Szalmuk Family Psycho-oncology Research Unit

Cabrini Research Annual Report 2020-21 Szalmuk Family Psycho-oncology Research Unit

PROFESSOR DAVID KISSANE AC

GRANT FUNDING HELD $1.32m

PUBLICATIONS 30 CLINICAL TRIAL 1

The discipline of Psycho-oncology focuses on helping patients adapt to the diagnosis and treatment of cancer, from early-stage disease to survivorship and, when disease is advanced, to palliative care and eventually bereavement care for the surviving family. In this sense, it is both patient and family-centred in its orientation.

Cabrini Research Annual Report 2020-21 Szalmuk Family Psycho-oncology Research Unit

Clinical services are delivered by psychiatrists and psychologists through the Cabrini Haematology and Oncology Centre. Research occurs in parallel and focuses on advancing adaptation to the illness.

During the 2020-21 year we have sustained our demoralisation research program through work on validation of a clinical interview to diagnose conditions such as adjustment disorder with demoralisation. We have also maintained our trial of Meaning and Purpose (MaP) Therapy as a form of treatment for demoralised patients, and begun work on the national implementation of screening for psycho-existential distress with the Psychoexistential Symptom Assessment Scale, a project that we were delighted to have funded by the Commonwealth Department of Health.

Currently, patients with unrecognised depression, unaddressed demoralisation and unabating anxiety account for the most vulnerable patients with advanced cancer, with limited access to skilled staff and evidence-based management. These under-served patients are in need of treatments to optimise their adjustment and prevent suicidal thinking. Several, evidence-based, medication and counselling approaches are available to effectively help these patients, but these remain underutilised in palliative care. Growing out of our research into the mental state of demoralisation, we have developed a screening tool to better identify these patients in need.

The Commonwealth Department of Health, through its program of dedicated grants for palliative care, awarded in conjunction with the University of Notre Dame Australia, Professor David Kissane AC and Associate Professor Natasha Michael, a grant of $1.05 million to implement Psycho-existential Screening with the Psychoexistential Symptom Assessment Scale (PeSAS) across six states and two territories over the next three years. Train-the-trainer workshops with experiential role-plays in a simulated setting will complement the online educational program which will be incorporated within the established End-ofLife Essentials e-learning platform. This education will build skills to converse about and assess psycho-existential wellbeing, familiarise staff with medication algorithms developed by experts and create local champions.

Unrecognised psycho-existential suffering accounts for as many hospital admissions and extended lengths of stay as unmanaged physical symptoms. This assessment and management model seeks to intervene early, prevent hospitalisation, relieve suffering and enhance quality-of-life in a most cost-effective way. The PeSAS tool has been incorporated into the PalCare Medical Record which is particularly used by community services across our country. Benchmarking outcomes with comparable services locally and nationally will create quality improvement goals. Sustained training and supervision of local champions across the three funded years will upskill healthcare providers and embed attention to this under-recognised and under-served population of palliative care patients.

STAFF

HEAD OF DEPARTMENT

Professor David Kissane AC

Dr Irene Bobevski, Research Fellow Genevieve Murphy, Research Nurse Jill Wilson, Research Nurse

STUDENTS

Felicity Moon, PhD, Monash University Associate Professor Natasha Michael, PhD, University of Notre Dame Australia Dr Lucy Kernick, PhD, University of Notre Dame Australia Dr John Wenham, PhD, University of Notre Dame Australia Dr Merlina Sulistio, MMed, University of Notre Dame Australia

Above: Dr Kathy Hauser, Cabrini Health Palliative and Support Services, and Professor David Kissane AC.