Guidelines Translation for Distress Management in Cancer Patients Based on CAN-IMPLEMENT: Implementation Part

Abstract

Background: Stomach cancer patients receiving chemotherapy suffered severe distress. This study aimed to align the Cancer-related Distress Management Guidelines into clinical practice among stomach cancer patients receiving chemotherapy, and to monitor the implementation process of Cancer-related Distress Management Guidelines, evaluate the effects of guidelines implementation, and maintain the guidelines implementation in clinical practice.Methods: A Guideline Adaptation and Implementation Planning Resource (CAN-IMPLEMENT) was used as the research framework, which include three phases. Here the Implementation Part (Phase 2 and Phase 3) was reported: alignment of Cancer-related Distress Management Guidelines in clinical practice among stomach cancer patients receiving chemotherapy, and process monitoring and outcome evaluation of Cancer-related Distress Management Guidelines.Results: After the guidelines implementation, the formal audit criteria, working pathways, assessment tools, multidisciplinary panels, training manual for healthcare professionals, education and handbook for patients and their caregivers of distress management were developed on institutional level, as well as the related assessment tools and record forms. The completion rate of distress management record was increased from 0.0% to 97.9% (P<0.001). The compliance of most items in the audit checklist for medical staff's distress management were improved, from 57.1% to 100.0% (P<0.001). The distress positive rate of stomach cancer patients receiving chemotherapy was decreased from 22.7% to 9.3% (P<0.05), and the distress scores were declined from 2 (0-9) to 0 (0-7) (P<0.001).Conclusions: The completion rate of distress management records increased significantly after guidelines implementation, revealing the process quality control of the distress management practice was good. At the institutional level, this guidelines implementation promoted the establishment of distress management system. To healthcare professionals, the guidelines implementation improved the distress management compliance. For stomach cancer patients receiving chemotherapy, distress management practices can effectively improve the distress of stomach cancer patients receiving chemotherapy.