Evaluation of distress management in inpatients with cancer by means of the distress thermometer: A mixed methods approach.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Anna Götz, Anja Kröner, Josef Jenewein, Rebecca Spirig
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引用次数: 0

Abstract

Objectives: To improve psychosocial care for oncology inpatients, we implemented screening for distress by means of distress thermometer (DT) at the Comprehensive Cancer Centre Zurich in 2011. Since then, several screening barriers have been reported regarding the application of the DT. This study aimed to evaluate the distress screening process between 2012 and 2016 to identify barriers preventing sustainability.

Methods: In this sequential explanatory mixed methods study, we synthesized the results of 2 quantitative retrospective descriptive studies and 1 qualitative focus group study. To compare and analyze the data, we used thematic triangulation.

Results: Nurses screened 32% (N = 7034) of all newly admitted inpatients with the DT, and 47% of the screenings showed a distress level ≥5. Of these cases, 9.7% were referred to psycho-oncological services and 44.7% to social services. In 15.7% of these cases, nurses generated a psychosocial nursing diagnosis. In focus group interviews, nurses attributed the low screening rate to the following barriers: adaptation to patients' individual needs, patient-related barriers and resistance, timing, communication challenges, established referral practice, and lack of integration in the nursing process.

Significance of results: To improve distress screening performance, the screening process should be tailored to patients' needs and to nurses' working conditions (e.g., timing, knowledge, and setting-specific factors). To gain more evidence on distress management as a basis for practical improvements, further evaluations of distress screening are required.

通过痛苦温度计评估癌症住院患者的痛苦管理:混合方法。
目的:为了改善肿瘤住院患者的社会心理护理,我们于 2011 年在苏黎世综合癌症中心采用痛苦温度计(DT)进行痛苦筛查。从那时起,就有报道称在使用 DT 时遇到了一些筛查障碍。本研究旨在评估 2012 年至 2016 年期间的窘迫感筛查过程,以确定阻碍可持续发展的障碍:在这项顺序解释性混合方法研究中,我们综合了 2 项定量回顾性描述研究和 1 项定性焦点小组研究的结果。为了对数据进行比较和分析,我们采用了专题三角测量法:护士对所有新入院的住院患者中的 32%(N = 7034)进行了 DT 筛查,47% 的筛查结果显示患者的痛苦程度≥5。在这些病例中,9.7%被转介到肿瘤心理服务机构,44.7%被转介到社会服务机构。在其中 15.7% 的病例中,护士做出了社会心理护理诊断。在焦点小组访谈中,护士们将筛查率低归因于以下障碍:适应患者的个人需求、与患者相关的障碍和阻力、时间安排、沟通挑战、既定的转诊惯例,以及在护理流程中缺乏整合:为了提高窘迫感筛查的效果,筛查过程应符合患者的需求和护士的工作条件(如时间、知识和特定环境因素)。为了获得更多有关窘迫管理的证据,作为实际改进的基础,需要对窘迫筛查进行进一步评估。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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