Randomized controlled trial to test a computerized psychosocial cancer assessment and referral program: methods and research design.
Randomized controlled trial to test a computerized psychosocial cancer assessment and referral program: methods and research design.
复制标题
测试计算机化社会心理癌症评估和转诊计划的随机对照试验：方法和研究设计。
DOI：
10.1016/j.cct.2013.02.001
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发表时间：
2013
影响因子：
2.2
通讯作者：
Boudreaux,EdwinD
中科院分区：
文献类型：
--
作者：
O'Hea,ErinL;Cutillo,Alexandra;Dietzen,Laura;Harralson,Tina;Grissom,Grant;Person,Sharina;Boudreaux,EdwinD
国家癌症联盟网络、国家癌症研究所和美国外科医师学会都强调肿瘤医生需要识别、处理和监测患者的社会心理需求。肿瘤心理健康评估和动态转诊（MHADRO）是一种患者驱动的、计算机化的社会心理评估，用于识别、处理和监测肿瘤患者面临的身体、心理和社会问题。本文介绍了一项随机对照试验（RCT）的方法，该试验在2、6和12个月时测试了MHADRO对患者预后的影响。在收集所有随访数据后，将在未来的出版物中介绍患者结局，包括总体心理困扰、抑郁、焦虑、功能残疾和社会心理资源的使用。来自美国不同地区的三个综合癌症中心的836名不同诊断的癌症患者被随机分配到MHADRO（干预）组或仅进行评估的对照组。向干预组的患者提供详细的个性化报告，并在需要时转介到精神卫生服务机构；他们的肿瘤医生收到了旨在促进临床决策的详细报告。那些表现出高度心理社会问题的患者可以选择授权将其报告的副本以电子方式发送给“最佳匹配”的心理健康专业人员。介绍了人口统计学和患者癌症相关数据，以及入组和拒绝入组患者之间的比较。讨论了RCT期间遇到的挑战和解决这些挑战的策略。
The National Cancer Coalition Network, National Cancer Institute, and American College of Surgeons all emphasize the need for oncology providers to identify, address, and monitor psychosocial needs of their patients. The Mental Health Assessment and Dynamic Referral for Oncology (MHADRO) is a patient-driven, computerized, psychosocial assessment that identifies, addresses, and monitors physical, psychological, and social issues faced by oncology patients. This paper presents the methodology of a randomized controlled trial (RCT) that tested the impact of the MHADRO on patient outcomes at 2, 6, and 12months. Patient outcomes including overall psychological distress, depression, anxiety, functional disability, and use of psychosocial resources will be presented in future publications after all follow-up data is gathered. Eight hundred and thirty six cancer patients with heterogeneous diagnoses, across three comprehensive cancer centers in different parts of the United States, were randomized to the MHADRO (intervention) or an assessment-only control group. Patients in the intervention group were provided detailed, personalized reports and, when needed, referrals to mental health services; their oncology provider received detailed reports designed to foster clinical decision making. Those patients who demonstrated high levels of psychosocial problems were given the option to authorize that a copy of their report be sent electronically to a “best match” mental health professional. Demographic and patient cancer-related data as well as comparisons between patients who were enrolled and those who declined enrollment are presented. Challenges encountered during the RCT and strategies used to address them are discussed.