Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2019 Nov;145(11):2845-2854.
doi: 10.1007/s00432-019-03018-7. Epub 2019 Sep 10.

Structured multi-disciplinary psychosocial care for cancer patients and the perceived quality of care from the patient perspective: a cluster-randomized trial

Susanne Singer  1   2 , Helge Danker  3 , Jürgen Meixensberger  4 , Susanne Briest  5 , Andreas Dietz  6 , Rolf-Dieter Kortmann  7 , Jens-Uwe Stolzenburg  8 , Anette Kersting  9 , Julia Roick  10
Affiliations
Randomized Controlled Trial

Structured multi-disciplinary psychosocial care for cancer patients and the perceived quality of care from the patient perspective: a cluster-randomized trial

Susanne Singer et al. J Cancer Res Clin Oncol. 2019 Nov.

Abstract

Purpose: We examined whether multi-disciplinary stepped psychosocial care for cancer patients improves quality of care from the patient perspective.

Methods: In a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for distress, consultation between doctor and patient, and the provision of psychosocial services. Quality of care was measured with the Quality of Care from the Patient Perspective questionnaire. The analysis employed mixed-effects multivariate regression, adjusting for age and gender.

Results: Thirteen wards were randomized, and 1012 patients participated (n = 570 in stepped care and n = 442 in standard care). Patients who were highly distressed at baseline had 2.3 times the odds of saying they had had the possibility to converse in private with doctors and/or psychologists/social workers when they were in stepped care compared to standard care, 1.3 times the odds of reporting having experienced shared decision-making, 1.1 times the odds of experiencing their doctors as empathic and personal, and 0.6 times the odds of experiencing the care at the ward to be patient oriented. There was no evidence for an effect of stepped care on perceived quality of care in patients with moderate or low distress.

Conclusions: Stepped care can improve some aspects of perceived quality of care in highly distressed patients.

Trial registration: http://www.clinicaltrials.gov . NCT01859429.

Keywords: Cancer; Distress; Psychosocial care; Quality of care; Randomized trial.

PubMed Disclaimer

Conflict of interest statement

We declare that we have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Patient flow through the trial (CONSORT diagram)
Fig. 2
Fig. 2
Perceived quality of care in stepped versus standard psychosocial care. For comparison, data from patients with cancer from the same hospital, 10 years before. Higher values indicate better perceived quality of care
See this image and copyright information in PMC

References

    1. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH (2002) Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J Am Med Assoc 288:1987–1993 - PubMed
    1. Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, Bruyneel L, Rafferty AM, Griffiths P, Moreno-Casbas MT, Tishelman C, Scott A, Brzostek T, Kinnunen J, Schwendimann R, Heinen M, Zikos D, Sjetne IS, Smith HL, Kutney-Lee A (2012) Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. Br Med J 344:e1717 - PMC - PubMed
    1. Angerud KH, Boman K, Brannstrom M (2018) Areas for quality improvements in heart failure care: quality of care from the family members’ perspective. Scand J Caring Sci 32:346–353 - PubMed
    1. Arving C, Sjoden PO, Lindstrom AT, Wasteson E, Glimelius B, Brandberg Y (2006) Satisfaction, utilisation and perceived benefit of individual psychosocial support for breast cancer patients—a randomised study of nurse versus psychologist interventions. Patient Educ Couns 62:235–243 - PubMed
    1. Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR (2009) Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics 50:383–391 - PubMed

Publication types

MeSH terms

Associated data