Effects of a Provincial-Wide Implementation of Screening for Distress on Healthcare Professionals' Confidence and Understanding of Person-Centered Care in Oncology

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Background: Although published studies report that screening for distress (SFD) improves the quality of care for patients with cancer, little is known about how SFD impacts healthcare professionals (HCPs). Objectives: This quality improvement project examined the impact of implementing the SFD intervention on HCPs' confidence in addressing patient distress and awareness of person-centered care. Patients and Methods: This project involved pre-evaluation and post-evaluation of the impact of implementing SFD. A total of 254 HCPs (cohort 1) were recruited from 17 facilities across the province to complete questionnaires. SFD was then implemented at all cancer care facilities over a 10-month implementation period, after which 157 HCPs (cohort 2) completed post-implementation questionnaires. At regional and community care centers, navigators supported the integration of SFD into routine practice; therefore, the impact of navigators was examined. Results: HCPs in cohort 2 reported significantly greater confidence in managing patients' distress and greater awareness about person-centered care relative to HCPs in cohort 1. HCPs at regional and community sites reported greater awareness in person-centeredness before and after the intervention, and reported fewer negative impacts of SFD relative to HCPs at tertiary sites. Caring for single or multiple tumor types was an effect modifier, with effects observed only in the HCPs treating multiple tumors. Conclusions: Implementation of SFD was beneficial for HCPs' confidence and awareness of person-centeredness. Factors comprising different models of care, such as having site-based navigators and caring for single or multiple tumors, influenced outcomes.

Author Contributions: Project evaluation, data analyses, literature review, and lead manuscript writer: Tamagawa. Project coordinator and prepared a grant application for the study: Groff. Assisted program coordination and staff education at different sites: Anderson and Champ. Program assistant and administration: Deiure. Literature review and manuscript writing: Looyis. Principal investigator, recipient of a grant for the study, and manuscript writing: Watson. Correspondence: Linda Watson, PhD, RN, Person-Centered Care Integration, CancerControl Alberta, Alberta Health Services, Tom Baker Cancer Center, Holy Cross Site, 2202 2nd Street SW, Calgary, AB, T2S 3C1, Canada. E-mail: linda.watson@albertahealthservices.ca
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