Empowering Minds: A Quality Improvement Initiative on Educating Radiation Therapists on Navigating Difficult Conversations Surrounding Anxiety and Depression in Palliative Patients

Abstract

Purpose/Aim

Radiation Therapists are knowledgeable and confident in supporting patients with anxiety and depression based on recognizing the signs and symptoms, discussing anxiety and depression and providing emotional support. However, when it comes to referring patients for additional support such as Psychosocial Oncology (PSO) or community programs, there is a knowledge gap. It is important for Radiation Therapists (RT) to have this knowledge so that they can better support the mental health needs of their patients and ensure they receive the additional support to get them through their radiation treatments. The aim of this project was to increase the number of psychosocial support referrals and disseminated psychosocial toolkits in palliative patients receiving fractionated radiation treatment with an ESAS score of 7 or more by 70% by March 2024.

Methods/Process

This change idea engaged two focus groups –RTs & patients from October 2023 – December 2024. Within the RT focus group, a needs assessment survey was conducted and based on the responses a series of webinars and resources were developed to meet the interest of RTs. Following the delivery of these resources, a survey was sent out to staff to evaluate the effectiveness of the resources in increasing confidence among staff. The second focus group was patient – driven where 10 palliative patients were interviewed on interest in learning about community support programs. A 1-pager document (psychosocial toolkit) was developed highlighting community support programs of interest. This document was shared with staff to give to palliative patients with an ESAS score of 7 or more.

Results or Benefits/Challenges

The results showed that there is still work to be done in ensuring that RTs still have these conversations, however through the process measures it was identified that there is an increase in interest among RTs in having these conversations and to learn more. Despite competing learning demands, there was still engagement among staff. One challenge was low attendance for some of the webinars/workshops due to scheduling conflicts. However, a number of these webinars were recorded and as a result we have created a diverse repository of resources for staff to refer to. Another challenge was that it was difficult to measure the number of community referrals that were generated through this initiative.

Conclusions/Impact

Since the implementation of this initiative the number of PSO referrals in our institution has increased to 29 referrals (November 2023 – December 2024) in comparison to 5 from November 2022 – February 2023. Among this group only 3 of the patients had an ESAS score of 7 or more, which shows the impact of having these discussions with patients regardless of their ESAS scores. After the webinars, there was an increase in RT confidence levels (N=30, 58%) in entering Epic referrals and referring patients to community programs. Interestingly, many RTs expressed interest in learning more about PSO supports through webinars.