title: Does routine psychosocial screening improve referral to psychosocial care providers and patient-radiotherapist communication? A cluster randomized controlled trial.
abstract: OBJECTIVE
  This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication.
  
  
  METHODS
  A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention.
  
  
  RESULTS
  Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (P<0.01). No effects were observed for numbers of referred patients, or for improved patient-radiotherapist communication.
  
  
  CONCLUSIONS
  Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients.
  
  
  CONCLUSIONS
  Psychosocial screening can be enhanced by effective radiotherapist-patient communication.
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands; Department of Health Services Research, CAPHRI School for Public Health and Primary, Maastricht University, Maastricht, The Netherlands. Electronic address: vivian.braeken@maastro.nl.
authors.forename: Anna P B M
authors.initials: AP
authors.lastname: Braeken
authors.forename: Lilian
authors.initials: L
authors.lastname: Lechner
authors.forename: Daniëlle B P
authors.initials: DB
authors.lastname: Eekers
authors.forename: Ruud M A
authors.initials: RM
authors.lastname: Houben
authors.forename: Francis C J M
authors.initials: FC
authors.lastname: van Gils
authors.forename: Ton
authors.initials: T
authors.lastname: Ambergen
authors.forename: Gertrudis I J M
authors.initials: GI
authors.lastname: Kempen
mesh_terms: D016000:Cluster Analysis; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000523:psychology*; D009426:Netherlands; D010817:Physician-Patient Relations; D011859:Radiography; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012947:Social Work; D011795:Surveys and Questionnaires
keywords: Cancer; Communication; Distress; Oncology; Screening