Oncology clinicians' feelings towards patients presented in supervision: A pre-post assessment using the feeling word checklist.

OBJECTIVE: Clinical supervision of oncology clinicians by psycho-oncologists is an important means of psychosocial competence transfer and support. Research on this essential liaison activity remains scarce. The aim of this study was to assess the impact of supervision on oncology clinicians' feelings towards patients presented in supervision. METHODS: Oncology clinicians' (n = 23) feelings towards patients presented in supervision were assessed with the Feeling Word Checklist (FWC). The FWC was filled in by supervisees prior and after their supervision sessions (n = 91), which were conducted by experienced supervisors (n = 6). Pre- post-modification of feelings was evaluated based on a selection of FWC items, which were beforehand considered as likely to change in a beneficial supervision. Items were evaluated on session level using t-tests for dependent groups. Composite scores were calculated for feelings expected to raise and feelings expected to decrease and analysed on the level of supervisees. RESULTS: Feelings related to threats, loss of orientation or hostility such as "anxious", "overwhelmed", "impotent", "confused", "angry", "depreciated" and "guilty" decreased significantly after supervision, while feelings related to the resume of the relationship ("attentive", "happy"), a better understanding of the patient ("empathic"), a regain of control ("confident") and being "useful" significantly increased. Feeling "interested" and "calm" remained unchanged. Significant increase or decrease in the composite scores for supervisees confirmed these results. CONCLUSIONS: This study demonstrates modification of feelings towards patients presented in supervision. This modification corresponds to the normative, formative, and especially restorative function (support of the clinician) of supervision.

Identifying complex patients in family medicine for potential benefit from a case manager: a short questionnaire derived from the INTERMED Self-Assessment (IMSA) questionnaire.

PURPOSE: To investigate how useful the Intermed-Self Assessment (IMSA) questionnaire and its components were for identifying which patient candidates would benefit most from case management (CM) in general practice. METHODS: The study was carried out in a group family medicine practice in Lausanne comprising seven GPs and four medical assistants, from February to April 2019. All the patients attending the practice between February and April 2019 were invited to complete the IMSA questionnaire. Additionally, their GPs were asked for their opinions on the potential benefits of each patient being assigned a case manager. Each IMSA item's value has been assessed as a predictor of GPs' opinions by using multivariate logistic models. A score including items retained as predictor was built. RESULTS: Three hundred and thirty one patients participated in the study (participation rate: 62%). Three items from the 20 item IMSA were sufficient to predict GPs' opinions about whether their patients could be expected to benefit if assigned a case manager. Those items addressed the patient's existing chronic diseases (item1), quality of life in relation to existing diseases (item 3), and their social situation (item 9). Using these three items as a score, a cut-off at 4 gave a sensitivity of 70% (ability to correctly identify patients who could benefit from a CM) and specificity of 73% (ability to correctly identify patients who should not benefit from a CM) and concerned about one patient in two. CONCLUSION: Identifying complex patients suitable for case management remains a challenge for primary care professionals. This paper describes a novel approach using a structured process of combining the results of standardized tools such as the one defined in this study, and the experience of the primary care team.

[Bio-Psycho-Social Needs Assessment in Family Medicine: Acceptability of the Intermed Self-Assessment]. / Evaluation des besoins bio-psycho-sociaux en médecine de famille: acceptabilité de l'INTERMED Self-Assessment.

Bio-Psycho-Social Needs Assessment in Family Medicine: Acceptability of the Intermed Self-Assessment Abstract. In view of the increasing number of patients with somato-psychic comorbidities, a tool for identifying complex patients such as the INTERMED self-assessment (IMSA) would prove useful in family medicine. An observational study was conducted in a practice with seven general practitioners to evaluate the acceptability of patients to fill in this questionnaire in the waiting room. The IMSA was quickly completed and well accepted by patients, who found the questions easy to understand and relevant to their health. The waiting room environment didn't seem to hinder the process. The majority of participants deemed useful that their doctor received the data from the questionnaire. The IMSA could be implemented in the practice to detect certain psycho-social fragilities at an early stage.

Résumé. Face à l'augmentation du nombre de patients présentant des comorbidités somato-psychiques, un outil d'identification des patients complexes tel que L'INTERMED self-assessment (IMSA) s'avèrerait utile en médecine de famille. Afin d'évaluer l'acceptabilité des patients de remplir ce questionnaire dans la salle d'attente de leur médecin, une étude observationnelle a été menée durant neuf semaines dans un cabinet regroupant sept généralistes. L'IMSA, rapide à remplir, est bien accepté par les patients qui jugent les questions faciles à comprendre et pertinentes pour leur santé. L'environnement de la salle d'attente ne semble pas être un obstacle. La majorité des participants estime utile que leur médecin reçoive les informations du questionnaire. L'IMSA pourrait être implémenté au cabinet pour détecter certaines fragilités psycho-sociales précocement.