The association of psychosocial screening and service provision in pediatric oncology: the Psychosocial Assessment Tool (PAT2.0) into clinical practice.

PURPOSE: Distress screening in oncology has been widely endorsed in recent years. However, current knowledge of the impact of screening on delivery of clinical psychosocial services is limited. This study investigated the association between screening and psychosocial services in the early period following diagnosis of childhood cancer. METHODS: The Psychosocial Assessment Tool (PAT2.0) was administered by clinical social workers in two pediatric oncology centers shortly following diagnosis. Psychosocial service activity in the first 8 weeks post diagnosis was collected via social work surveys and extraction of information from hospital databases. RESULTS: PAT2.0 and psychosocial service data were obtained for 89 families with a child newly diagnosed with cancer. Distribution of PAT2.0 risk categories was consistent with previous studies (57.3 % universal, 38.2 % targeted, 4.5 % clinical). Significant, weak to moderate correlations between PAT2.0 and social workers' estimates of psychosocial risk were observed. No significant differences in the amount of psychosocial services provided to families with "universal" versus "elevated" (i.e., targeted or clinical) risk were found. Number of days in hospital was strongly and positively associated with the amount of psychosocial services families received in the first 8 weeks following diagnosis. CONCLUSIONS: Psychosocial risk, as measured by the PAT2.0, and allocation of psychosocial services were not significantly associated in the early period following diagnosis. Further investigation is required to understand if differences emerge over time when psychosocial screening is implemented clinically. Development of clinical pathways of care needs to account for patients who may predominantly be treated in the outpatient setting.

Work-related stress and reward: an Australian study of multidisciplinary pediatric oncology healthcare providers.

OBJECTIVE: Managing staff stress and preventing long-term burnout in oncology staff are highly important for both staff and patient well-being. Research addressing work-related stress in adult oncology is well documented; however, less is known about this topic in the pediatric context. This study examined sources of work-related stress and reward specific to multidisciplinary staff working in pediatric oncology in Australia. METHOD: Participants were 107 pediatric oncology clinicians, including medical, nursing, and allied health staff from two Australian pediatric oncology centers. Participants completed an online survey using two newly developed measures: the work stressors scale-pediatric oncology and the work rewards scale-pediatric oncology. RESULTS: The most commonly reported sources of both stress and reward are related to patient care and interactions with children. Results indicated that levels of work-related stress and reward were similar between the professional disciplines and between the two hospitals. Regression analyses revealed no demographic or organizational factors that were associated with either stress or reward. CONCLUSIONS: Work-related stress and reward are not mutually exclusive; particular situations and events can be simultaneously stressful and rewarding for healthcare providers. Although patient care and interactions with children was found to be the most stressful aspect of working in this speciality, it was also the greatest source of reward. Results are discussed in relation to workplace approaches to staff well-being and stress reduction.