Evaluation of a Program for Routine Implementation of Symptom Distress Screening and Referral in Cancer Care
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: A nurse-led symptom distress screening program.
- Who it may be relevant to
- Registry conditions: Neoplasms. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Hong Kong
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Evaluation of a Program for Routine Implementation of Symptom Distress Screening and Referral in Cancer Care: a Stepped Wedge Cluster Randomized Trial
Overview
This study proposes to evaluate the process and outcome of an implementation program designed to implement nurse-led symptom distress screening and referral into routine cancer care clinics. Specifically, using a stepped-wedge cluster randomized controlled trial, This study aim to test if a systematic symptom distress screening program increases the proportion of eligible patients screened and referred compared to usual control. For process evaluation, this study will use qualitative methods to assess the experience and response to the implementation program.
Detailed description
This study proposes to evaluate the process and outcome of an implementation program designed to implement nurse-led symptom distress screening and referral into routine cancer care clinics. Specifically, using a stepped-wedge cluster randomized controlled trial, this study aim to test if a systematic symptom distress screening program (i.e. using the five implementation strategies including training, audit, feedback, facilitation and adaptable workflow) increases the proportion of eligible patients screened and referred compared to usual control under which no implementation strategies will be used to facilitate the adoption of the systematic symptom distress screening and referral. The investigator hypothesize that (1) the intervention will increase the proportion of eligible patients screened; (2) the intervention will increase the proportion of patients with moderate to severe symptom distress referred for psychosocial support.
For process evaluation, this study will use qualitative methods to assess the experience and response to the implementation program.
Interventions
- Other A nurse-led symptom distress screening program
Five implementation strategies will be conducted individually for each of the study unit at the timepoint when the study unit is being randomly allocated to the implementation condition. For each study unit, all nurses will first receive a half-day training. Each study unit under the implementation condition will receive weekly audit and feedback reports to summarize the proportion of eligible patients, proportion of eligible patients being screened, proportion of patients appropriately referred
Primary outcome measures
- Change in the number of eligible patient screened [Time frame: Pre- and post-implementation phase, up to 24 months]
- Change in the number of eligible patient referred [Time frame: Pre- and post-implementation phase, up to 24 months]
Secondary outcome measures (7)
- Change in referral uptake [Time frame: Pre- and post-implementation phase, up to 24 months]
- Process evaluation in providers by conducting qualitative interviews [Time frame: post-implementation phase, up to 24 months]
- Process evaluation in patients by conducting qualitative interviews [Time frame: post-implementation phase, up to 24 months]
- Number of staff receiving training [Time frame: pre-implementation phase, up to 24 months]
- Change in staff knowledge about the implementation of the screening programme assessed using categorical Likert scales [Time frame: pre- and post-training workshop, and post-implementation phase, up to 24 months]
- Change in staff's belief in the symptom distress screening programme assessed using categorical Likert scales [Time frame: pre- and post-training workshop, and post-implementation phase, up to 24 months]
- Change in staff self-efficacy in administrating the symptom distress screening programme assessed using categorical Likert scales [Time frame: pre- and post-training workshop, and post-implementation phase, up to 24 months]
Eligibility criteria
Inclusion criteria
- All cancer patients within two years post-treatment attending the specialized outpatient clinics for surveillance will be eligible for symptom distress screening, with no exclusions by any demographic and clinical characteristics.
Exclusion criteria
- All cancer patients beyond two years post-treatment
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Crossover
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
Hong Kong · 10 centers
- JCICC — Hong Kong
- Kwong Wah Hospital-Breast Center — Hong Kong
- North District Hospital — Hong Kong
- Pamela Youde Nethersole Eastern Hospital-Department of oncology — Hong Kong
- Prince of Wales Hospital-Department of Surgery — Hong Kong
- Queen Mary Hospital-Department of Obstetrics & Gynaecology — Hong Kong
- Queen Mary Hospital-Department of Oncology — Hong Kong
- Queen Mary Hospital-Department of Surgery — Hong Kong
- … and 2 more centers
Identifiers
NCT: NCT05949996 · UW22-645