An evaluation of the clinical interactions relating to psychological wellbeing and distress between teenagers and young adults (TYAs) diagnosed with cancer and non-psychologist TYA staff

Background: Recently an integrated care model was proposed for the management of psychological distress in adults living with cancer, involving a key worker who was a nurse managing higher levels of psychological distress, under the supervision of a liaison psychiatrist. Our research is focussing on whether a similar model would be feasible and effective for teenagers and young adults living with cancer.
Aim: The aim of this study was to describe the competencies related specifically to communication, psychological support and psychological care, that are currently implemented in the care specifically of TYA patients with cancer by TYA-specialised non-psychologist professionals. This enables an understanding of the skills and suitability of TYA professionals to manage psychological distress.
Method: Clinical interactions between clinical nurse specialists, youth workers and social workers and TYAs with cancer were audiotaped in two TYA principal treatment centres, with detailed consent, and subjected to a qualitative framework analysis to categorise and evaluate the skills in use and their delivery.
Results: Excellent communication skills and specific psychological care skills in use by non-psychologist TYA healthcare professionals were identified. Skills included showing a holistic interest in the patient; Informal screening / assessment of the patient; formal screening for distress; empathic responses to disclosures of distress and integrated resolution of psychological, practical and physical concerns. However, there was no evidence of a holistic assessment of the patient’s distress using a formal assessment tool.
Conclusion: A description of a range of skills present (and absent) in practice in a group of specialist professionals working with TYAs with cancer are presented. These will be considered in the development of an integrated model of care for TYA with cancer and distress, including training programmes and supervision structures to support that model.