The usefulness and feasibility of a screening instrument to identify psychosocial problems in patients receiving curative radiotherapy: a process evaluation

Abstract

BackgroundPsychosocial problems in cancer patients are often unrecognized and untreated due to the low awareness of the existence of these problems or pressures of time. The awareness of the need to identify psychosocial problems in cancer patients is growing and has affected the development of screening instruments. This study explored the usefulness and feasibility of using a screening instrument (SIPP: Screening Inventory of Psychosocial Problems) to identify psychosocial problems in cancer patients receiving curative radiotherapy treatment (RT).MethodsThe study was conducted in a radiation oncology department in the Netherlands. Several methods were used to document the usefulness and feasibility of the SIPP. Data were collected using self-report questionnaires completed by seven radiotherapists and 268 cancer patients.ResultsRegarding the screening procedure 33 patients were offered to consult a psychosocial care provider (e.g. social worker, psychologist) during the first consultation with their radiotherapist. Of these patients, 31 patients suffered from at least sub-clinical symptoms and two patients hardly suffered from any symptoms. Patients' acceptance rate 63.6% (21/33) was high. Patients were positive about the content of the SIPP (mean scores vary from 8.00 to 8.88, out of a range between 0 and 10) and about the importance of discussing items of the SIPP with their radiotherapist (mean score = 7.42). Radiotherapists' perspectives about the contribution of the SIPP to discuss the different psychosocial problems were mixed (mean scores varied from 3.17 to 4.67). Patients were more positive about discussing items of the SIPP if the radiotherapists had positive attitudes towards screening and discussing psychosocial problems.ConclusionsThe screening procedure appeared to be feasible in a radiotherapy department. In general, patients' perspectives were at least moderate. Radiotherapists considered the usefulness and feasibility of the SIPP generally to be lower, but their evaluations were mixed. A positive attitude to using screening instruments like the SIPP needs to be encouraged among radiotherapists, as this may not only improve the usefulness of a screening instrument, but also patients' satisfaction with care.Trial RegistrationClinicalTrials.gov: NCT00859768

Reduced patient anxiety as a result of radiation therapist-led psychosocial support: a systematic review

“…These studies indicate that RT‐led ‘screening and needs assessment’ is feasible, improves communication with patients and increases RT knowledge of patient issues …”

“…Such samples are insufficiently powered to detect small but meaningful effect sizes. Furthermore, only two studies incorporated control groups to enable assessment of intervention effect …”

“…However, global assessment of the usefulness of the SIPP varied across information items and time points. At 7 months post‐study commencement, RTs highly rated SIPP as useful to ‘contribute to discussion’, ‘quality of consult’ and ‘contribution to psychosocial discussions’, but these aspects were rated poorly at 13 months . Mitchell and Symonds reported that 43% of RTs rated screening with the ‘distress and emotion thermometers’ as useful.…”

The Utility and Feasibility of Extending Beyond Traditional Patient Descriptions in Daily Practice

“…They may also potentially foster improvements in well‐being and emotional status in patients with malignancy . These tools have also been used to facilitate earlier referral for specialist assessment, and have even been associated with favorable patient satisfaction results . If they are administered at planned intervals, they may also have the potential to preempt recall bias in patient responses over time.…”

Psychological Assessment in Psychopharmacology

“…There is however momentum building for multi-domain Screening for Distress, as the 6th vital sign globally. Twelve randomised trials that have examined screening for psychological problems (or wellbeing) divided in six concerning emotional complications and six involving QL and one that studied both domains (Table 4.1) (Maunsell et al 1996;Sarna 1998;McLachlan et al 2001;Detmar et al 2002;Velikova et al 2004;Mills et al 2009;Carlson et al 2010bCarlson et al , 2012Braeken et al 2011;Klinkhammer-Schalke et al 2012;Hollingworth et al 2012). For example, in one British study, 28 oncologists treating 286 cancer patients were randomly assigned to an intervention group who underwent screening along with feedback of results to physicians, a screen-only group who completed questionnaires without feedback and a control group with no screening at all (Velikova et al 2004(Velikova et al , 2010.…”