Oncologists in Italy have demonstrated that a structured approach to providing health information to cancer patients really does make a difference to their psychological and physical well-being and recommend that should be implemented in every oncology unit. The results of a study involving 3,300 patients to test a new way to deliver health information to cancer patients were announced today (20 October 2002) at the European Society for Medical Oncology Congress in Nice, France.
Dr Rodolfo Passalacqua from the Azienda Ospedaliera, Cremona, Italy, said, "We still don't know the best way to give advice to cancer patients, although we know that patients have a strong need to receive more information about their disease." Dr Passalacqua and his team developed a new information structure, known as the Point of Information and Support (PIS), located in oncology units for patients, their families, and friends, taking into account their personal needs and their socio-cultural background. Each PIS comprises a library with booklets, videos and essential information about different types of cancer and cancer drugs. A trained oncology nurse welcomes the patient and mediates between the medical oncologist and the patient, helping patients to obtain specific information and to discuss any topics of concern to the patient. A medical oncologist acts as a referee co-ordinator of the PIS.
Dr Passalacqua's team tested the efficacy of this new structure by means of a randomised trial in 38 cancer centres all over Italy by comparing the centres with a PIS with a control group. The result was measured in relation to a reduction in anxiety and depression and patients' satisfaction for the information provided by the staff, as reported by the patients and compared with the control group. At the end of the six-month period of the study, 3,300 consecutive, unselected cancer patients, attending the randomised centres, were surveyed by means of an anonymous questionnaire.
"Globally, nearly one quarter of the patients reported moderate to severe levels of anxiety or depression. Almost all of the patients reported to be highly satisfied with the health information provided by the staff," said Dr Passalacqua.
A few centres did not succeed in starting up the new structure for different reasons, such as lack of nurses, organisational difficulties, misunderstandings, and internal conflicts in the oncology units. In the centres where these difficulties were overcome and the PIS worked well, moderate to severe levels of anxiety or depression decreased significantly compared to the other centres where the PIS had not been implemented. In the same way, patients' satisfaction for the information they received was higher in the centres where PIS was working well (93.6%) and most of them (89%) had a reasonable knowledge of their disease.
"For the first time, we have shown that it is possible to create a library for information and support for cancer patients in oncology units, managed by an oncology nurse belonging to the same unit, and this structure reduces patients' anxiety and depression and increases patients' satisfaction. The PIS should be adopted in every oncology unit. All health care staff, in collaboration with psycho-oncologists, should receive the appropriate training," said Dr Passalacqua.
Since over 20% of all cancer patients report a moderate to severe level of distress and 40% of them have a borderline distress condition, early detection of psychological distress and a reduction in anxiety and depression should be a priority. The PIS has a positive impact on these aspects, by providing adequate and personalised information to the patient.