Screening for Psychological Distress in Adult Primary Brain Tumor Patients and Caregivers: Considerations for Cancer Care Coordination.

INTRODUCTION: This study aimed to assess psychological distress (PD) as scored by the Distress Thermometer (DT) in adult primary brain tumor patients and caregivers (CGs) in a clinic setting and ascertain if any high-risk subgroups for PD exist. MATERIAL AND METHODS: From May 2012 to August 2013, n = 96 patients and n = 32 CG underwent DT screening at diagnosis, and a differing cohort of n = 12 patients and n = 14 CGs at first recurrence. Groups were described by diagnosis (high grade, low grade, and benign) and English versus non English speaking. Those with DT score ≥4 met caseness criteria for referral to psycho-oncology services. One-way ANOVA tests were conducted to test for between-group differences where appropriate. RESULTS: At diagnosis and first recurrence, 37.5 and 75.0% (respectively) of patients had DT scores above the cutoff for distress. At diagnosis, 78.1% of CGs met caseness criteria for distress. All CGs at recurrence met distress criterion. Patients with high-grade glioma had significantly higher scores than those with a benign tumor. For patients at diagnosis, non English speaking participants did not report significantly higher DT scores than English speaking participants. DISCUSSION: Psychological distress is particularly elevated in CGs and in patients with high-grade glioma at diagnosis. Effective PD screening, triage, and referral by skilled care coordinators are vital to enable timely needs assessment, psychological support, and effective intervention.

Australian experience of neuro-oncology care coordination: a conversation.

BACKGROUND: The role of care coordinator was introduced to support patients, caregivers, and healthcare professionals who work within a specialty, as well as to optimize and standardize care. Specifically, the role of neuro-oncology care coordinator is a developing one-and one that has encountered various barriers and difficulties. Patients diagnosed with neurologic cancer must endure a disease trajectory and multimodal treatment approach that present unique challenges to themselves and to the healthcare system. Consequently, the care coordinator role is needed. OBJECTIVES: This article focuses on the role of the neuro-oncology care coordinator, including its challenges, the needs of patients with neurologic cancer, and the benefits this role can bring. METHODS: Three neuro-oncology care coordinators from New South Wales, Australia, discussed their role in the healthcare system via structured meetings, conversations, and email correspondence. FINDINGS: Making others aware of the issues faced by neuro-oncology care coordinators, as well as their patients, may help to solidify necessary supportive roles within the healthcare system.

Breakaway technique training as a means of increasing confidence in managing aggression in neuroscience nursing.

OBJECTIVE: The objective of this paper was to evaluate breakaway technique training with neuroscience nursing staff as a measure of increased confidence and safety in managing aggression. METHODS: A quasi experimental design was used in a sample of neuroscience nursing staff (n=31), participating in 2×1h breakaway technique workshops. The workshops consisted of supervised skills training in safe breakaway techniques. A pre- and postintervention-matched questionnaire measuring confidence and safety around managing aggressive patients, and exposure to and confidence in dealing with breakaways, was self administered. RESULTS: Statistically significant increases in confidence and safety in working with aggressive patients, and confidence levels for safe breakaways were reported. Qualitative comments demonstrated a desire for ongoing skills workshops. CONCLUSIONS: This study provides early evidence of the importance of incorporating breakaway training into existing training programs which aim to minimise and manage aggression and violence in generalist settings.