The effect of including a 'psychooncological statement' in the discharge summary on patient-physician communication: a randomized controlled trial.

OBJECTIVE: The objective of this study is to determine whether the inclusion of a 'psychooncological statement' (PO-statement) in the discharge summary enhances patient-physician communication about psychosocial issues across the inpatient and outpatient sector. METHODS: A total of 1416 cancer patients were randomly assigned to the intervention (with PO-statement in the discharge summary) or control group (discharge summary without PO-statement). Shortly before discharge from the hospital (T1), patients from the intervention group were screened for psychosocial distress. Based on the electronic clinical documentation system, screening results were subsequently integrated into the discharge summary, which automatically generated a PO-statement. To determine the effect of the PO-statement, patients as well as their primary care physicians (n = 596) were asked during follow-up care (T2) whether psychosocial distress was discussed during the last consultation. RESULTS: Including a PO-statement in the discharge summary did not result in more frequent discussions about psychosocial issues compared with the control group from the patients' and physicians' perspectives. Instead, discussions about psychosocial well-being were significantly associated with women of the patient (p = <0.001) and the physician (p = 0.011), medical discipline (gynecologists; p = 0.002), cancer diagnosis (gynecological cancer; p = 0.002), metastases (p = <0.001), professional training of patients (none, p = 0.026), and psychosocial qualification of physicians (p = 0.018). CONCLUSION: Written information on psychosocial distress in the discharge summary alone does not affect communication.

Patients' acceptance and psychometric properties of the EORTC QLQ-CX24 after surgery.

OBJECTIVE: The aim of this study was to evaluate patients' acceptance and the reliability and validity of a recently developed instrument to assess quality of life among cervical cancer patients, the European Organization for Research and Treatment of Cancer Cervical Cancer Module (EORTC QLQ-CX24), in surgically treated patients after primary surgery. METHODS: The EORTC QLQ-CX24 was administered to 134 cervical cancer patients who had undergone pelvic surgery. Additional questionnaires completed were the EORTC QLQ-C30, and the Hospital Anxiety and Depression Scale. Sociodemographic and medical data were recorded. RESULTS: Missing values occurred in 4.5% of all non-optional items. Internal consistencies (Cronbach's alpha coefficients) for the three multi-item scales ranged from 0.70 to 0.87 (Symptom Experience 0.70, Body Image 0.87, Sexual/Vaginal Functioning 0.76), whereas scaling errors occurred in 6.8%, 0.0%, and 6.3% of the cases. In all domains, the entire range of the scale was used by patients. The scales were able to discriminate between different subgroups of patients. CONCLUSION: These psychometric analyses confirm that the EORTC QLQ-CX24 is a useful tool for the assessment of quality of life in cervical cancer patients after surgery.