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Enhancing clinical practice in the management of distress: The Therapeutic Practices for Distress Management (TPDM) project
Author(s) -
McLeod Deborah,
Esplen Mary Jane,
Wong Jiahui,
Hack Thomas F.,
Fillion Lise,
Howell Doris,
Fitch Margaret,
Dufresne Julie
Publication year - 2018
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.4831
Subject(s) - knowledge translation , distress , medicine , intervention (counseling) , quality management , focus group , clinical practice , program evaluation , nursing , family medicine , clinical psychology , knowledge management , management system , business , management , public administration , marketing , computer science , political science , economics
Objective The Therapeutic Practices for Distress Management (TPDM) project was carried out to support clinicians in integrating recommendations from four clinical practice guidelines (CPGs) in routine care at five Pan Canadian cancer care sites. Methods Using a concurrent, mixed‐method study design and knowledge translation (KT) activities, this project included two phases: phase I—a baseline/preparation phase and phase II—an intervention phase plus evaluation. The intervention phase (the focus of this report) included a one‐year education and supervision program (24 hours in virtual class; 12‐hour group supervision). Primary outcomes were knowledge and self‐efficacy in practicing CPGs as measured by a Knowledge and Self‐Efficacy Survey (KSES). A secondary outcome was observer‐rated performances with standardized patients (objective structured clinical exams). Participants included 80 (90%) nurses, and 9 (10%) social workers (N = 89). Results The TPDM program was effective in accomplishing change in knowledge, self‐efficacy, and performance. All measures demonstrated significant change pre and post module, with evidence of increasing knowledge ( P < .01) and confidence ( P < .01) over time. Further, there was evidence of a shift in barriers and enablers to practicing in alignment with the CPGs. Conclusions A tailored education program using case‐based learning and supervision over time improves knowledge and practice among front line clinicians. The findings have implications for quality improvement in cancer care.