Integrating psychosocial care into routine cancer care: A stepped-wedge design cluster randomized controlled trial (SWD-RCT) to evaluate effectiveness of the HuCare Quality Improvement Strategy (HQIS) on health-related quality of life (HRQoL)
AMER SOC CLINICAL ONCOLOGY, 2019
Online
unknown
Zugriff:
6515 Background: Cancer patients (pts) often do not receive evidence-based psychosocial care. We evaluate the effects of an implementation strategy we previously demonstrated feasible, which includes communication skill training for all physicians and nurses; four support visits at the centers by an improvement team to assist staff in identifying obstacles, finding solutions, and strengthening motivation; screening for distress and social needs; individualized pts' education with a referring nurse; use of a question prompt list. Methods: Multicenter incomplete SWD-RCT with 3 clusters of 5 centers each. Consecutive outpatients requiring medical treatment and diagnosed in the previous 2 months were eligible. Primary endpoint: difference of at least one of the 2 domains of HRQoL emotional or social functions, at 3 months from baseline, in pts of the centers that implemented the HQIS vs standard of care (SoC). Secondary endpoints include: patient mood, long-term effect, overall HRQoL. Analyses were performed using a beta-binomial regression model. Results: 762 pts were enrolled. At baseline, 41% showed high anxiety (HADS-A>7), and 88% had at least one psychosocial need. 299 health professionals attended 3-day courses (84% of all clinical staff). 647 pts (85%) were available for analysis. The 315 pts who received HQIS exhibited better quality of life for the emotional domain than those assigned to SOC (OR=1.115, p=0.016). Pts who showed the greatest improvement were the older (OR=1.003, p=0.035), had lower anxiety basal levels (OR=0.853, p
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Integrating psychosocial care into routine cancer care: A stepped-wedge design cluster randomized controlled trial (SWD-RCT) to evaluate effectiveness of the HuCare Quality Improvement Strategy (HQIS) on health-related quality of life (HRQoL)
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Autor/in / Beteiligte Person: | Giordani, Paolo ; Caputo, Francesca ; Caminiti, Caterina ; Mattioli, Rodolfo ; Cinieri, Saverio ; Procopio, Giuseppe ; Sarobba, Giuseppina ; Verusio, Claudio ; Passalacqua, Rodolfo ; Gori, Stefania ; Russo, Antonio ; Sacco, Cosimo ; Zerilli, Filippo ; Iezzi, Elisa ; Pazzola, Antonio ; Airoldi, Mario ; Pinto, Carmine ; Novello, Silvia ; Aragona, Marcello ; Maria Antonietta Annunziata |
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Veröffentlichung: | AMER SOC CLINICAL ONCOLOGY, 2019 |
Medientyp: | unknown |
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