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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

Authors :
Anette Kersting
Andreas Dietz
Thomas Berg
Henning Spieker
Kirsten Papsdorf
Joachim Mössner
Isabell Hoffmann
Susanne Singer
Dietger Niederwieser
Helge Danker
Jens Einenkel
Susanne Briest
Hubert Wirtz
Franziska Schiefke
Julia Roick
Anja Dietel
Jürgen Meixensberger
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

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