In January of 2019, the University of Iowa Stead Family Children’s Hospital (UI SFCH) formalized their Pediatric Psychosocial Oncology Program by utilizing 15 evidence-based Standards for Psychosocial Care for Children with Cancer and Families as a foundation for program development. The psychosocial oncology clinical team members identified ongoing gaps in care and a need to improve progress toward achieving these standards. Reviewing and analyzing the Pediatric Psychosocial Standard of Care Institutional Assessment Tool further highlighted the need for program development but also demonstrated the need to design institutionally specific objective measures to monitor program improvements over time. The current project focused on the creation of a program evaluation system with objective measures specific to the UI SFCH practice setting. Barriers such as staffing and cost were identified and addressed. Additionally, a REDCap®database using a structured chart review as its foundation was initiated, which permitted the comprehensive evaluation of the standards of care at UI SFCH. The Matrix and Guidelines included in the Pediatric Psychosocial Standard of Care Institutional Assessment Tool comprised the framework to develop institution specific objective measurements for each standard of care. The objective measures of interest were social work assessments and provider biopsychosocial assessments. Data were exported and uploaded to a statistical program for data analysis. The statistical significance of percentage changes was evaluated with a one-tailedt-test;pvalues < 0.05 were considered significant. The development of this REDCap®database project allowed for the evaluation of the program’s current efficiency in implementing the PSCPCC standards of care. Using the database in the future will allow psychosocial oncology team members to easily identify other areas for improvement and to ensure that all 15 standards of psychosocial care are being comprehensively addressed in the care of pediatric oncology patients and interactions with their families.
2019年1月，爱荷华大学斯蒂德家庭儿童医院以《儿童癌症患者及家庭心理社会护理的15项循证标准》为基础，正式建立了儿科心理社会肿瘤学项目。心理社会肿瘤学临床团队成员发现当前护理工作中存在持续缺口，亟需推进这些标准的落实进程。通过对《儿科心理社会护理标准机构评估工具》的审阅分析，不仅进一步凸显了项目发展的必要性，更揭示出需要建立机构特异性客观指标以持续监测项目改进效果。本项目重点构建了针对爱荷华大学斯蒂德家庭儿童医院实践环境的项目评估体系，识别并解决了人员配置与成本等实施障碍。同时建立了以结构化病历审查为基础的REDCap®数据库，实现了对该院护理标准的系统性评估。以《儿科心理社会护理标准机构评估工具》中的矩阵与指南为框架，针对每项护理标准开发了机构特异性客观测量指标，重点关注社会工作评估与医疗提供者生物心理社会评估两类指标。研究数据经导出后上传至统计程序进行分析，采用单尾t检验评估百分比变化的统计学显著性，以p值<0.05为具有统计学意义。该REDCap®数据库项目的开发实现了对当前心理社会护理标准实施效能的评估。未来通过该数据库的持续应用，心理社会肿瘤学团队成员可精准识别其他待改进领域，确保在儿科肿瘤患者护理及家属互动中全面贯彻全部15项心理社会护理标准。
肿瘤(癌症)患者之家