Do radiation therapists feel able to routinely screen for symptoms and distress in people with cancer: barriers impacting practice

Abstract

Introduction: This study aimed to evaluate radiation therapists' (RTs) perceptions regarding the perceived barriers, knowledge, attitudes, confidence and role in administering an electronic screening tool to routinely screen for cancer patients' symptoms and distress. Methods: RTs at two radiation therapy departments completed a cross-sectional paper/pen survey to assess their demographic and workplace characteristics, perceptions of barriers, knowledge, attitudes, confidence and opinion of their role in symptom and distress screening. Responses were evaluated using simple frequencies and free-text responses using thematic analysis. Results: Of 39 RTs approached, 37 (95%) participated. The majority had not previously attended any emotional cues (77%) or psychosocial training (86%); 68% reported confidence discussing psychosocial concerns and recognising signs of anxiety and depression in patients, and 65% felt discussing patients' psychosocial concerns was part of their role. Administering the tool to patients was agreed to be the role of RTs by 38% of participants. Lack of education about psychosocial issues was the highest-ranked barrier to delivering the patient screening tool, with 74% of RTs responding 'it has made it difficult'. Conclusion: Whilst RTs are willing to play a role in patients' psychosocial support, they do not feel able to fulfil this role adequately because they lacked knowledge and confidence to administer symptom and distress screening. This research has highlighted the need for RT education on psychosocial concerns and recognising and responding to emotional cues. Understanding the impact education may have on the knowledge, attitude, confidence and role of RTs performing routine symptom and distress screening is required.

Stepping into the real world: a mixed-methods evaluation of the implementation of electronic patient reported outcomes in routine lung cancer care

“…The HCP survey was adapted from a previously published measure [ 36 ], examining staff and environmental factors related to successful implementation of interventions in hospital settings [ 37 ]. The 27-item questionnaire (Additional file 1 ) assessed barriers (8-items), knowledge and attitudes (4-items), HCP confidence and role (6-items); and demographic and workplace characteristics (9-items); and included a free-text question on barriers.…”

Screening for distress in cancer care: How to overcome barriers after unsuccessful implementation?

“…Oncology staff have reported in the past feeling overloaded with their routine tasks and perceive this change in practice as an additional burden. Lack of training and support on psychosocial issues, the fear of inadequate response to patients' distress, as well as the failure to offer appropriate resources and help, have been documented in healthcare professionals (Mitchell, 2013;Ercolano et al, 2018;Knies et al, 2019;Arnold et al, 2021). Even when distress screening becomes part of routine cancer care, some barriers persist and need to be addressed on a long-term basis in order to monitor compliance (Pereira et al, 2016).…”

Patient self-reported follow-up for radiation oncology patients during COVID-19: feasibility and patient-clinician agreement

“…PROs can be measured in absolute terms, such as a pain rating scale of zero to 10, or changes in reported nausea [10]. The collection of PROs in cancer care has become an important and frequent clinical practice activity to understand the impact of the disease on the patient and develop appropriate support and screening measures [11][12][13]. However, whilst there has been a proliferation of validated PRO tools used in cancer care [14][15][16][17], there is no gold standard for measuring PROs in radiation oncology follow-up care [18,19].…”