Taking a "Snapshot": Evaluation of a Conversation Aid for Identifying Psychosocial Needs in Young Adults with Cancer.

Poort, Hanneke; Souza, Phoebe M.; Malinowski, Paige K.; MacDougall, Katelyn M.; Barysauskas, Constance M.; Lau Greenberg, Teresa; Tulsky, James A.; Fasciano, Karen M.

Purpose: Young adults (YAs) aged 18–35 years with cancer often experience unmet psychosocial needs. We aimed to evaluate a conversation aid ("Snapshot") that offered a framework for discussing YA-specific psychosocial concerns between patients and clinicians. Methods: We developed and implemented Snapshot between 2014 and 2016 as part of a quality improvement initiative at Dana-Farber Cancer Institute. We extracted pre- and postimplementation data from chart documentation of psychosocial concerns. YAs and social workers provided qualitative feedback on the use of Snapshot in clinical care. Results: Postintervention chart reviews revealed a significant increase in the median number of topics documented in charts after implementation of Snapshot (preintervention median = 9 [range: 1–15] vs. postintervention median = 11 [range 6–15]; p = 0.003). Overall, YAs and social workers reported that using Snapshot improved communication and consistency of psychosocial care, with documented improvement in the following domains: understanding illness (p < 0.001), sexuality and intimacy (p = 0.03), symptom burden (p = 0.003), care planning (p < 0.001), support for caregivers and children (p = 0.02), and social, work, and home changes (p = 0.05). Conclusion: Snapshot improved the quality of psychosocial needs assessment among YAs with cancer. Implementation was successful in reducing variability identified in the preintervention cohort and increasing the number of YA-specific psychosocial topics discussed. A standardized conversation aid has the potential to improve quality of care for YAs by enabling early identification and intervention of psychosocial issues for all patients.

CANCER patient psychology; COMMUNICATION; CONCEPTUAL structures; CONVERSATION; INTIMACY (Psychology); SERVICES for caregivers; MEDICAL quality control; NEEDS assessment; PHYSICIAN-patient relations; QUALITY assurance; HUMAN sexuality; SOCIAL workers; ADVANCE directives (Medical care); SOCIAL support; EARLY medical intervention; EARLY diagnosis; ATTITUDES toward illness; ADULTS

Journal of Adolescent & Young Adult Oncology, 2018, Vol 7, Issue 5, p565

2156-5333

Academic Journal

10.1089/jayao.2018.0027