌患者在随访中表现出比最低限度筛查的患者更低的痛苦。在全面筛查和分诊条件下，减少焦虑和抑郁的最佳预测因素是接受心理社会服务转诊。 结论 常规在线筛查在大型癌症中心是可行的，并且可能有助于降低未来的痛苦水平，特别是在与适当资源相结合时。 J 临床肿瘤杂志 28：4884-4891。 (c) 2010 年美国临床肿瘤学会
Purpose Distress has been recognized as the sixth vital sign in cancer care and several guidelines recommend routine screening. Despite this, screening for distress is rarely conducted and infrequently evaluated.Methods A program of routine online screening for distress was implemented for new patients with breast and lung cancer. Patients were randomly assigned to one of three conditions: (1) minimal screening: the distress thermometer (DT) only plus usual care; (2) full screening: DT, problem checklist, Psychological Screen for Cancer part C measuring anxiety and depression, a personalized report summarizing concerns and the report on the medical file; or (3) triage: full screening plus optional personalized phone triage with referral to resources. Patients in all conditions received an information packet and were reassessed 3 months later with the full screening battery.Results Five hundred eighty-five patients with breast cancer and 549 patients with lung cancer were assessed at baseline (89% of all patients), and 75.5% retained for follow-up. High prevalence of baseline distress was found across patients. Twenty percent fewer patients with lung cancer in triage continued to have high distress at follow-up compared to those in the other two groups, and patients with breast cancer in the full screening and triage conditions showed lower distress at follow-up than those in minimal screening. The best predictor of decreased anxiety and depression in full screening and triage conditions was receiving a referral to psychosocial services.Conclusion Routine online screening is feasible in a large cancer center and may help to reduce future distress levels, particularly when coupled with uptake of appropriate resources. J Clin Oncol 28: 4884-4891. (c) 2010 by American Society of Clinical Oncology