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

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

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.

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Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This study was funded by the German Federal Ministry of Health (#NKP-332-026).

Author information

Authors and Affiliations

  1. Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Centre Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany

    Susanne Singer

  2. University Cancer Centre, University Medical Centre Mainz, Mainz, Germany

    Susanne Singer

  3. Department of Medical Psychology and Medical Sociology, University Medical Centre Leipzig, Leipzig, Germany

    Helge Danker

  4. Department of Neurosurgery, University Medical Centre Leipzig, Leipzig, Germany

    Jürgen Meixensberger

  5. Department of Obstetrics and Gynecology, University Medical Centre Leipzig, Leipzig, Germany

    Susanne Briest

  6. Department of Otolaryngology, University Medical Centre Leipzig, Leipzig, Germany

    Andreas Dietz

  7. Department of Radiation-Oncology, University Medical Centre Leipzig, Leipzig, Germany

    Rolf-Dieter Kortmann

  8. Department of Urology, University Medical Centre Leipzig, Leipzig, Germany

    Jens-Uwe Stolzenburg

  9. Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Leipzig, Leipzig, Germany

    Anette Kersting

  10. Institute of Medical Sociology, University of Halle, Halle, Germany

    Julia Roick

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  1. Susanne Singer
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  2. Helge Danker
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Correspondence to Susanne Singer.

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Singer, S., Danker, H., Meixensberger, J. et al. Structured multi-disciplinary psychosocial care for cancer patients and the perceived quality of care from the patient perspective: a cluster-randomized trial. J Cancer Res Clin Oncol 145, 2845–2854 (2019). https://doi.org/10.1007/s00432-019-03018-7

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  • DOI: https://doi.org/10.1007/s00432-019-03018-7

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