scholarly journals The role of implementation science in improving distress assessment and management in oncology: a commentary on “Screening for psychosocial distress among patients with cancer: implications for clinical practice, healthcare policy, and dissemination to enhance cancer survivorship”

2019 ◽  
Vol 9 (2) ◽  
pp. 292-295 ◽  
Author(s):  
Paul B Jacobsen ◽  
Wynne E Norton
Keyword(s):  
Implementation Science ◽  
Psychosocial Care ◽  
Clinical Effectiveness ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Future Research ◽  
Distress Screening ◽  
Screening Programs ◽  
Patients With Cancer ◽  
Pragmatic Clinical Trials

Abstract Despite considerable evidence that psychosocial interventions can effectively relieve distress in patients with cancer, many individuals who could benefit from these interventions do not receive them. A proposed solution to this problem is the establishment of programs in oncology settings that routinely screen for distress and refer patients for appropriate psychosocial care. This commentary addresses a review by Ehlers et al. that describes policies and procedures related to distress screening, summarizes prior research on this topic, and identifies key areas for future research. Among their major conclusions is the need for research to fill the gap in knowledge about how best to implement new distress screening programs as well as optimize the use and efficiency of existing programs. This commentary focuses on how the types of study methods, designs, and outcomes that are commonplace in implementation science to facilitate the integration of research into practice can be applied to distress screening programs. Priorities identified include designing and conducting pragmatic clinical trials, evaluating multilevel interventions, and using hybrid designs to simultaneously evaluate clinical effectiveness and barriers and facilitators of implementation. Use of these approaches holds considerable potential for developing an evidence base that can promote more widespread adoption of effective distress screening programs and inform further development of standards and policies related to the psychosocial care of patients with cancer.

The Role of Implementation Science in Advancing Psychosocial Cancer Care

2021 ◽  
pp. 400-406
Author(s):  
Paul B. Jacobsen ◽  
Wynne E. Norton
Keyword(s):  
Implementation Science ◽  
Psychosocial Care ◽  
Clinical Effectiveness ◽  
Models Of Care ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
Considerable Evidence ◽  
Patients With Cancer ◽  
Pragmatic Clinical Trials

Despite considerable evidence that psychosocial care can effectively reduce distress in patients with cancer, many individuals who could benefit from these services do not receive them. This situation reflects, in part, the general lack of studies informed by implementation science that are designed specifically to promote the adoption of evidence-based models of psychosocial care as part of routine clinical practice. Thus, part of the solution involves expanding the scope of research in psychosocial oncology to include designing and conducting pragmatic clinical trials and using hybrid designs to simultaneously evaluate clinical effectiveness and barriers and facilitators of implementation. Use of these approaches holds considerable potential for promoting more widespread adoption of evidence-based models of care and providing stronger support for standards and policies related to the psychosocial care of people with cancer.

scholarly journals Management of Distress in Patients with Cancer—Are We Doing the Right Thing?

2020 ◽  
Vol 54 (12) ◽  
pp. 978-984
Author(s):  
Joost Dekker ◽  
Kristi D Graves ◽  
Terry A Badger ◽  
Michael A Diefenbach
Keyword(s):  
Emotional Support ◽  
Hybrid Approach ◽  
Psychosocial Care ◽  
Evidence Base ◽  
Case Finding ◽  
Lessons Learned ◽  
Distress Screening ◽  
Underlying Assumption ◽  
Patients With Cancer ◽  
The Right

Abstract Background Screening for distress and referral for the provision of psychosocial care is currently the preferred approach to the management of distress in patients with cancer. To date, this approach has shown a limited effect on the reduction of distress. Recent commentaries have argued that the implementation of distress screening should be improved. On the other hand, the underlying assumption that a referral for psychosocial care is required for distressed patients can be questioned. This has led to the development of an alternative approach, called emotional support and case finding. Purpose In the context of finding innovative solutions to tomorrow’s health challenges, we explore ways to optimize distress management in patients with cancer. Methods and Results We discuss three different approaches: (i) optimization of screening and referral, (ii) provision of emotional support and case finding, and (iii) a hybrid approach with multiple assessments, using mobile technology. Conclusions We suggest continued research on the screening and referral approach, to broaden the evidence-base on improving emotional support and case finding, and to evaluate the utility of multiple assessments of distress with new interactive mobile tools. Lessons learned from these efforts can be applied to other disease areas, such as cardiovascular disease or diabetes.

scholarly journals The contribution of implementation science to improving the design and evaluation of integrated care programmes for older people with frailty

2019 ◽  
Vol 27 (3) ◽  
pp. 232-240 ◽  
Author(s):  
Euan Sadler ◽  
Jane Sandall ◽  
Nick Sevdalis ◽  
Dan Wilson
Keyword(s):  
Older People ◽  
Integrated Care ◽  
Implementation Science ◽  
Stakeholder Engagement ◽  
Implementation Strategies ◽  
Evidence Base ◽  
Future Research ◽  
Content Type ◽  
Policy Practice ◽  
Local Setting

Purpose The purpose of this paper is to discuss three potential contributions from implementation science that can help clinicians and researchers to design and evaluate more effective integrated care programmes for older people with frailty. Design/methodology/approach This viewpoint paper focuses on three contributions: stakeholder engagement, using implementation science frameworks, and assessment of implementation strategies and outcomes. Findings Stakeholder engagement enhances the acceptability of interventions to recipients and providers and improves reach and sustainability. Implementation science frameworks assess provider, recipient and wider context factors enabling and hindering implementation, and guide selection and tailoring of appropriate implementation strategies. The assessment of implementation strategies and outcomes enables the evaluation of the effectiveness and implementation of integrated care programmes for this population. Research limitations/implications Implementation science provides a systematic way to think about why integrated care programmes for older people with frailty are not implemented successfully. The field has an evidence base, including how to tailor implementation science strategies to the local setting, and assess implementation outcomes to provide clinicians and researchers with an understanding of how their programme is working. The authors draw out implications for policy, practice and future research. Originality/value Different models to deliver integrated care to support older people with frailty exist, but it is not known which is most effective, for which individuals and in which clinical or psychosocial circumstances. Implementation science can play a valuable role in designing and evaluating more effective integrated care programmes for this population.

Screening for Distress and Unmet Needs in Patients With Cancer: Review and Recommendations

2012 ◽  
Vol 30 (11) ◽  
pp. 1160-1177 ◽  
Author(s):  
Linda E. Carlson ◽  
Amy Waller ◽  
Alex J. Mitchell
Keyword(s):  
Quality Of Life ◽  
Psychometric Properties ◽  
Unmet Needs ◽  
Assessment Tools ◽  
Screening Tools ◽  
Distress Screening ◽  
Screening Programs ◽  
Patients With Cancer ◽  
Screening For Distress

Purpose This review summarizes the need for and process of screening for distress and assessing unmet needs of patients with cancer as well as the possible benefits of implementing screening. Methods Three areas of the relevant literature were reviewed and summarized using structured literature searches: psychometric properties of commonly used distress screening tools, psychometric properties of relevant unmet needs assessment tools, and implementation of distress screening programs that assessed patient-reported outcomes (PROs). Results Distress and unmet needs are common problems in cancer settings, and programs that routinely screen for and treat distress are feasible, particularly when staff are supported and links with specialist psychosocial services exist. Many distress screening and unmet need tools have been subject to preliminary validation, but few have been compared head to head in independent centers and in different stages of cancer. Research investigating the overall effectiveness of screening for distress in terms of improved recognition and treatment of distress and associated problems is not yet conclusive, but screening seems to improve communication between patients and clinicians and may enhance psychosocial referrals. Direct effects on quality of life are uncertain, but screening may help improve discussion of quality-of-life issues. Conclusion Involving all stakeholders and frontline clinicians when planning screening for distress programs is recommended. Training frontline staff to deliver screening programs is crucial, and continuing to rigorously evaluate outcomes, including PROs, process of care, referrals, and economic costs and benefits is essential.

scholarly journals An Implementation Process Evaluation Based on an Integrated Psychosocial Support Program of Colorectal Cancer Couples in China: A Pilot Study

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 110
Author(s):  
Jieyu Li ◽  
Xingjuan Luo ◽  
Qiuping Li
Keyword(s):  
Colorectal Cancer ◽  
Psychosocial Support ◽  
Qualitative Interviews ◽  
Psychosocial Care ◽  
Implementation Process ◽  
Psychosocial Interventions ◽  
Analysis Data ◽  
Future Research ◽  
Successful Implementation ◽  
Personal Factors

Studies have shown that the qualitative process assessment of cancer couple-based psychosocial interventions is often ignored. This article aims to evaluate the implementation process of an integrated psychosocial program developed for colorectal cancer couples. Semi-structured qualitative interviews were conducted with eight colorectal cancer couple participants and two intervention facilitators. Normalization Process Theory was used to guide the data collection and analysis. Data analysis was conducted using a directed content analysis approach within a framework approach. Participants had a good understanding of the program significance. For most participants, the intervention duration was appropriate, and was well integrated into daily life. A lack of understanding of psychological nursing, and a lack of confidence in the use of online platforms and other personal factors, inhibited participants’ experience of participating in the intervention. The facilitator’s challenge in the implementation process was being flexible in dealing with situations occurring outside of the framework plan. Face-to-face and online psychological interventions require more flexibility, and participant cognition of psychosocial care was the key to the successful implementation of the intervention. Future research should consider raising participants’ awareness of psychological care to better integrate this type of intervention into participants’ daily lives and routine care.

scholarly journals Utilization of Psychotherapeutic Interventions by Pediatric Psychosocial Providers

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1045
Author(s):  
Cynthia Fair ◽  
Amanda Thompson ◽  
Marie Barnett ◽  
Stacy Flowers ◽  
June Burke ◽  
...  
Keyword(s):  
Online Survey ◽  
Behavioral Therapy ◽  
Family Members ◽  
Psychosocial Care ◽  
Psychosocial Interventions ◽  
The United States ◽  
Future Research ◽  
Children With Cancer ◽  
Psychotherapeutic Interventions ◽  
Evidenced Based

One of the Standards of Psychosocial Care for Children with Cancer and their Families recommends that all youth with cancer and their family members have access to psychotherapeutic interventions and support throughout the cancer trajectory. This study was created to identify the psychosocial interventions and services provided to children with cancer and their family members, to ascertain whether there are differences in interventions provided by age of the patient and stage of treatment, and to learn about barriers to psychosocial service provision. An online survey was disseminated to psychosocial providers through the listservs of national and international professional organizations. The majority of the 242 respondents were either psychologists (39.3%) or social workers (26.9%) and 79.7% worked in the United States. The intervention offered most often to pediatric patients, caregivers, and siblings, at every stage of treatment, was psychoeducation (41.7–48.8%). Evidence-based interventions, including cognitive behavioral therapy (56.6%) and mindfulness-based interventions (57.9%) were reported to be frequently used with patients. Interventions designed specifically for the pediatric oncology population were not commonly endorsed. Psychosocial providers reported quality of care would be improved by additional staff, better communication/collaboration with medical team members and increased community-based resources. Future research should focus on improving accessibility to population-specific evidenced-based interventions and translating science to practice.

scholarly journals Embracing policy implementation science to ensure translation of evidence to cancer control policy

2021 ◽  
Vol 11 (11) ◽  
pp. 1972-1979
Author(s):  
Karen M Emmons ◽  
David Chambers ◽  
Ali Abazeed
Keyword(s):  
Policy Implementation ◽  
Implementation Science ◽  
Scientific Discovery ◽  
Scientific Evidence ◽  
Cancer Control ◽  
Control Policy ◽  
Evidence Base ◽  
Future Research ◽  
Health Related ◽  
The Usa

Abstract Although health-related policies are abundant, efforts to understand how to ensure that these policies serve as an effective vehicle for translating scientific evidence are relatively sparse. This paper explores how policy-focused implementation science (IS) may contribute to understanding the translation of scientific evidence to health-related policy in governmental and nongovernmental sectors. Expanding the focus of implementation science in cancer control could systematically address policy to both increase the use of scientific evidence in general and to address health equity. In this Commentary, we look to relevant work outside of IS that could be informative, most notably from the field of political science. We propose several ideas for future research that could help move the field of policy implementation science in cancer control in the USA forward. Although most efforts to increase uptake of the scientific evidence base reference translation to “practice and policy,” there has been relatively little emphasis in the USA on implementation at the policy level, especially related to cancer control. If we are to achieve the full benefits of scientific discovery on population and public health, we will need to consider policy as a critical mechanism by which evidence can be translated to practice. We have a robust set of methods within implementation science that are increasing the pace of adoption and maintenance of evidence-based programs in a variety of settings. Building on these efforts, the time is right to expand our focus to include policy implementation.

Evidence-Based Treatment of Depression in Patients With Cancer

2012 ◽  
Vol 30 (11) ◽  
pp. 1187-1196 ◽  
Author(s):  
Madeline Li ◽  
Peter Fitzgerald ◽  
Gary Rodin
Keyword(s):  
Evidence Base ◽  
Current Evidence ◽  
Future Research ◽  
Research Directions ◽  
Evidence Based Treatment ◽  
Patients With Cancer ◽  
Relative Paucity ◽  
Treatment Of Depression ◽  
Future Research Directions ◽  
Pharmacologic Treatments

Purpose Depression is a common condition in patients with cancer, although there has been a relative paucity of research on the effectiveness of treatment in this population. This review summarizes the psychosocial and pharmacologic treatment of depression in patients with cancer based on a consideration of evidence regarding etiologic factors and treatment outcomes. Methods A review of the evidence base for psychosocial and pharmacologic interventions for depression in patients with cancer was performed, including original studies, systematic reviews, and meta-analytic studies in the literature. Results Recent evidence from randomized controlled trials has demonstrated the efficacy of psychosocial and pharmacologic treatments to alleviate depression in patients with cancer. Further research is needed to establish their relative and combined efficacy and their role in the treatment of depression that is less severe and occurs in association with more advanced disease. First-line recommendations for the treatment of depression in patients with cancer are difficult to derive based on current evidence, because comparative studies have not been conducted to support the superiority of one treatment modality over another in this population. Conclusion Both psychosocial and pharmacologic interventions have been shown to be efficacious in treating depression in cancer, but further research is needed to establish their relative and combined benefit. Future research directions include the development and evaluation of novel interventions targeted to specific biologic and psychosocial risk factors.

Psychosocial Interventions With Cognitive-Behavioral Components for the Treatment of Cancer-Related Traumatic Stress Symptoms: A Review of Randomized Controlled Trials

2013 ◽  
Vol 27 (3) ◽  
pp. 258-284 ◽  
Author(s):  
Maria Nenova ◽  
Loretta Morris ◽  
Laurie Paul ◽  
Yuelin Li ◽  
Allison Applebaum ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Randomized Clinical Trials ◽  
Behavioral Therapy ◽  
Psychosocial Interventions ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Patients With Cancer ◽  
Stress Symptoms ◽  
Discernible Effect

Background: Cancer-related traumatic stress symptoms, including posttraumatic stress disorder (PTSD), can significantly impact the quality of life and psychological adjustment of patients and survivors with cancer. Cognitive behavioral therapy (CBT) is an effective intervention previously shown to ameliorate non-cancer-related PTSD. Because of some of the unique aspects of cancer-related traumatic stress, such as the internal and ongoing nature of the traumatic stressor, it is important to review the overall efficacy of CBT interventions in populations with cancer. Objective: To review the findings of randomized clinical trials (RCTs) testing the efficacy of interventions with CBT components for cancer-related traumatic stress symptoms, including intrusion and avoidance, in adults with cancer. Methods: Eligible RCTs were identified via search of OVID, PubMed, EMBASE, and Scopus. Bayesian random effects analysis of treatment effect sizes (ES) was conducted in a portion of the studies for which data were available. Results: Nineteen RCTs met search criteria. Six trials reported reductions in traumatic stress symptoms as a result of the intervention and 13 studies reported null findings. Bayesian modeling based on 13 studies showed no overall discernible effect of interventions with CBT components on intrusion and avoidance symptoms. Conclusions: Most of the studies were not designed to target traumatic stress symptoms in highly distressed patients with cancer and did not include previously validated CBT components, such as cognitive restructuring and exposure. Thus, there was insufficient evidence from which to draw definitive conclusions about the efficacy of CBT interventions for the treatment of cancer-related traumatic stress symptoms, including PTSD. However, interventions with CBT components may have potential for the reduction of PTSD symptoms in highly distressed patients. Future research should focus on testing trauma-focused interventions in demographically and clinically diverse samples.

Using corpora in depth psychology: a trigram-based analysis of a corpus of fetish fantasies

Corpora ◽  
2012 ◽  
Vol 7 (1) ◽  
pp. 69-90 ◽  
Author(s):  
Andrew Wilson
Keyword(s):  
Depth Psychology ◽  
Constant Pressure ◽  
Psychological Theory ◽  
Evidence Base ◽  
Future Research ◽  
German Language ◽  
Alternative Theory ◽  
Depth Psychological ◽  
Psychological Constructs ◽  
Quantitative Linguistics

Contemporary depth psychology is under constant pressure to demonstrate and strengthen its evidence base. In this paper, I show how the analysis of large corpora can contribute to this goal of developing and testing depth-psychological theory. To provide a basis for evaluating statements about foot and shoe fetishism, I analyse the thirty-six most frequent three-word phrases (or trigrams) in a corpus of about 1.6 million words of amateur fetish stories written in the German language. Zipfian methods from quantitative linguistics are used to specify the number of phrases for analysis and I argue that these reflect the core themes of the corpus. The analysis reveals three main dimensions. First, it corroborates the observations of the early sexologists that foot and shoe fetishism is very closely intertwined with sadomasochism. Secondly, it shows that genitalia-related phrases are also common, but an examination of their contexts questions Freud's theory that fetishism results from an assumption of female castration. Thirdly, it reveals that the mouth also plays a key role; however, the frequent co-presence of genitalia references in the same texts does not seem to support straightforwardly the most common alternative theory of fetishism based on object relations. Future research could valuably extend this approach to other fetishes and, in due course, to other depth-psychological constructs.

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