Hostname: page-component-7479d7b7d-767nl Total loading time: 0 Render date: 2024-07-10T20:26:44.288Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  25 August 2020

A. Casellas-Grau ,
C. Jordán de Luna ,
J. Maté ,
C. Ochoa ,
E.C. Sumalla  and
F. Gil Open the ORCID record for F. Gil [Opens in a new window]
A. Casellas-Grau
Affiliation:
Catalan Institute of Oncology, Psychosocial Observatory in Cancer, Psycho-Oncology Unit, L'Hospitalet de Llobregat, Spain Universitat de Vic – Universitat Central de Catalunya, Vic, Catalunya, Spain
C. Jordán de Luna
Affiliation:
Pharmaceutical Services, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
J. Maté
Affiliation:
Catalan Institute of Oncology, Psychosocial Observatory in Cancer, Psycho-Oncology Unit, L'Hospitalet de Llobregat, Spain
C. Ochoa
Affiliation:
Catalan Institute of Oncology, Psychosocial Observatory in Cancer, Psycho-Oncology Unit, L'Hospitalet de Llobregat, Spain Universitat de Barcelona, Barcelona, Spain
E.C. Sumalla
Affiliation:
Catalan Institute of Oncology, Psychosocial Observatory in Cancer, Psycho-Oncology Unit, L'Hospitalet de Llobregat, Spain
F. Gil*
Affiliation:
Catalan Institute of Oncology, Psychosocial Observatory in Cancer, Psycho-Oncology Unit, L'Hospitalet de Llobregat, Spain Escola superior de Ciències de la Salut, Tecnocampus-Mataró, Universitat Pompeu Fabra, Mataro, Spain
*
Author for correspondence: Francisco Luis Gil Moncayo, Psycho-oncology Unit, Hospital Duran i Reynals, Institut Català d'Oncologia, Av. Gran Via de L'Hospitalet, 199-203, 08907 - L'Hospitalet de Llobregat (Barcelona), Spain. E-mail: fgil@iconcologia.net
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Cancer is one of the biggest health challenges of our times, affecting all the personal areas of a patient. The interrelationships between these areas and the need for multidisciplinary care require the assessment of psychosocial complexity in cancer patients. The main aim of this study was to reach a consensus on the general definition of psychosocial complexity in cancer and its main elements according to the experts in the field.

Method

A Delphi study was performed, which first involved a comprehensive review of the literature to create a questionnaire that was validated by two expert panels. The first panel consisted of intra-institutional experts, while the second included extra-institutional experts in the field. The study included three more rounds: (1) validation of the questionnaire by the internal panel, (2) discussion of the results and resolving discrepancies, and (3) validation of the questionnaire by the external panel.

Results

After the four-round Delphi process, we obtained a consensus definition of psychosocial complexity in cancer patients, as well as of its main factors: medical–physical, social-family, psychological, and spiritual. A 21-indicators list and its 8-indicators brief version were also proposed as indicators of psychosocial complexity.

Significance of results

We present a definition of psychosocial complexity in cancer patients that has been agreed by experts, also establishing its four factors: medical–physical, social-family, psychological, and spiritual. This has led to the development of a list of indicators (and its brief version) that, after a validation process, could help health professionals to identify patients with high psychosocial complexity to provide them an optimal care.

Keywords

CancerDelphiOncologyPsychosocial complexityPsyhcooncologySpirituality
Type
Original Article
Information
Palliative & Supportive Care , Volume 19 , Issue 1 , February 2021 , pp. 17 - 27
Check for updates
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Borràs, JM and Prades, J (2017) El desarollo de la atención multidisciplinar en la atención al cáncer. De cuando Europa se presentó en el comité de tumores. Encuentros Multidisciplinares 55, 1–6.Google Scholar
Bray, F, Ferlay, J, Soerjomataram, I, et al. (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians 68, 394–424.Google ScholarPubMed
Dalkey, N and Helmer, O (1963) An experimental application of the Delphi method to the use of experts. Management Science 9, 458–467.CrossRefGoogle Scholar
Gil, FL, Maté, J, Ochoa, C, et al. (2019) Abordaje de la complejidad psicosocial en pacientes con cáncer. Medicina Clínica. Epub ahead of print 25 May 2019. doi:10.1016/j.medcli.2019.03.022.Google Scholar
Gómez-Batiste, X, Martínez-Muñoz, M, Blay, C, et al. (2013) Identificación de personas con enfermedades crónicas avanzadas y necesidad de atención paliativa en servicios sanitarios y sociales: Elaboración del instrumento NECPAL CCOMS-ICO©. Medicina Clínica 140, 241–245.CrossRefGoogle Scholar
Grassi, L, Spiegel, D and Riba, M (2017) Advancing psychosocial care in cancer patients. F1000Research 6, 2083–2094.CrossRefGoogle ScholarPubMed
Hasson, F, Keeney, S and McKenna, H (2000) Research guidelines for the Delphi survey technique. Journal of Advanced Nursing 32, 1008–1015.Google ScholarPubMed
Holzner, B, Kemmler, G, Kopp, M, et al. (2001) Quality of life in breast cancer patients — not enough attention for long-term survivors? Psychosomatics 42, 117–123.CrossRefGoogle Scholar
Hsu, CC and Sandford, BA (2005) The Delphi technique. Dublin: National Children's Office 7, 120–125. doi:10.1576/toag.7.2.120.27071.Google Scholar
Huyse, FJ (1997) From consultation to complexity of care prediction and health service needs assessment. Journal of Psychosomatic Research 43, 233–240.CrossRefGoogle ScholarPubMed
Huyse, FJ, Lyons, JS, Stiefel, FC, et al. (1999) ‘INTERMED’: A method to assess health service needs. I. Development and reliability. General Hospital Psychiatry 21, 39–48.CrossRefGoogle Scholar
Kathol, R, Saravay, SM, Lobo, A, et al. (2006) Epidemiologic trends and costs of fragmentation. Medical Clinics of North America 90, 549–572.CrossRefGoogle ScholarPubMed
Lobo, E, Bellido, M, Campos, R, et al. (2003) Primera validación en español del método INTERMED: Un sistema de temprana detección de problemas biopsicosociales y de consumo de servicios en pacientes médico-quirúrgicos. Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace 67, 89–98.Google Scholar
Martin-Rosello, ML (2017). Validación y desarrollo de IDC-PAL, instrumento diagnóstico de la complejidad en ciudados paliativos. PhD Thesis, University of Málaga, Spain.Google Scholar
Maté, J, Bayés, R, González-Barboteo, J, et al. (2008) ¿A qué se atribuye que los enfermos oncológicos de una unidad de cuidados paliativos mueran en paz? Psicooncologia 5, 303–321.Google Scholar
Maté-Méndez, J, González-Barboteo, J, Calsina-Berna, A, et al. (2013) The Institut Català d'Oncologia model of palliative care: An integrated and comprehensive framework to address the essential needs of patients with advanced cancer. Journal of Palliative Care 29, 237–243.CrossRefGoogle ScholarPubMed
Mayou, R and Hawton, K (1986) Psychiatric disorder in the general hospital. British Journal of Psychiatry 149, 172–190.CrossRefGoogle ScholarPubMed
Powell, C (2003) The Delphi technique: Myths and realities. Journal of Advanced Nursing 4, 376–382.CrossRefGoogle Scholar
Salvador, MR, Garrido, N, Perea, I, et al. (2017) El valor del Instrumento Diagnóstico de la Complejidad en Cuidados Paliativos para identificar la complejidad en pacientes tributarios de cuidados paliativos. Medicina Paliativa 24, 196–203.CrossRefGoogle Scholar
Sepúlveda, C, Marlin, A, Yoshida, T, et al. (2002) Palliative care: the World Health Organization's global perspective. Journal of Pain and Symptom Management 24, 91–96.CrossRefGoogle ScholarPubMed
Steele, R, Bosma, H, Johnston, MF, et al. (2008) Research priorities in pediatric palliative care: A Delphi study. Journal of Palliative Care 24, 229–239.CrossRefGoogle ScholarPubMed
Tuca, A, Gómez-Martínez, M and Prat, A (2018) Predictive model of complexity in early palliative care: A cohort of advanced cancer patients (PALCOM study). Supportive Care in Cancer 26, 241–249.CrossRefGoogle Scholar