Joanne M Shaw1, Melanie A Price2,3, Josephine M Clayton4,5, Peter Grimison5,6, Tim Shaw5, Nicole Rankin7, Phyllis N Butow2,3. 1. Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia. joanne.shaw@sydney.edu.au. 2. Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia. 3. Centre for Medical Psychology and Evidence-based Decision-making, School of Psychology, The University of Sydney, Sydney, NSW, Australia. 4. HammondCare Palliative & Supportive Care Service, Greenwich Hospital, Greenwich, NSW, Australia. 5. Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. 6. The Chris O'Brien Lifehouse, Camperdown, NSW, Australia. 7. Sydney Catalyst, The University of Sydney, Sydney, NSW, Australia.
Abstract
PURPOSE: People with cancer and their families experience high levels of psychological morbidity. However, many cancer services do not routinely screen patients for anxiety and depression, and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context. METHODS: A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Co-operative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale. RESULTS: Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after two Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings. CONCLUSIONS: This study identified a core set of evidence- and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancer patients.
PURPOSE:People with cancer and their families experience high levels of psychological morbidity. However, many cancer services do not routinely screen patients for anxiety and depression, and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context. METHODS: A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Co-operative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale. RESULTS: Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after two Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings. CONCLUSIONS: This study identified a core set of evidence- and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancerpatients.
Authors: Nina S Kadan-Lottick; Lauren C Vanderwerker; Susan D Block; Baohui Zhang; Holly G Prigerson Journal: Cancer Date: 2005-12-15 Impact factor: 6.860
Authors: Michael Kusch; Hildegard Labouvie; Vera Schiewer; Natalie Talalaev; Jan C Cwik; Sonja Bussmann; Lusine Vaganian; Alexander L Gerlach; Antje Dresen; Natalia Cecon; Sandra Salm; Theresia Krieger; Holger Pfaff; Clarissa Lemmen; Lisa Derendorf; Stephanie Stock; Christina Samel; Anna Hagemeier; Martin Hellmich; Bernd Leicher; Gregor Hültenschmidt; Jessica Swoboda; Peter Haas; Anna Arning; Andrea Göttel; Kathrin Schwickerath; Ullrich Graeven; Stefanie Houwaart; Hedy Kerek-Bodden; Steffen Krebs; Christiana Muth; Christina Hecker; Marcel Reiser; Cornelia Mauch; Jennifer Benner; Gerdamarie Schmidt; Christiane Karlowsky; Gisela Vimalanandan; Lukas Matyschik; Lars Galonska; Annette Francke; Karin Osborne; Ursula Nestle; Markus Bäumer; Kordula Schmitz; Jürgen Wolf; Michael Hallek Journal: BMC Health Serv Res Date: 2022-04-22 Impact factor: 2.908
Authors: Phyllis Butow; Joanne Shaw; Heather L Shepherd; Melanie Price; Lindy Masya; Brian Kelly; Nicole M Rankin; Afaf Girgis; Thomas F Hack; Philip Beale; Rosalie Viney; Haryana M Dhillon; Joseph Coll; Patrick Kelly; Melanie Lovell; Peter Grimison; Tim Shaw; Tim Luckett; Jessica Cuddy; Fiona White Journal: BMC Cancer Date: 2018-11-07 Impact factor: 4.430
Authors: Heather L Shepherd; Liesbeth Geerligs; Phyllis Butow; Lindy Masya; Joanne Shaw; Melanie Price; Haryana M Dhillon; Thomas F Hack; Afaf Girgis; Tim Luckett; Melanie Lovell; Brian Kelly; Philip Beale; Peter Grimison; Tim Shaw; Rosalie Viney; Nicole M Rankin Journal: Front Public Health Date: 2019-10-18
Authors: Jean-Baptiste Gartner; Kassim Said Abasse; Frédéric Bergeron; Paolo Landa; Célia Lemaire; André Côté Journal: BMC Health Serv Res Date: 2022-04-26 Impact factor: 2.908
Authors: Joanne Shaw; Karen Allison; Jessica Cuddy; Toni Lindsay; Peter Grimison; Heather Shepherd; Phyllis Butow; Tim Shaw; Kate Baychek; Brian Kelly Journal: BMC Health Serv Res Date: 2022-01-31 Impact factor: 2.655