Interdisciplinary provider visits attenuate relationship between patient concerns and distress in older adults with cancer.

IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Quality of Life Research Pub Date : 2024-11-01 Epub Date: 2024-08-20 DOI:10.1007/s11136-024-03760-7
Kelly M McConnell, Alexandra K Zaleta, Rebecca Saracino, Melissa Miller
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Abstract

Purpose: This study examined the relationship between multidimensional patient concerns and anxiety and depression in a national sample of older adults with cancer (OACs ≥ 65 years) and the buffering effect of visiting providers across disciplines (e.g., oncology, allied health, primary care, mental health) on these relationships.

Methods: Participants completed a cross-sectional survey through the Cancer Support Community's Cancer Experience Registry (CER), an online community-based research initiative. Eligible participants were 65 years and older and diagnosed with cancer in the past five years. Participants completed self-report measures of (1) the severity of their concerns across multiple domains, (2) anxiety and depression, and (3) whether they received care for "symptoms and side effects" from various providers.

Results: The sample consisted of 277 OACs; 45% endorsed elevated anxiety and 31% endorsed elevated depression. The most severe concerns were in the domains of body image and healthy lifestyle and symptom burden and impact. More severe concerns were associated with higher levels of anxiety and depression. The relationship between concern severity and distress was weaker in OACs who saw a palliative care, mental health, physical or occupational therapy provider, pharmacist, or primary care provider relative to OACs who did not. A visit with an oncology provider did not moderate most relationships between concerns and distress.

Conclusions: The relationship between OACs' concerns and distress was attenuated by treatment with a specialty provider. Interdisciplinary team care may be a vital component of comprehensive patient-centered care for OACs.

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跨学科医疗服务提供者访问可减轻癌症老年患者的担忧与痛苦之间的关系。
目的:本研究调查了全国老年癌症患者(OACs ≥ 65 岁)样本中患者的多维关切与焦虑和抑郁之间的关系,以及跨学科(如肿瘤学、专职医疗、初级保健、心理健康)就诊提供者对这些关系的缓冲作用:参与者通过癌症支持社区的癌症经历注册表(CER)完成了一项横截面调查,这是一项基于社区的在线研究计划。符合条件的参与者年龄在 65 岁及以上,并在过去五年中被诊断出患有癌症。参与者完成了以下方面的自我报告测量:(1) 他们对多个领域的担忧的严重程度;(2) 焦虑和抑郁;(3) 他们是否从不同的医疗服务提供者那里得到了 "症状和副作用 "方面的治疗:样本包括 277 名 OAC;45% 表示焦虑加重,31% 表示抑郁加重。最严重的问题集中在身体形象和健康生活方式以及症状负担和影响方面。更严重的担忧与更高程度的焦虑和抑郁有关。与没有接受姑息治疗、心理健康、物理或职业治疗的 OAC 相比,接受姑息治疗、心理健康、物理或职业治疗、药剂师或初级医疗服务提供者治疗的 OAC 的担忧严重程度与抑郁之间的关系更弱。与肿瘤科医疗服务提供者的就诊并不能缓和大多数担忧与痛苦之间的关系:结论:接受专科医疗服务提供者的治疗会减轻 OAC 患者的担忧与痛苦之间的关系。跨学科团队护理可能是为 OAC 提供以患者为中心的综合护理的重要组成部分。
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来源期刊
Quality of Life Research
Quality of Life Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
8.60%
发文量
224
审稿时长
3-8 weeks
期刊介绍: Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.
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