Developing a consensus definition of psychosocial complexity in cancer patients using Delphi methods

Interdisciplinary Pain Board for Managing Patients with Palliative Care Needs and Substance Use Disorder: A Pilot Study

Context: Patients with cancer-related pain and concurrent substance use disorder (SUD) present a unique set of challenges for palliative care clinicians. A structured forum for interdisciplinary collaboration is needed to effectively manage this complex population. Objectives: Describe the feasibility and acceptability of a palliative care Complex Pain Board (CPB), an interdisciplinary team meeting to provide concrete care recommendations for patients with cancer-related pain and concurrent SUD and/or psychosocial complexity. Methods: We conducted a retrospective analysis of cases presented at CPB between May 2021 and June 2022 and a cross-sectional analysis of CBP participant surveys. Results: Among 28 cases included for analysis, gastrointestinal cancers (n = 7, 25.9%) and multiple myeloma (n = 5, 18.5%) were the most frequent cancer diagnoses. Primary reasons for referral were SUD (n = 22, 78.6%) and provider/team distress (n = 13, 46.4%). The most frequent recommendations made at CBP were encouraging interdisciplinary collaboration (n = 18, 64.3%), maintaining healthy boundaries (n = 15, 53.6%), and SUD management (n = 13, 46.4%). Of 14 scheduled meetings, most meetings involved the presentation of ≥1 cases (n = 12, 86%). Among 40 CBP participant surveys, most attendees (n = 38, 95%) were likely or highly likely to continue to attend. Conclusion: CPB is a feasible and acceptable intervention that allows for palliative care clinicians to collaborate and receive interdisciplinary team feedback and peer support on the management of patients with cancer-related pain and concurrent SUD and/or psychosocial complexity in the ambulatory care setting. Key Message: A regular, interdisciplinary team meeting (CPB) is a feasible and acceptable intervention to help palliative care clinicians manage challenging cases involving patients with cancer and concurrent SUD and/or psychosocial complexity.

Establishing internationally accepted conceptual and operational definitions of social prescribing through expert consensus: a Delphi study

OBJECTIVE

The aim of this study was to establish internationally accepted conceptual and operational definitions of social prescribing.

DESIGN

A three-round Delphi study was conducted.

SETTING

This study was conducted virtually using an online survey platform.

PARTICIPANTS

This study involved an international, multidisciplinary panel of experts. The expert panel (n=48) represented 26 countries across five continents, numerous expert groups and a variety of years of experience with social prescribing, with the average being 5 years (range=1-20 years).

RESULTS

After three rounds, internationally accepted conceptual and operational definitions of social prescribing were established. The definitions were transformed into the Common Understanding of Social Prescribing (CUSP) conceptual framework.

CONCLUSION

This foundational work offers a common thread-a shared sense of what social prescribing is, which may be woven into social prescribing research, policy and practice to foster common understanding of this concept.

Establishing Internationally Accepted Conceptual and Operational Definitions of Social Prescribing Through Expert Consensus: A Delphi Study Protocol

Introduction

There is currently no agreed definition of social prescribing. This is problematic for research, policy, and practice, as the use of common language is the crux of establishing a common understanding. Both conceptual and operational definitions of social prescribing are needed to address this gap. Therefore, the aim of the study that is outlined in this protocol is to establish internationally accepted conceptual and operational definitions of social prescribing.

Methodology

A Delphi study will be conducted to develop internationally accepted conceptual and operational definitions of social prescribing with an international, multidisciplinary panel of experts. It is anticipated that this study will involve approximately 40 participants (range = 20-60 participants) and consist of 3-5 rounds. Consensus will be defined a priori as ≥80% agreement.

Discussion

Not only will these definitions serve to unite the social prescribing community, but they will also inform research, policy, and practice. By laying the groundwork for the formation of a robust evidence base, this foundational work will support the advancement of social prescribing and help to unlock the full potential of the social prescribing movement.

Conclusion

This important work will be foundational and timely, given the rapid spread of the social prescribing movement around the world.

Gil Moncayo F, Ochoa Arnedo C, Casellas-Grau A, Trelis Navarro J, Calle Rodríguez C. Consenso sobre el estándar de atención psicooncológica, complejidad psicosocial y actividad asistencial en el Instituto Catalán de Oncología

Introducción: La atención psicosocial de las personas con enfermedad oncológica y la familia debe formar parte de todo modelo integral de atención que pretenda reducir el impacto vital del cáncer. Las intervenciones psicosociales han probado su eficacia en la ayuda a pacientes y familiares para afrontar las situaciones de alta complejidad psicosocial emergentes a consecuencia de un diagnóstico de cáncer. Objetivo: Definir y explicar el modelo de Atención Psicosocial del Comité Psicosocial del Instituto Catalán de Oncología (ICO) utilizando criterios de vulnerabilidad, complejidad y derivación; enmarcado y basado en los valores del ICO (centrados en las necesidades de pacientes con cáncer y sus familias). Método: El modelo que se presenta en este documento consta de cinco pilares: 1) Principios de la Práctica Psicosocial en Oncología; 2) Áreas de actuación en la Atención Psicosocial del paciente con cáncer y la familia; 3) Cribado de malestar emocional y derivación del paciente con cáncer y la familia para una atención psicooncológica específica; 4) Comité Psicosocial: (objetivos; funciones; organización; composición; disciplinas participantes; criterios de derivación y niveles de complejidad; y procedimiento); y 5) Índice de productividad. Resultados: Pacientes y familiares atendidos por el CPS mostraron mejoría estadísticamente significativa en los niveles del malestar emocional, pasando de una media inicial de 8,12/10 (EVA/ ENV) a una media 6,27/10 (EVA/ENV). Asimismo, se constata que las intervenciones derivadas del comité psicosocial redujeron el porcentaje de casos iniciales de alta complejidad, pasando de un 69,3% a un 49,3%. Conclusiones: El abordaje de la complejidad psicosocial mediante un modelo basado en criterios multi e interdisciplinarios consensuados ayuda en la toma de decisiones sobre las acciones a seguir y en la mejora del malestar emocional y complejidad de los pacientes y la familia.