Understanding and Addressing the Informational Needs of Radiation Therapists Concerning the Management of Anxiety and Depression in Patients Receiving Radiation Therapy Treatment

Abstract

Background: Cancer Care Ontario has mandated that all health care professionals working within oncology centres in Ontario should routinely screen and address symptoms of anxiety and depression in cancer patients. This study aims to assess the informational needs of Radiation Therapists (RTs) concerning the discussion and management of anxiety and depression symptoms in patients receiving radiation therapy treatment. It will also attempt to determine whether RTs believe that reviewing patients' self-reported symptoms should be included as part of their routine patient assessment. Methodology:A questionnaire was initially piloted at the host institution to six randomly chosen RTs and then sent via email to all Radiation Therapists practicing in Ontario, Canada (n= 921). The online questionnaire consisted of multiple choice questions and was divided into four themes: 1) RT comfort levels surrounding the topics of anxiety and depression, 2) management of anxiety and depression in cancer patients, 3) further education needed/requested in anxiety and depression symptom management and 4) the Edmonton Symptom Assessment System (ESAS). Data analyses included the calculation of means and two sample two-sided t-tests to examine the relationships between various demographics and responses.Results: RTs feel more comfortable in the discussion of issues surrounding anxiety when compared to depression. The most common positive factor affecting RTs' comfort levels addressing emotional distress is previous experience with patients who have expressed these symptoms; whereas the most common adverse factor affecting comfort levels is the lack of education regarding emotional distress. Eighty-seven percent (87%) of RTs would

Communication skills training for the radiotherapy team to manage cancer patients’ emotional concerns: a systematic review

“…To our knowledge, this is the first review to have looked at the effectiveness of communication skills programmes for members of the RT to support cancer patients with their emotional concerns during treatment. Despite the available evidence on the importance of the relationship between patients and the RT34–36 and recommendations to target staff education to increase comfort levels with emotional conversations,14 37 only nine articles met the review’s inclusion criteria, of which seven focused specifically on communication skills. Surprisingly, even though fear of cancer recurrence is the most common concern for patients during and after radiotherapy treatment,5 none of the included studies took this specific concern into consideration; instead, the current focus is on patient anxiety, (general) concerns and depression.…”

“…However, not all forms of support are equally effective, and it has been suggested to develop communication skills training (CST) for the radiotherapy team (RT) to improve communication-related and patient outcomes 12 13. Also radiation therapists themselves indicate that they would appreciate further education to help patients deal with emotional distress 14. Various CST courses for oncology professionals in general have already shown improvements in clinicians’ self-efficacy, communication skills and strategies, as well as transfer of these strategies into the clinical practice 15 16.…”

Being in safe hands: Patients’ perceptions of how cancer services may support psychological well‐being

“…Potential barriers to effective professional‐patient exchanges were identified in this study. Staff who were viewed as too busy or who occupied technical roles were considered less likely to deal with psycho‐social concerns, however all professionals have a key role in reducing patients’ anxiety and distress (Lavergne, Taylor, Gillies, & Barisic, ; Merchant, O'Connor, & Halkett, ). Our findings highlight the importance of all staff being aware of their overall demeanour and its effect on patients’ well‐being.…”

Do radiation therapists feel able to routinely screen for symptoms and distress in people with cancer: barriers impacting practice

“…Results of two separate studies that surveyed Canadian RTs identify these as important variables related to confidence, with one study finding that RTs with previous experience in dealing with emotions had increased confidence, 20 and the other that confidence in various aspects of patient care increased with years of experience. 21 Similar to findings of Lavergne et al, 20 RTs in this study were most confident in dealing with signs of distress and anxiety, with depression the emotion they were least confident to manage. RTs are more confident dealing with anxiety because its more commonly experienced by patients during treatment with depression occurring afterwards.…”