This study is to evaluate the impact of the "stepped and collaborative care model" (SCCM) on health-related quality of life in somatic hospital patients with psychosocial distress.
Given the burden of psychosocial distress, the public health relevance, and the current standard of health care, new approaches to a model of care for patients with mental-somatic multimorbidity are urgently needed. SomPsyNet is a comprehensive healthcare project for patients from somatic hospitals that promotes the prevention of psychosocial distress by establishing a stepped and collaborative care network in Basel-Stadt, Switzerland and may therefore help to counteract against the described lack of care. SomPsyNet is a "stepped and collaborative care model" (SCCM) including a Psychosomatic-psychiatric consultation and liaison Service (CL Service) and post hospital intervention supported by a collaborative network structure. It aims to identify patients with psychosocial distress at an early stage during their hospital stay in a standardized way. Implementation of the SCCM within this study using the stepped-wedge cluster randomized trial (SW-CRT) design will take place in phases: * SomPsyNet phase 0: treatment as usual (TAU) in combination with the baseline and follow-up survey in a distressed focus sample. * SomPsyNet phase 1: TAU in combination with the baseline survey, implementation of screening questions stage 1 ('baseline distress information from professionals', without consequence) in hospital routine and follow-up survey in a distressed focus sample. * SomPsyNet phase 2 refers to the implementation of the SCCM: baseline survey, assessment of screening questions stage 1 (with consequence), screening questions stage 2 (with consequence) and if necessary psychosomatic-psychiatric consultation and liaison service including if applicable post hospital intervention and a follow-up survey in a distressed focus sample.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
2,500
Implementation of the SCCM includes a baseline survey, assessment of screening questions stage 1 (with consequence), screening questions stage 2 (with consequence) and if necessary psychosomatic-psychiatric consultation and liaison service including if applicable post hospital intervention and a follow-up survey in a distressed focus sample.
Universitäre Altersmedizin Felix Platter
Basel, Switzerland
Department of Psychosomatics/ Division of Medicine; University Hospital of Basel
Basel, Switzerland
Universitätsspital Basel - Frauenklinik
Basel, Switzerland
Bethesda Spital AG
Basel, Switzerland
Change in health related quality of life
Health related quality of life will be assessed with the 'Mental Health Component Summary score' of the Short Form-36 (SF-36). The SF-36 consists of 36-Items to measure health-related quality of life using eight concepts (physical functioning (PF, 10 items), physical role functioning (RP, 4 items), bodily pain (BP, 2 items), general health perception (GH, 5 items), vitality (VT, 4 items), social role functioning (SF, 2 items), emotional role functioning (RE, 3 items) and mental health (MH, 5 items) to measure the 'Mental Health Component Summary score'
Time frame: Baseline to 6 months follow-up
Change in Depression
Current depressive disorders assessed by the eight-item Patient Health Questionnaire depression scale (PHQ-8)
Time frame: Baseline to 6 months follow-up
Change in Generalized Anxiety Disorder
Generalized Anxiety Disorder assessed by the 7-item Generalized Anxiety Disorder Scale (GAD-7)
Time frame: Baseline to 6 months follow-up
Change in Somatic symptom disorder
Psychological features of Somatic Symptom Disorder (SSD) assessed by the 12-item Somatic Symptom Disorder Scale (SSD-12)
Time frame: Baseline to 6 months follow-up
Change in Somatic symptom burden
Somatic symptom severity assessed by the 8-item Somatic Symptom Scale-8 (SSS-8)
Time frame: Baseline to 6 months follow-up
Change in Quality of life
"Health-related quality of life assessed by the 5-level EuroQol 5-dimensional questionnaire (EQ-5D- 5L)"
Time frame: Baseline to 6 months follow-up
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Change in health related quality of life
Health-related quality of life assessed by the Physical Health Component Summary score of the SF-36
Time frame: Baseline to 6 months follow-up
Health economics
total costs of hospital treatment including additional medical, psychiatric or physiotherapeutic treatment during patient's hospital stay; follow-up costs at treating hospitals; healthcare costs, relevant sub-categories of costs and medical resource use based on health insurance claims data; indirect costs due to reduced productivity
Time frame: 6 months to 3 years following initiation of the SCCM in a given patient
Resilience
Resilience assessed by the Resilience Scale for Adults (RSA)
Time frame: 6 months follow-up
Social support
Social support assessed by the Oslo social support scale (OSSS-3)
Time frame: 6 months follow-up