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The primary aim for this research was to explore the overlap and differences between the concepts related to secondary traumatization: posttraumatic stress disorder (PTSD), secondary traumatic stress (STS), compassion fatigue (CF), and burnout (BRN). A secondary aim for this research was to examine the impact of secondary traumatization and some of the personal and professional elements that affect how pediatric healthcare providers experience PTSD, STS, CF, and BRN. An online survey was sent via e-mail to numerous list serves for healthcare providers who had worked on PICU, NICU, or PEDS units within the last year. The analyses revealed that a significant overlap existed between the terms of STS, PTSD, BRN, CS, and CF for PICU, NICU, and PEDS providers. However, a hierarchical linear regression revealed a significant amount of unique contributions to the variance in CF based on each of the measured concepts. Despite previous literature that indicates that the terms STS and CF can be used interchangeably, the two most prominent measures utilized in the assessment of CF and STS are actually capturing at least some unique elements. Given these results, future researchers should examine and conceptualize the difference in etiology, prevalence, symptoms, and treatment efficacy for CF and STS as separate but related entities and then return their focus to understanding secondary traumatization in healthcare providers.

Purpose Telechaplaincy (the use of telecommunications and virtual technology to deliver spiritual and religious care by healthcare chaplains or other religious/spiritual leaders) is a relatively novel intervention that has increasingly been used in recent years, and especially during COVID-19. Telephone-based chaplaincy is one mode of telechaplaincy. The purpose of this study was to (1) describe telephone-based chaplaincy interventions delivered as the first point of contact to patients who screen positive for religious/spiritual concern(s) using an electronic data system, and (2) assess the feasibility and acceptability of delivering interventions in an outpatient cancer institute using this methodology. Methods Patients were screened for religious and spiritual (R/S) concern(s) using an electronic data system. Patients indicating R/S concern(s) were offered a telephone-based chaplaincy intervention and asked to complete a survey assessing acceptability of the intervention. Feasibility and acceptability data were collected. Results Thirty percent of screened patients indicated R/S concern(s). Telephone-based chaplaincy interventions were offered to 100% of eligible patients, establishing contact with 61% of eligible patients, and offering chaplaincy interventions to 48% of those patients. Survey participants report high acceptability of the offered intervention. Conclusion This is the first study examining feasibility and acceptability of telephone-based chaplaincy with oncology patients. Telephone-based chaplaincy is feasible and acceptable within an outpatient oncology setting, supporting the promise of this interventional strategy. Further research is needed to refine practices.

76 Background: Pain is one of the most common cancer symptoms. Individuals in pain often experience psychological distress in the form of anxiety and depression. Social support is an important resource utilized by patients to cope with cancer. Aims: (1) Identify clinicodemographic factors influencing cancer pain; (2) examine social support as a moderator of the relation between anxiety, depression and cancer pain. Methods: Participants included stage I-IV cancer patients (N = 11,815) who completed a routine tablet-based psychosocial distress screening at a large academic hybrid, multi-site, community-based cancer institute (Jan 2017- Jan 2019). Participants were matched to the Cancer Registry (N = 7,333); clinicodemographic factors were incorporated into lasso regression models. Models identified pain predictors from self-reported anxiety, depression and social support. Analyses examined if the effect of anxiety and depression on pain differed by levels of social support. Results: Median age was 59 (RNG, 18-101), 61% female and 77% white. Tumor site (GI, Gyn, head/neck), advanced disease, black race, and lower income were independently associated with severe pain. Anxiety (β = 0.48, p < .001) and depression (β = 0.69, p < 0.001) were related to pain intensity after accounting for clinicodemographic factors. The effect of depression on pain differed by level of social support (p = 0.009). The effect of anxiety on pain differed in patients reporting transportation issues (p = 0.035). Conclusions: This is the largest study to date examining cancer pain intensity, psychological factors of anxiety and depression, and social support. Our data suggests that patient characteristics of race, income, tumor site, and disease staging independently predict pain intensity. Anxiety and depression are significant factors of pain intensity; these associations remain after accounting for patient characteristics. Social support buffers the negative impact of anxiety/depression on pain. Clinicians who treat cancer pain should be attuned to modifiable psychological factors which can greatly influence a patient’s pain experience. Findings emphasize the need for interdisciplinary multimodal approaches for cancer pain.

Effective screening practices are needed for chaplains to prioritize patients most in need. This exploratory study suggests that screening for struggle to find meaning/hope in life, fear of death, and anxiety will help chaplains identify patients who have R/S concerns and will likely accept R/S interventions. Developing effective telehealth practices like this is an important direction for the field.