Barriers and facilitators to implementation and sustainment of guideline-recommended depression screening for patients with breast cancer in medical oncology: a qualitative study
Objectives Implementation of guideline-recommended depression screening in oncology presents numerous challenges. Implementation strategies that are responsive to local context may be critical elements of adoption and sustainment. We evaluated barriers and facilitators to implementation of a depress...
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| Veröffentlicht in: | Supportive care in cancer 2023-08, Vol.31 (8), p.461, Article 461 |
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| creator | Hahn, Erin E. Munoz-Plaza, Corrine E. Lyons, Lindsay Joe Lee, Janet S. Pounds, Dana La Cava, Shannon Brasfield, Farah M. Durna, Lara N. Kwan, Karen W. Beard, David B. Ferreira, Alexander Gould, Michael K. |
| description | Objectives
Implementation of guideline-recommended depression screening in oncology presents numerous challenges. Implementation strategies that are responsive to local context may be critical elements of adoption and sustainment. We evaluated barriers and facilitators to implementation of a depression screening program for breast cancer patients in a community medical oncology setting as part of a cluster randomized controlled trial.
Methods
Guided by the Consolidated Framework for Implementation Research, we employed qualitative methods to evaluate clinician, administrator, and patient perceptions of the program using semi-structured interviews. We used a team-coding approach for the data; thematic development focused on barriers and facilitators to implementation using a grounded theory approach. The codebook was refined through open discussions of subjectivity and unintentional bias, coding, and memo applications (including emergent coding), and the hierarchical structure and relationships of themes.
Results
We conducted 20 interviews with 11 clinicians/administrators and 9 patients. Five major themes emerged: (1) gradual acceptance and support of the intervention and workflow; (2) compatibility with system and personal norms and goals; (3) reinforcement of the value of and need for adaptability; (4) self-efficacy within the nursing team; and (5) importance of identifying accountable front-line staff beyond leadership “champions.”
Conclusions
Findings suggest a high degree of acceptability and feasibility due to the selection of appropriate implementation strategies, alignment of norms and goals, and a high degree of workflow adaptability. These findings will be uniquely helpful in generating actionable, real-world knowledge to inform the design, implementation, and sustainment of guideline-recommended depression screening programs in oncology.
Trial Registration
ClinicalTrials.gov
#NCT02941614 |
| doi_str_mv | 10.1007/s00520-023-07922-0 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2836292787</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A756968539</galeid><sourcerecordid>A756968539</sourcerecordid><originalsourceid>FETCH-LOGICAL-c393t-dfd717e6c8ee2891078d20595821c44f1e28ef203c22859c19886937664a123b3</originalsourceid><addsrcrecordid>eNp9ks2OFCEUhYnROG3rC7gwJG7c1MhPFRTuxol_ySRudE1ouJRMqqAGqsb0a_mE0t2jE40xLEgO37k5wEHoOSXnlBD5uhDSMdIQxhsiFWMNeYA2tOW8kZyrh2hDVEublnfdGXpSyjUhVMqOPUZnXLZctFJu0I-3JucAuWATHfbGhjEsZklVWBIO0zzCBLEqIcUjUtaymBAPIk4eD2twMIYITQabpio7cNjBnKGUg6fYDBBDHLBPGc91UHUW_D0s3_AugykLtiZayDhEPIEL1ow4RZvGNOzfYINvVnOMFG4Bl2V1-6fokTdjgWd3-xZ9ff_uy-XH5urzh0-XF1eN5YovjfNOUgnC9gCsV5TI3jHSqa5n1Latp1UFzwi3jPWdslT1vVBcCtEayviOb9Gr09w5p5sVyqKnUCyMo4mQ1qJZzwVTTPayoi__Qq_TmmNNd6Ro_S4h7qnBjKBD9GnJxh6G6gvZCSX6ribfovN_UHU5mIJNEXyo-h8GdjLYnErJ4PWcw2TyXlOiD0XRp6LoWhR9LIom1fTiLvG6q6_-2_KrGRXgJ6DUozhAvr_Sf8b-BFjUypE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2836110066</pqid></control><display><type>article</type><title>Barriers and facilitators to implementation and sustainment of guideline-recommended depression screening for patients with breast cancer in medical oncology: a qualitative study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Hahn, Erin E. ; Munoz-Plaza, Corrine E. ; Lyons, Lindsay Joe ; Lee, Janet S. ; Pounds, Dana ; La Cava, Shannon ; Brasfield, Farah M. ; Durna, Lara N. ; Kwan, Karen W. ; Beard, David B. ; Ferreira, Alexander ; Gould, Michael K.</creator><creatorcontrib>Hahn, Erin E. ; Munoz-Plaza, Corrine E. ; Lyons, Lindsay Joe ; Lee, Janet S. ; Pounds, Dana ; La Cava, Shannon ; Brasfield, Farah M. ; Durna, Lara N. ; Kwan, Karen W. ; Beard, David B. ; Ferreira, Alexander ; Gould, Michael K.</creatorcontrib><description>Objectives
Implementation of guideline-recommended depression screening in oncology presents numerous challenges. Implementation strategies that are responsive to local context may be critical elements of adoption and sustainment. We evaluated barriers and facilitators to implementation of a depression screening program for breast cancer patients in a community medical oncology setting as part of a cluster randomized controlled trial.
Methods
Guided by the Consolidated Framework for Implementation Research, we employed qualitative methods to evaluate clinician, administrator, and patient perceptions of the program using semi-structured interviews. We used a team-coding approach for the data; thematic development focused on barriers and facilitators to implementation using a grounded theory approach. The codebook was refined through open discussions of subjectivity and unintentional bias, coding, and memo applications (including emergent coding), and the hierarchical structure and relationships of themes.
Results
We conducted 20 interviews with 11 clinicians/administrators and 9 patients. Five major themes emerged: (1) gradual acceptance and support of the intervention and workflow; (2) compatibility with system and personal norms and goals; (3) reinforcement of the value of and need for adaptability; (4) self-efficacy within the nursing team; and (5) importance of identifying accountable front-line staff beyond leadership “champions.”
Conclusions
Findings suggest a high degree of acceptability and feasibility due to the selection of appropriate implementation strategies, alignment of norms and goals, and a high degree of workflow adaptability. These findings will be uniquely helpful in generating actionable, real-world knowledge to inform the design, implementation, and sustainment of guideline-recommended depression screening programs in oncology.
Trial Registration
ClinicalTrials.gov
#NCT02941614</description><identifier>ISSN: 0941-4355</identifier><identifier>ISSN: 1433-7339</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-023-07922-0</identifier><identifier>PMID: 37436477</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adaptation, Psychological ; Adult ; Breast cancer ; Breast Neoplasms - complications ; Breast Neoplasms - psychology ; Cancer ; Cancer patients ; Clinical practice guidelines ; Depression - diagnosis ; Depression - etiology ; Depression, Mental ; Female ; Humans ; Male ; Mass Screening ; Medical screening ; Medicine ; Medicine & Public Health ; Mental depression ; Middle Aged ; Nursing ; Nursing Research ; Oncology ; Oncology, Experimental ; Pain Medicine ; Practice Guidelines as Topic ; Qualitative Research ; Rehabilitation Medicine</subject><ispartof>Supportive care in cancer, 2023-08, Vol.31 (8), p.461, Article 461</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c393t-dfd717e6c8ee2891078d20595821c44f1e28ef203c22859c19886937664a123b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-023-07922-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-023-07922-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37436477$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hahn, Erin E.</creatorcontrib><creatorcontrib>Munoz-Plaza, Corrine E.</creatorcontrib><creatorcontrib>Lyons, Lindsay Joe</creatorcontrib><creatorcontrib>Lee, Janet S.</creatorcontrib><creatorcontrib>Pounds, Dana</creatorcontrib><creatorcontrib>La Cava, Shannon</creatorcontrib><creatorcontrib>Brasfield, Farah M.</creatorcontrib><creatorcontrib>Durna, Lara N.</creatorcontrib><creatorcontrib>Kwan, Karen W.</creatorcontrib><creatorcontrib>Beard, David B.</creatorcontrib><creatorcontrib>Ferreira, Alexander</creatorcontrib><creatorcontrib>Gould, Michael K.</creatorcontrib><title>Barriers and facilitators to implementation and sustainment of guideline-recommended depression screening for patients with breast cancer in medical oncology: a qualitative study</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Objectives
Implementation of guideline-recommended depression screening in oncology presents numerous challenges. Implementation strategies that are responsive to local context may be critical elements of adoption and sustainment. We evaluated barriers and facilitators to implementation of a depression screening program for breast cancer patients in a community medical oncology setting as part of a cluster randomized controlled trial.
Methods
Guided by the Consolidated Framework for Implementation Research, we employed qualitative methods to evaluate clinician, administrator, and patient perceptions of the program using semi-structured interviews. We used a team-coding approach for the data; thematic development focused on barriers and facilitators to implementation using a grounded theory approach. The codebook was refined through open discussions of subjectivity and unintentional bias, coding, and memo applications (including emergent coding), and the hierarchical structure and relationships of themes.
Results
We conducted 20 interviews with 11 clinicians/administrators and 9 patients. Five major themes emerged: (1) gradual acceptance and support of the intervention and workflow; (2) compatibility with system and personal norms and goals; (3) reinforcement of the value of and need for adaptability; (4) self-efficacy within the nursing team; and (5) importance of identifying accountable front-line staff beyond leadership “champions.”
Conclusions
Findings suggest a high degree of acceptability and feasibility due to the selection of appropriate implementation strategies, alignment of norms and goals, and a high degree of workflow adaptability. These findings will be uniquely helpful in generating actionable, real-world knowledge to inform the design, implementation, and sustainment of guideline-recommended depression screening programs in oncology.
Trial Registration
ClinicalTrials.gov
#NCT02941614</description><subject>Adaptation, Psychological</subject><subject>Adult</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - psychology</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Clinical practice guidelines</subject><subject>Depression - diagnosis</subject><subject>Depression - etiology</subject><subject>Depression, Mental</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mass Screening</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Pain Medicine</subject><subject>Practice Guidelines as Topic</subject><subject>Qualitative Research</subject><subject>Rehabilitation Medicine</subject><issn>0941-4355</issn><issn>1433-7339</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9ks2OFCEUhYnROG3rC7gwJG7c1MhPFRTuxol_ySRudE1ouJRMqqAGqsb0a_mE0t2jE40xLEgO37k5wEHoOSXnlBD5uhDSMdIQxhsiFWMNeYA2tOW8kZyrh2hDVEublnfdGXpSyjUhVMqOPUZnXLZctFJu0I-3JucAuWATHfbGhjEsZklVWBIO0zzCBLEqIcUjUtaymBAPIk4eD2twMIYITQabpio7cNjBnKGUg6fYDBBDHLBPGc91UHUW_D0s3_AugykLtiZayDhEPIEL1ow4RZvGNOzfYINvVnOMFG4Bl2V1-6fokTdjgWd3-xZ9ff_uy-XH5urzh0-XF1eN5YovjfNOUgnC9gCsV5TI3jHSqa5n1Latp1UFzwi3jPWdslT1vVBcCtEayviOb9Gr09w5p5sVyqKnUCyMo4mQ1qJZzwVTTPayoi__Qq_TmmNNd6Ro_S4h7qnBjKBD9GnJxh6G6gvZCSX6ribfovN_UHU5mIJNEXyo-h8GdjLYnErJ4PWcw2TyXlOiD0XRp6LoWhR9LIom1fTiLvG6q6_-2_KrGRXgJ6DUozhAvr_Sf8b-BFjUypE</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Hahn, Erin E.</creator><creator>Munoz-Plaza, Corrine E.</creator><creator>Lyons, Lindsay Joe</creator><creator>Lee, Janet S.</creator><creator>Pounds, Dana</creator><creator>La Cava, Shannon</creator><creator>Brasfield, Farah M.</creator><creator>Durna, Lara N.</creator><creator>Kwan, Karen W.</creator><creator>Beard, David B.</creator><creator>Ferreira, Alexander</creator><creator>Gould, Michael K.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20230801</creationdate><title>Barriers and facilitators to implementation and sustainment of guideline-recommended depression screening for patients with breast cancer in medical oncology: a qualitative study</title><author>Hahn, Erin E. ; Munoz-Plaza, Corrine E. ; Lyons, Lindsay Joe ; Lee, Janet S. ; Pounds, Dana ; La Cava, Shannon ; Brasfield, Farah M. ; Durna, Lara N. ; Kwan, Karen W. ; Beard, David B. ; Ferreira, Alexander ; Gould, Michael K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-dfd717e6c8ee2891078d20595821c44f1e28ef203c22859c19886937664a123b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adaptation, Psychological</topic><topic>Adult</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - psychology</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Clinical practice guidelines</topic><topic>Depression - diagnosis</topic><topic>Depression - etiology</topic><topic>Depression, Mental</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mass Screening</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Oncology, Experimental</topic><topic>Pain Medicine</topic><topic>Practice Guidelines as Topic</topic><topic>Qualitative Research</topic><topic>Rehabilitation Medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hahn, Erin E.</creatorcontrib><creatorcontrib>Munoz-Plaza, Corrine E.</creatorcontrib><creatorcontrib>Lyons, Lindsay Joe</creatorcontrib><creatorcontrib>Lee, Janet S.</creatorcontrib><creatorcontrib>Pounds, Dana</creatorcontrib><creatorcontrib>La Cava, Shannon</creatorcontrib><creatorcontrib>Brasfield, Farah M.</creatorcontrib><creatorcontrib>Durna, Lara N.</creatorcontrib><creatorcontrib>Kwan, Karen W.</creatorcontrib><creatorcontrib>Beard, David B.</creatorcontrib><creatorcontrib>Ferreira, Alexander</creatorcontrib><creatorcontrib>Gould, Michael K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hahn, Erin E.</au><au>Munoz-Plaza, Corrine E.</au><au>Lyons, Lindsay Joe</au><au>Lee, Janet S.</au><au>Pounds, Dana</au><au>La Cava, Shannon</au><au>Brasfield, Farah M.</au><au>Durna, Lara N.</au><au>Kwan, Karen W.</au><au>Beard, David B.</au><au>Ferreira, Alexander</au><au>Gould, Michael K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Barriers and facilitators to implementation and sustainment of guideline-recommended depression screening for patients with breast cancer in medical oncology: a qualitative study</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>31</volume><issue>8</issue><spage>461</spage><pages>461-</pages><artnum>461</artnum><issn>0941-4355</issn><issn>1433-7339</issn><eissn>1433-7339</eissn><abstract>Objectives
Implementation of guideline-recommended depression screening in oncology presents numerous challenges. Implementation strategies that are responsive to local context may be critical elements of adoption and sustainment. We evaluated barriers and facilitators to implementation of a depression screening program for breast cancer patients in a community medical oncology setting as part of a cluster randomized controlled trial.
Methods
Guided by the Consolidated Framework for Implementation Research, we employed qualitative methods to evaluate clinician, administrator, and patient perceptions of the program using semi-structured interviews. We used a team-coding approach for the data; thematic development focused on barriers and facilitators to implementation using a grounded theory approach. The codebook was refined through open discussions of subjectivity and unintentional bias, coding, and memo applications (including emergent coding), and the hierarchical structure and relationships of themes.
Results
We conducted 20 interviews with 11 clinicians/administrators and 9 patients. Five major themes emerged: (1) gradual acceptance and support of the intervention and workflow; (2) compatibility with system and personal norms and goals; (3) reinforcement of the value of and need for adaptability; (4) self-efficacy within the nursing team; and (5) importance of identifying accountable front-line staff beyond leadership “champions.”
Conclusions
Findings suggest a high degree of acceptability and feasibility due to the selection of appropriate implementation strategies, alignment of norms and goals, and a high degree of workflow adaptability. These findings will be uniquely helpful in generating actionable, real-world knowledge to inform the design, implementation, and sustainment of guideline-recommended depression screening programs in oncology.
Trial Registration
ClinicalTrials.gov
#NCT02941614</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37436477</pmid><doi>10.1007/s00520-023-07922-0</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0941-4355 |
| ispartof | Supportive care in cancer, 2023-08, Vol.31 (8), p.461, Article 461 |
| issn | 0941-4355 1433-7339 1433-7339 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adaptation, Psychological Adult Breast cancer Breast Neoplasms - complications Breast Neoplasms - psychology Cancer Cancer patients Clinical practice guidelines Depression - diagnosis Depression - etiology Depression, Mental Female Humans Male Mass Screening Medical screening Medicine Medicine & Public Health Mental depression Middle Aged Nursing Nursing Research Oncology Oncology, Experimental Pain Medicine Practice Guidelines as Topic Qualitative Research Rehabilitation Medicine |
| title | Barriers and facilitators to implementation and sustainment of guideline-recommended depression screening for patients with breast cancer in medical oncology: a qualitative study |
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