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Article: Implementing a nurse-led screening clinic for symptom distress with community-based referral for cancer survivors: A feasibility study

TitleImplementing a nurse-led screening clinic for symptom distress with community-based referral for cancer survivors: A feasibility study
Authors
Keywordscancer
implementation study
oncology
stepped-care model
survivorship
symptom distress screening
symptom management
Issue Date2024
Citation
Psycho-Oncology, 2024, v. 33, n. 1, article no. e6261 How to Cite?
AbstractIntroduction: This prospective, single-arm, pragmatic implementation study evaluated the feasibility of a nurse-led symptom-screening program embedded in routine oncology post-treatment outpatient clinics by assessing (1) the acceptance rate for symptom distress screening (SDS), (2) the prevalence of SDS cases, (3) the acceptance rate for community-based psychosocial support services, and (4) the effect of referred psychosocial support services on reducing symptom distress. Methods: Using the modified Edmonton Symptom Assessment System (ESAS-r), we screened patients who recently completed cancer treatment. Patients screening positive for moderate-to-severe symptom distress were referred to a nurse-led community-based symptom-management program involving stepped-care symptom/psychosocial management interventions using a pre-defined triage system. Reassessments were conducted at 3-months and 9-months thereafter. The primary outcomes included SDS acceptance rate, SDS case prevalence, intervention acceptance rate, and ESAS-r score change over time. Results: Overall, 2988/3742(80%) eligible patients consented to SDS, with 970(32%) reporting ≥1 ESAS-r symptom as moderate-to-severe (caseness). All cases received psychoeducational material, 673/970(69%) accepted psychosocial support service referrals. Among 328 patients completing both reassessments, ESAS-r scores improved significantly over time (p < 0.0001); 101(30.8%) of patients remained ESAS cases throughout the study, 112(34.1%) recovered at 3-month post-baseline, an additional 72(22%) recovered at 9-month post-baseline, while 43(12.2%) had resumed ESAS caseness at 9-month post-baseline. Conclusion: Nurse-led SDS programs with well-structured referral pathways to community-based services and continued monitoring are feasible and acceptable in cancer patients and may help in reducing symptom distress. We intend next to develop optimal strategies for SDS implementation and referral within routine cancer care services.
Persistent Identifierhttp://hdl.handle.net/10722/336959
ISSN
2023 Impact Factor: 3.3
2023 SCImago Journal Rankings: 1.136
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, Wendy Wing Tak-
dc.contributor.authorNg, Danielle W.L.-
dc.contributor.authorFielding, Richard-
dc.contributor.authorSin, Vivian-
dc.contributor.authorTsang, Catherine-
dc.contributor.authorChan, Wendy W.L.-
dc.contributor.authorFoo, Chi Chung-
dc.contributor.authorKwong, Ava-
dc.contributor.authorChan, Karen K.L.-
dc.date.accessioned2024-02-29T06:57:42Z-
dc.date.available2024-02-29T06:57:42Z-
dc.date.issued2024-
dc.identifier.citationPsycho-Oncology, 2024, v. 33, n. 1, article no. e6261-
dc.identifier.issn1057-9249-
dc.identifier.urihttp://hdl.handle.net/10722/336959-
dc.description.abstractIntroduction: This prospective, single-arm, pragmatic implementation study evaluated the feasibility of a nurse-led symptom-screening program embedded in routine oncology post-treatment outpatient clinics by assessing (1) the acceptance rate for symptom distress screening (SDS), (2) the prevalence of SDS cases, (3) the acceptance rate for community-based psychosocial support services, and (4) the effect of referred psychosocial support services on reducing symptom distress. Methods: Using the modified Edmonton Symptom Assessment System (ESAS-r), we screened patients who recently completed cancer treatment. Patients screening positive for moderate-to-severe symptom distress were referred to a nurse-led community-based symptom-management program involving stepped-care symptom/psychosocial management interventions using a pre-defined triage system. Reassessments were conducted at 3-months and 9-months thereafter. The primary outcomes included SDS acceptance rate, SDS case prevalence, intervention acceptance rate, and ESAS-r score change over time. Results: Overall, 2988/3742(80%) eligible patients consented to SDS, with 970(32%) reporting ≥1 ESAS-r symptom as moderate-to-severe (caseness). All cases received psychoeducational material, 673/970(69%) accepted psychosocial support service referrals. Among 328 patients completing both reassessments, ESAS-r scores improved significantly over time (p < 0.0001); 101(30.8%) of patients remained ESAS cases throughout the study, 112(34.1%) recovered at 3-month post-baseline, an additional 72(22%) recovered at 9-month post-baseline, while 43(12.2%) had resumed ESAS caseness at 9-month post-baseline. Conclusion: Nurse-led SDS programs with well-structured referral pathways to community-based services and continued monitoring are feasible and acceptable in cancer patients and may help in reducing symptom distress. We intend next to develop optimal strategies for SDS implementation and referral within routine cancer care services.-
dc.languageeng-
dc.relation.ispartofPsycho-Oncology-
dc.subjectcancer-
dc.subjectimplementation study-
dc.subjectoncology-
dc.subjectstepped-care model-
dc.subjectsurvivorship-
dc.subjectsymptom distress screening-
dc.subjectsymptom management-
dc.titleImplementing a nurse-led screening clinic for symptom distress with community-based referral for cancer survivors: A feasibility study-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/pon.6261-
dc.identifier.pmid38047720-
dc.identifier.scopuseid_2-s2.0-85178389595-
dc.identifier.volume33-
dc.identifier.issue1-
dc.identifier.spagearticle no. e6261-
dc.identifier.epagearticle no. e6261-
dc.identifier.eissn1099-1611-
dc.identifier.isiWOS:001113291900001-

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