(017) Use of Knowledge Translation Methodology to Incorporate Research Results into Clinical Practice: Bringing Mindfulness and Cognitive Behavioural Therapy into a local prostate cancer program
Notice bibliographique
Résumé
Abstract Introduction There is an unmet need for psychological therapies that address sex-related distress in couples after prostate cancer (PCa) beyond pharmaceuticals and device aids. We recently completed a clinical trial that found both mindfulness and cognitive behavioural therapy (CBT) improved couples’ sexual health after prostate cancer (PCa). Given the benefits of these therapies to patients yet the poor translation of research into routine clinical care, we sought to use evidence-informed methods of knowledge translation to make this transition. Objective This was a knowledge translation (KT) and implementation science project. We aimed to share information about the efficacy of these therapies to PCa patients and their partners in a local prostate cancer program by creating and implementing KT tools in a format that was accessible, affirming, and effective. Methods We utilized two KT frameworks: the Knowledge to Action (KTA) cycle and the Consolidated Framework for Implementation Research (CFIR), and collaborated with knowledge partners (prostate cancer program clinical leader partnerships, patient partner consultations, and a focus group of the program staff analyzed using the CFIR framework) to guide implementation. Results We used the first four stages of the KTA cycle, informed by our knowledge partners, to create our KT tools. The first stage involved clarifying the knowledge gap. We then included the evidence-based mindfulness and CBT approaches to various existing time points of patient education in the local program's context. Next, we conducted our focus group to identify potential barriers and facilitators to implementation, and modified our implementation plan accordingly. We created an information card that explained CBT and mindfulness using terminology appropriate for the patient population. The card contained a link to a patient education video we created that instructed patients on how to practice these skills at home. This link was hosted on a webpage with external CBT and mindfulness resource links. Implementation is currently underway. Eligible patients receive the information card at clinical appointments with a registered sexual health nurse and access the education video, which then guides them on how to practice these therapies at home. A questionnaire has been developed to evaluate patient use of these tools, ease of use of the tools, and whether the tools were helpful with respect to improving sexual intimacy and mental health. Data collection is in progress. Conclusions By creating three KT tools to implement mindfulness and CBT patient education materials, we incorporated research findings into routine clinic flow of a local prostate cancer program. These tools have large implications for the current patient population: we filled a gap of a lack of psychosocial education for sexual intimacy for couples after prostate cancer to practice. To the best of our knowledge, this is the first study to use KTA methodology to apply results from a clinical trial directly into clinical practice. This methodology should be incorporated into research funding mechanisms in order to encourage more widespread adoption of bringing research findings into practice. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Coloplast, Sustained Therapeutics, AstraZeneca, Astellas, Genetech, Lantheus Merck, Sharp & Dohme, Myovant, Menarini, Tolmar, Vaccitech, Verity
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,148 | 0,135 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,006 | 0,003 |
| Science ouverte | 0,002 | 0,009 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».