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Cost-utility analysis of individual psychosocial support interventions for breast cancer patients in a randomized controlled study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Socialpediatrisk forskning/Sarkadi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology. (Vårdforskning i onkologisk vård)
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2014 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, no 3, 251-258 p.Article in journal (Refereed) Published
Abstract [en]

Background The Distress Thermometer (DT) has been used in psycho-oncology research across the globe and has been recommended as a clinical tool to be used routinely in cancer settings to detect clinically significant distress. We sought to characterize the translation and validation of the DT in cancer patients in different countries and cultures and summarize how the translated versions function to detect clinically significant distress. Methods An electronic mail survey was sent to the members of the International Psychosocial Oncology Society Federation of Psycho-Oncology Societies and electronic searches of English language databases were conducted to identify translations of the DT and studies designed to validate these translations. Results Our efforts yielded a total of 21 non-English translations of the DT; 18 of these were validated in studies designed for that purpose. A variety of instruments were used in receiver operating characteristic curve analysis to derive an optimal cut-off score indicative of clinically significant distress. Cut-off scores varied by language, country, and clinical setting and to sample characteristics. In the majority of studies, a score of 4 maximized sensitivity and specificity relative to an established criterion. Conclusions These findings provide a broad, international perspective on the current state of psychosocial screening using the DT. Findings also demonstrate widespread awareness of the need for psychological and social support of persons diagnosed with and treated for cancer.

Place, publisher, year, edition, pages
2014. Vol. 23, no 3, 251-258 p.
Keyword [en]
validity; cancer; screening; distress; Distress Thermometer
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-206096DOI: 10.1002/pon.3411ISI: 000332952500002PubMedID: 24115469OAI: oai:DiVA.org:uu-206096DiVA: diva2:643446
Funder
Swedish Cancer Society
Available from: 2013-08-27 Created: 2013-08-27 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Individual psychosocial support for breast cancer patients: Quality of life, psychological effects, patient satisfaction, health care utilization and costs
Open this publication in new window or tab >>Individual psychosocial support for breast cancer patients: Quality of life, psychological effects, patient satisfaction, health care utilization and costs
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A randomized intervention study, with the aim to compare the effects of individual psychosocial support provided by (1) oncology nurses specially trained in psychological techniques (INS), or (2) psychologists (IPS), to (3) standard care (SC). Breast cancer patients, living in Uppsala County, and about to start adjuvant treatment at the Department of Oncology, Uppsala, were consecutively included between 1998 and 2000. The patients were assessed seven times during two years by self-administered questionnaires. Study I revealed positive effects of both INS and IPS as compared to SC on global quality of life, side effects, and post-traumatic distress. A lower proportion of patients in the intervention groups had psychosocial support provided in routine care compared with the SC group. In study II the patients reported being highly satisfied with the intervention, irrespective of profession providing the support. However, patients in the INS group reported higher levels of benefit regarding disease-related problems than those in the IPS group. In study III total Health Care costs were lower in the intervention groups and since a gain in quality-adjusted life years (QALY) was seen (mean .1 QALY), the interventions dominated. The costs for the interventions were 44 291- 48 978 SEK. In study IV, daily reporting of anxiety, depression and activity on Visual Analogue Scales (VAS) were completed during two weeks before and after the Hospital Anxiety and Depression Scale (HADS) assessments. A point assessment with the HADS captured the situation better than four weeks assessment on three VAS in the diary. The HADS was considered preferable to the diary. The conclusion is that psychosocial support is beneficial for breast cancer patients and that the intervention delivered by nurses was as effective as that given by psychologists. The costs for the interventions were limited.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 73 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 268
Keyword
Oncology nursing, Breast cancer patients, Individual psychosocial support, Intervention study, Randomized, Quality of life, Psychological effects, Patient satisfaction, Health care utilization and costs, Onkologisk vård
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-7929 (URN)978-91-554-6922-1 (ISBN)
Public defence
2007-09-07, Auditorium Minus, Gustavianum, Uppsala, 09:00
Opponent
Supervisors
Available from: 2007-05-24 Created: 2007-05-24 Last updated: 2013-08-29Bibliographically approved

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Arving, CeciliaFeldman, InnaJohansson, BirgittaGlimelius, Bengt

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