Stepped Care - Optimising Psycho-oncological Care Provision by Structured Screening and Diagnosis

Study Overview
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Brief Summary
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The study will examine whether the provision of psychosocial support services for cancer patients in acute care can be optimized by the use of a structured combination of screening procedures with physician interviews and structured patient pathways. There is strong evidence that a third of all cancer patients in acute care are suffering from mental health conditions and that a third expresses the need for professional psycho-oncological support. However, physicians and nurses do not always identify these patients in need for support. Screening questionnaires are significantly better to identify distressed patients however the use of screenings alone does not necessarily improve the patients' emotional well-being. Purpose of this study is to evaluate a psychosocial stepped care model which aims to decrease the patients' distress.

Official Title
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Stepped Care - Optimising Psycho-oncological Care Provision by Structured Screening and Diagnosis

Conditions
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Cancer

Intervention / Treatment
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* Other: Stepped Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients in acute care for cancer written informed consent 18 years and older ability to complete questionnaires Exclusion Criteria: - insufficient command of German

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Stepped Care<br>Structured stepped requirement of psychosocial support | Other: Stepped Care<br>* Step 1: Screening for psychosocial distress Step 2: If a patient is moderately or highly distressed according to step 1, the physician performs a brief structured interview and arranges, if necessary, appropriate psychosocial care Step 3: psychosocial care as indicated by step 2<br>|
| No Intervention: Care as usual<br>Unstructured requirement of psychosocial support | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mental condition | Hospital Anxiety and Depression Scale, HADS | from baseline until 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Social functioning | Role Functioning Subscale, EORTC QLQ-C30 | from baseline until 6 months | 
| Satisfaction with treatment | Quality of Care from the Patients Perspective, QPP | at discharge from acute care hospital, 6 months after admission to acute care hospital | 
| Comorbid mental disorders | Structured Clinical Interview for DSM-IV, SCID | at discharge from acute care hospital, 6 months after admission to acute care hospital | 
| Use of healthcare services | Questionnaire from the German Federal Health Survey (Bundesgesundheitssurvey) | 6 months after admission to acute care hospital | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cancer patients, Psycho-oncological Care Provision, Structured Screening, Stepped care