Effects of a Provincial-Wide Implementation of Screening for Distress on Healthcare Professionals' Confidence and Understanding of Person-Centered Care in Oncology
Effects of a Provincial-Wide Implementation of Screening for Distress on Healthcare Professionals' Confidence and Understanding of Person-Centered Care in Oncology
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DOI：
10.6004/jnccn.2016.0135
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发表时间：
2016-10-01
影响因子：
13.4
通讯作者：
Watson, Linda
中科院分区：
文献类型：
--
作者：
Tamagawa, Rie;Groff, Shannon;Watson, Linda
背景资料：尽管已发表的研究报告表明，筛查痛苦（SFD）可以提高癌症患者的护理质量，但人们对SFD如何影响医疗保健专业人员（HCP）知之甚少。目的：该质量改进项目检查了实施SFD干预对HCP解决患者痛苦的信心和以人为本的护理意识的影响。患者和方法：本项目涉及实施SFD的影响的前评价和后评价。从全省17个机构共招募了254名HCP（队列1）完成问卷调查。然后在所有癌症护理机构实施SFD，为期10个月，之后157名HCP（队列2）完成了实施后问卷调查。在区域和社区护理中心，导航员支持将SFD纳入常规实践;因此，对导航员的影响进行了检查。结果如下：队列2中的HCP报告称，与队列1中的HCP相比，队列2中的HCP对管理患者痛苦的信心显着更大，并且对以人为本的护理的意识也更强。区域和社区站点的HCP报告在干预前后对以人为本的认识更高，并且报告SFD相对于三级站点的HCP的负面影响更少。照顾单一或多种肿瘤类型是一种效果调节剂，仅在治疗多种肿瘤的HCP中观察到效果。结论：SFD的实施有利于提高医务人员的自信心和以人为本的意识。包括不同护理模式的因素，如基于站点的导航和照顾单个或多个肿瘤，影响结果。
Background: Although published studies report that screening for distress (SFD) improves the quality of care for patients with cancer, little is known about how SFD impacts healthcare professionals (HCPs). Objectives: This quality improvement project examined the impact of implementing the SFD intervention on HCPs' confidence in addressing patient distress and awareness of person-centered care. Patients and Methods: This project involved pre-evaluation and post-evaluation of the impact of implementing SFD. A total of 254 HCPs (cohort 1) were recruited from 17 facilities across the province to complete questionnaires. SFD was then implemented at all cancer care facilities over a 10-month implementation period, after which 157 HCPs (cohort 2) completed post-implementation questionnaires. At regional and community care centers, navigators supported the integration of SFD into routine practice; therefore, the impact of navigators was examined. Results: HCPs in cohort 2 reported significantly greater confidence in managing patients' distress and greater awareness about person-centered care relative to HCPs in cohort 1. HCPs at regional and community sites reported greater awareness in person-centeredness before and after the intervention, and reported fewer negative impacts of SFD relative to HCPs at tertiary sites. Caring for single or multiple tumor types was an effect modifier, with effects observed only in the HCPs treating multiple tumors. Conclusions: Implementation of SFD was beneficial for HCPs' confidence and awareness of person-centeredness. Factors comprising different models of care, such as having site-based navigators and caring for single or multiple tumors, influenced outcomes.