title: Everybody wants it done but nobody wants to do it: an exploration of the barrier and enablers of critical components towards creating a clinical pathway for anxiety and depression in cancer.
abstract: BACKGROUND
  This study aimed to explore barriers to and enablers for future implementation of a draft clinical pathway for anxiety and depression in cancer patients in the Australian context.
  
  
  METHODS
  Health professionals reviewed a draft clinical pathway and participated in qualitative interviews about the delivery of psychosocial care in their setting, individual components of the draft pathway, and barriers and enablers for its future implementation.
  
  
  RESULTS
  Five interrelated themes were identified: ownership; resources and responsibility; education and training; patient reluctance; and integration with health services beyond oncology.
  
  
  CONCLUSIONS
  The five themes were perceived as both barriers and enablers and provide a basis for an implementation plan that includes strategies to overcome barriers. The next steps are to design and deliver the clinical pathway with specific implementation strategies that address team ownership, endorsement by leaders, education and training modules designed for health professionals and patients and identify ways to integrate the pathway into existing cancer services.
authors.affiliation: Translational Research Fellow, Sydney Catalyst, The University of Sydney, Chris O'Brien Lifehouse, Level 6, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia. nicole.rankin@ctc.usyd.edu.au.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Rankin
authors.affiliation: Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia. Phyllis.butow@sydney.edu.au.
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.affiliation: Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia. thidanly@gmail.com.
authors.forename: Thida
authors.initials: T
authors.lastname: Thein
authors.affiliation: Workforce Education and Development Group, Sydney Medical School, The University of Sydney, Sydney, Australia. tracy.robinson@sydney.edu.au.
authors.forename: Tracy
authors.initials: T
authors.lastname: Robinson
authors.affiliation: Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia. joanne.shaw@sydney.edu.au.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Shaw
authors.affiliation: Psycho-Oncology Co-operative Research Group, School of Psychology, The University of Sydney, Sydney, Australia. melanie.price@sydney.edu.au.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Price
authors.affiliation: Calvary Mater Newcastle Hospital, Newcastle, Australia. Kerrie.Clover@calvarymater.org.au.
authors.forename: Kerrie
authors.initials: K
authors.lastname: Clover
authors.affiliation: Workforce Education and Development Group, Sydney Medical School, The University of Sydney, Sydney, Australia. tim.shaw@sydney.edu.au.
authors.forename: Tim
authors.initials: T
authors.lastname: Shaw
authors.affiliation: Chris O'Brien Lifehouse, Missenden Road, Camperdown, NSW, Australia. peter.grimison@lh.org.au.
authors.forename: Peter
authors.initials: P
authors.lastname: Grimison
mesh_terms: D000368:Aged; D001007:Anxiety / Q000628:therapy*; D001315:Australia; D019091:Critical Pathways; D003866:Depressive Disorder / Q000628:therapy*; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006296:Health Services; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D011613:Psychotherapy; D036301:Qualitative Research