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A pan-Canadian web-based education program to support screening for distress: Evaluation of outcomes

Published online by Cambridge University Press:  13 August 2013

Deborah L. McLeod ,
Angela C. Morck  and
Janet A. Curran
Deborah L. McLeod*
Affiliation:
Psychosocial Oncology Team (NSCC), QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
Angela C. Morck
Affiliation:
University of Calgary, Calgary, Alberta, Canada
Janet A. Curran
Affiliation:
Dalhousie University, Halifax, Nova Scotia, Canada
*
Address correspondence and reprint requests to: Deborah L. McLeod, Psychosocial Oncology Team (NSCC), QEII Health Sciences Centre, Victoria 11-006, 1278 Tower Rd., Halifax, Nova Scotia, CanadaB3H 2Y9. E-mail: deborahl.mcleod@cdha.nshealth.ca
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Abstract

Objective:

Cancer-related distress has been endorsed as the sixth vital sign by many international cancer organizations, and some countries such as Canada have implemented national screening for distress programs. The completion of a screening tool is an important first step in improving responsiveness to cancer-related distress, but screening must be followed with skilled supportive care to make a difference in patient-reported outcomes. Our objective was to create a web-based education program to support nurses and other frontline staff in providing an initial response to screening results.

Method:

To address screening and supportive care learning needs, the Canadian Association of Psychosocial Oncology (CAPO), with support from the Canadian Partnership Against Cancer, created a web-based education program as one component of the national screening for distress agenda. The program provides clinically grounded and interactive learning through the use of PowerPoint presentations, video clips of clinical interactions with patients and family members, and test questions. Presentation topics include, for example, strategies for dealing with screening results, managing referrals, and supportive counseling. We employed a matched pairs, pre-post survey design to assess the effect of the education program on confidence in screening and in providing initial supportive care.

Results:

Our analysis of the first 147 matched pairs to complete the course suggests that satisfaction with the course was high. Statistically significant increases in confidence in relation to screening for distress and assessing distress, and in providing initial supportive care, were evident.

Significance of results:

Our ongoing experience with CAPO's Interprofessional Psychosocial Oncology Distance Education (IPODE) project (www.ipode.ca) project suggests that healthcare professionals value web-based learning for its accessibility and convenience. Such programs appear to offer excellent opportunities for cost-effective education that supports practice change.

Keywords

Screening for distressPsychosocial oncologyWeb-based educationOncology nursing
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 1 , February 2014 , pp. 15 - 23
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Accreditation Canada (2008). Qmentum program 2009 standards: Cancer care and oncology services (ver 2). www.accreditation-canada.caGoogle Scholar
Adler, N.E. & Page, E.K. (2008). Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington, D.C.: The National Academies Press.Google Scholar
Bainbridge, D., Seow, H., Sussman, J., et al. (2011). Multidisciplinary healthcare professionals' perception of the use and utility of a symptom assessment system for oncology patients. Journal of Oncology Practice, 7, 19–23.CrossRefGoogle Scholar
Booth, K., Maguire, P.M., Butterworth, T., et al. (1996). Perceived professional support and the use of blocking behaviours by hospice nurses. Journal of Advanced Nursing, 24, 522–527.Google Scholar
Botti, M., Endacott, R., Watts, R., et al. (2006). Barriers to providing psychosocial support for patients with cancer. Cancer Nursing, 29, 309–316.Google Scholar
Bultz, B.D. & Carlson, L.E. (2006). Emotional distress: The sixth vital sign – future directions in cancer care. Psycho-oncology, 15, 93–96.CrossRefGoogle ScholarPubMed
Canadian Association of Nurses in Oncology (CANO) (2006). Practice Standards and Competencies for the Specialized Oncology Nurse. www.cano-acio.ca/~ASSETS/DOCUMENT/Practice/CONEP_Standards2006September28_REVISEDFor_20Website.pdf (Accessed on August 7, 2013).Google Scholar
Dolbeault, S., Boistard, B., Meuric, J., et al. (2011). Screening for distress and supportive care needs during the initial phase of the care process: a qualitative description of a clinical pilot experiment in a French cancer centre. Psycho-oncology, 20, 669–674.Google Scholar
Douglas, C.J. (2008). Teaching supportive psychotherapy to psychiatric residents. American Journal of Psychiatry, 165, 445–452.Google Scholar
Ell, K., Xie, B., Quon, B., et al. (2008). Randomized controlled trial of collaborative care management of depression among low-income patients with cancer. Journal of Clinical Oncology, 26, 4488–4496.Google Scholar
Fallowfield, L. & Jenkins, V. (2004). Communicating sad, bad, and difficult news in medicine. Lancet, 363, 312–317.Google Scholar
Fallowfield, L. & Jenkins, V. (2006). Current concepts of communication skills training in oncology. Recent Results in Cancer Research, 168, 105–112.Google Scholar
Fallowfield, L., Saul, J. & Gilligan, B. (2001). Teaching senior nurses how to teach communication skills in oncology. Cancer Nursing, 24, 185–191.CrossRefGoogle ScholarPubMed
Fann, J.R., Ell, K., & Sharpe, M. (2012). Integrating psychosocial care into cancer services. Journal of Clinical Oncology, 30, 1178–1186.Google Scholar
Faulkner, A. (1992). The evaluation of training programs for communication skills in palliative care. Journal of Cancer Care, 1, 75–78.Google Scholar
Faulkner, A. & Maguire, P. (1984). Teaching ward nurses to monitor cancer patients. Clinical Oncology, 10, 383–389.Google Scholar
Fillion, L., Cook, S., Blais, M., et al. (2011). Implementation of screening for distress with professional cancer navigators. Oncologie, 13, 277–289.Google Scholar
Fitch, M. (2011). Screening for distress: A role for oncology nursing. Current Opinion in Oncology, 23, 331–337.CrossRefGoogle ScholarPubMed
Frost, M.H., Brueggen, C. & Mangan, M. (1997). Intervening with the psychosocial needs of patients and families: perceived importance and skill level. Cancer Nursing, 20, 350–358.CrossRefGoogle ScholarPubMed
Fukui, S., Ogawa, K., Ohtsuka, M., et al. (2008). A randomized study assessing the efficacy of communication skill training on patients' psychologic distress and coping: nurses' communication with patients just after being diagnosed with cancer. Cancer, 113, 1462–1470.Google Scholar
Fukui, S., Ogawa, K. & Yamagishi, A. (2011). Effectiveness of communication skills training of nurses on the quality of life and satisfaction with healthcare professionals among newly diagnosed cancer patients: a preliminary study. Psycho-oncology, 20, 1285–1291.CrossRefGoogle ScholarPubMed
Gerteis, M., Edgman-Levitan, S., Daley, J., et al. (1993). Through the Patients' Eyes: Understanding and Promoting Patient-centered Care. San Francisco: Jossey–Bass.Google Scholar
Heaven, C.M. & Maguire, P. (1996). Training hospice nurses to elicit patient concerns. Journal of Advanced Nursing, 23, 280–286.CrossRefGoogle ScholarPubMed
Holland, J., Watson, M., & Dunn, J. (2011). The IPOS New International Standard of Quality Cancer Care: Integrating the psychosocial domain into routine care. Psycho-oncology, 20, 677–680.Google Scholar
Howell, D., Currie, S., Mayo, S., et al. (2009). A Pan-Canadian Clinical Practice Guideline: Assessment of Psychosocial Health Care Needs of the Adult Cancer Patient. Toronto: Canadian Partnership Against Cancer (Cancer Journey Action Group) and the Canadian Association of Psychosocial Oncology.Google Scholar
Howell, D., Keller-Olaman, S., Oliver, T., et al. (2010). A Pan-Canadian Practice Guideline: Screening, Assessment and Care of Psychosocial Distress (Depression, Anxiety) in Adults with Cancer. Toronto: Canadian Partnership Against Cancer (Canadian Journey Action Group) and the Canadian Association of Psychosocial Oncology.Google Scholar
Howell, D., Keller-Olaman, S., Oliver, T.K., et al. on behalf of the Cancer Journey Advisory Group of the Canadian Partnership Against Cancer (2011). A Pan-Canadian Practice Guideline: Screening, Assessment and Care of Cancer-Related Fatigue in Adults with Cancer. Toronto: Canadian Partnership Against Cancer (Cancer Journey Advisory Group) and the Canadian Association of Psychosocial Oncology.Google Scholar
Jacobsen, P.B. (2009). Promoting evidence-based psychosocial care for cancer patients. Psycho-oncology, 18, 6–13.Google Scholar
Jacobsen, P.B. & Wagner, L.I. (2012). A new quality standard: The integration of psychosocial care into routine cancer care. Journal of Clinical Oncology, 30, 1154–1159.Google Scholar
Kruijver, I.P.M., Garssen, B., Visser, A.P., et al. (2006). Signalising psychosocial problems in cancer care. The structural use of short psychosocial checklist during medical or nursing visits. Patient Education and Counseling, 62, 163–177.CrossRefGoogle ScholarPubMed
Kruijver, I.P., Kerkstra, A., Francke, A.L., et al. (2000). Evaluation of communication training programs in nursing care: A review of the literature. Patient Education and Counseling, 39, 129–145.Google Scholar
Linden, W., Vodemarier, A., MacKenzie, R., et al. (2012). Anxiety and depression after cancer diagnosis: Prevalence rates by cancer type, gender, and age. Journal of Affective Disorders, 141, 343–351CrossRefGoogle ScholarPubMed
Lowry, R. (2012). Concepts & Applications of Inferential Statistics. http://vassarstats.net/textbook/ch12a.html (Accessed on August 7, 2013).Google Scholar
Lynch, J., Goodhart, F., Saunders, Y., et al. (2011). Screening for psychological distress in patients with lung cancer: Results of a clinical audit evaluating the use of the patient Distress Thermometer. Supportive Care in Cancer, 19, 193–202.CrossRefGoogle Scholar
Maguire, P. (1999). Improving communication with cancer patients. European Journal of Cancer, 35, 2058–2065.Google Scholar
Maguire, P. & Pitceathly, C. (2003). Improving the psychological care of cancer patients and their relatives. The role of specialist nurses. Journal of Psychosomatic Research, 55, 469–474.CrossRefGoogle ScholarPubMed
McLeod, D.L., Curran, J., & White, M. (2011). Interprofessional psychosocial oncology education: Nurse outcomes of the IPODE project. Psychoncologie, 5, 109–115.Google Scholar
McLeod, D.L., Tapp, D.M., Moules, N.J., et al. (2010). Family nursing in oncology and palliative care: Knowing the family and other narratives. European Journal of Oncology Nursing, 14, 93–100.Google Scholar
Mehnert, A. (2004). Prevalence of post-traumatic stress disorder, anxiety and depression in a representative sample of breast cancer patients. Psycho-oncology, 13, S62.Google Scholar
Moorey, S., Cort, E., Kapari, M., et al. (2009). A cluster randomized controlled trial of cognitive behaviour therapy for common mental disorders in patients with advanced cancer. Psychological Medicine, 39, 713–723.Google Scholar
National Comprehensive Cancer Network (2010). NCCN Clinical Practice Guidelines in Oncology: Distress Management. Fort Washington, PA: NCCN; 2010. Version 2.2013. http://www.nccn.org/professionals/physician_gls/pdf/distress.pdfGoogle Scholar
Neumann, M., Galushko, M., Karbach, U., et al. (2010). Barriers to using psycho- oncology services: a qualitative research into the perspectives of users, their relatives, nonusers, physicians and nurses. Supportive Care in Cancer, 18, 1147–1156.CrossRefGoogle ScholarPubMed
Newell, S.A., Sanson-Fisher, R.W. & Savolainen, N.J. (2002). Systematic review of psychological therapies for cancer patients: Overview and recommendations for future research. Journal of the National Cancer Institute, 94, 558–584.CrossRefGoogle ScholarPubMed
Passik, S.D. & Lowery, A.E. (2011). Recognition of depression and methods of depression screening in people with cancer. In Depression and Cancer. Kissane, D.W.M., Maj, M. & Sartorius, N. (eds.), pp. 81–100. West Sussex: Wiley Blackwell.Google Scholar
Pinsker, H. (1997). A Primer of Supportive Psychotherapy. Hillsdale, NJ: The Analytic Press, Inc.Google Scholar
Razavi, D., Delvaux, N., Marchal, S., et al. (1993). The effects of a 24-h psychological training program on attitudes, communication skills and occupational stress in oncology: A randomised study. European Journal of Cancer, 29A, 1858–1863.Google Scholar
Razavi, D., Delvaux, N., Marchal, S. et al. (2002). Does training increase the use of more emotionally laden words by nurses when talking with cancer patients? A randomized study. British Journal of Cancer, 87, 1–7.Google Scholar
Regan, M., Ristevski, E., Jones, R., et al. (2012). Examining the introduction of a supportive care screening and referral process for cancer patients: how does practice compare with protocols? Supportive Care in Cancer, 20, 1074–1078.Google Scholar
Sanson-Fisher, R.W., Girgis, A., Boyes, A., et al. (2000). The unmet supportive care needs of persons with cancer. Cancer, 88, 226–237.3.0.CO;2-P>CrossRefGoogle Scholar
Santos, F.R.M. (2004). Symptoms of post-traumatic stress disorder in patients with malignant hematologic disease. Psycho-oncology, 13, S67.Google Scholar
Sivesind, D., Parker, P.A., Cohen, L., et al. (2003). Communicating with patients in cancer care: What areas do nurses find most challenging? Journal of Cancer Education, 18, 202–209.CrossRefGoogle ScholarPubMed
Stewart, M., Belle Brown, J., Donner, A., et al. (2000). The impact of patient-centered care on outcomes. Journal of Family Practice, 49, 796–804.Google Scholar
Strong, V., Waters, R., Hibberd, C., et al. (2008). Management of depression for people with cancer (SMaRT oncology 1): A randomised trial. Lancet, 372, 40–48.Google Scholar
Walker, J. & Sharpe, M. (2009). Depression care for people with cancer: A collaborative care intervention. General Hospital Psychiatry, 31, 436–441.Google Scholar
Wilkinson, S. (1991). Factors which influence how nurses communicate with cancer patients. Journal of Advanced Nursing, 16, 677–688.Google Scholar
Wilkinson, S.M., Gambles, M. & Roberts, A. (2002). The essence of cancer care: The impact of training on nurses' ability to communicate effectively. Journal of Advanced Nursing, 40, 731–738.Google Scholar
Wilkinson, S., Perry, R., Blanchard, K., et al. (2008). Effectiveness of a three-day communication skills course in changing nurses' communication skills with cancer/ palliative care patients: A randomised controlled trial. Palliative Medicine, 22, 365–375.CrossRefGoogle ScholarPubMed
Wen, K.Y. & Gustafson, D.H. (2004). Needs assessment for cancer persons and their families. Health and Quality of Life Outcomes, 2, 11.Google Scholar
Zabora, J., Blanchard, C.G., Smith, E.D., et al. (1997). Prevalence of psychological distress among cancer patients across the disease continuum. Journal of Psychosocial Oncology, 15, 73–87.Google Scholar