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Effects of stepped psychooncological care on referral to psychosocial services and emotional well-being in cancer patients: A cluster-randomized phase III trial
Effects of stepped psychooncological care on referral to psychosocial services and emotional well-being in cancer patients: A cluster-randomized phase III trial
- Source :
- Psycho-Oncology. 26:1675-1683
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Objective Emotional distress in cancer patients often goes unnoticed in daily routine; therefore, distress screening is now recommended in many national guidelines. However, screening alone does not necessarily translate into better well-being. We examined whether stepped psychooncological care improves referral to consultation-liaison (CL) services and improves well-being. Methods In a cluster-randomized trial, wards were randomly allocated to stepped versus standard care. Stepped care comprised screening for distress, consultation between doctor and patient about the patient's need for CL services, and provision of CL service. Primary outcomes were referral to psychosocial services and emotional well-being half a year after baseline, measured with the Hospital Anxiety and Depression Scale. A secondary endpoint was uptake of outpatient health care. Analysis employed mixed-effects multivariate regression modeling. Results Thirteen wards were randomized; 1012 patients participated. With stepped care (N = 570; 7 wards), 22% of the patients were referred to CL services and 3% with standard care (N = 442; 6 wards; odds ratio [OR] 10.0; P
- Subjects :
- Adult
Male
medicine.medical_specialty
Referral
Experimental and Cognitive Psychology
Anxiety
Hospital Anxiety and Depression Scale
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Neoplasms
Physicians
Health care
Social Work, Psychiatric
medicine
Humans
030212 general & internal medicine
Referral and Consultation
Aged
Physician-Patient Relations
business.industry
Odds ratio
Middle Aged
medicine.disease
Comorbidity
Psychotherapy
Psychiatry and Mental health
Distress
Mental Health
Oncology
030220 oncology & carcinogenesis
Physical therapy
Female
Patient Participation
business
Psychosocial
Subjects
Details
- ISSN :
- 10579249
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Psycho-Oncology
- Accession number :
- edsair.doi.dedup.....5d4a4b914292228c29a5443a262c016e
- Full Text :
- https://doi.org/10.1002/pon.4492