Hee Su Park, Katharine E Brock, Katherine Lee, Karyn Korsah, Linda M Radbill
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引用次数: 0
Abstract
Objective: A childhood cancer diagnosis can have serious psychological impact on patients and families. While psychological and psychiatric providers bring unique expertise, they are not routinely integrated into pediatric palliative care (PPC) teams. This study aims to outline the psychological concerns addressed by PPC providers during visits for children with cancer.
Methods: This secondary analysis stems from a retrospective cohort study of patients 0-27 years with cancer seen by inpatient and/or outpatient PPC within an academic pediatric oncology center between 2017-2022. In the electronic health record (EHR), clinicians selected the topics (subdomains) addressed in each visit. Those related to psychological and psychiatric needs of patients were included. Data were abstracted from the EHR, PPC clinic database, and cancer registry. Differences in the frequency of subdomains were analyzed by demographics, location of PPC service, and more.
Results: Across 467 PPC-recipients, there were 7548 PPC visits, of which 89.8% discussed ≥ 1 psychological subdomain and 40.8% discussed ≥ 2 psychological subdomains. The top five psychological subdomains (wellbeing, anxiety, fatigue/tiredness, sleep difficulties, and depression/sadness) were more strongly associated with outpatient visits than inpatient encounters (p ≤ 0.001). The number of psychological subdomains was positively associated with the number of physical symptoms managed in a visit (p < 0.001).
Conclusions: In an overwhelming majority of visits, PPC clinicians address psychological symptoms. The psychological domains within PPC practice are wide-ranging and likely incompletely recognized. Gaps in recognizing and managing psychological challenges in children with cancer can be addressed by implementing screening tools and incorporating psychologists and psychiatrists within PPC teams.
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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