Meeting Psychosocial Needs of Women with Breast Cancer (2004) / Chapter Skim
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Executive Summary
Executive Summary
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. The report is one of a three-part series from the BoarcT on cancer survivorship, ancT it follows ancT builcTs on the BoarcT's 1999 report, Ensuring Quality Cancer Care, in which the BoarcT concluclecT that psychosocial support services were an essential component of quality cancer care.
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Nevertheless, given the crosscutting nature of psychosocial distress in cancer, as defined below, the Board believes that much of the information gleaned from the study of breast cancer patients is also applicable to other cancer patient groups .
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how effective are they? Interventions to aciciress psychosocial problems anti distress begin with basic information about the disease anti treatment options from the breast cancer care clinician (often a meclical oncologist)
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Some may fincI information ancI support on the Internet, for example, young survivors coalition, cancerancicareers.org, or the American Society of Clinical Oncology's "People Living with Cancer." Other women, however, clo not have social supports built into their lives. They may also lack access to psychosocial services, either because care providers clo not refer them to the available services or because of other barriers (e.g., no health insurance or no reimbursement for services)
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An estimated 8 percent of women with breast cancer are uninsured, or, if patients are insured, there is coverage of mental health services with lower reimbursement levels or placement of mental health services in behavioral health contracts, separate from meclical coverage. Still other barriers are the reluctance to discuss psychosocial concerns with the busy oncologist provicler; the stigma associated with seeking or using mental health services; physicians' failure to ask patients about distressing emotional symptoms; anti the lack of simple, rapicI instruments for screening for psychosocial distress (see Chapter 31.
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better ways of aciciressing them. To improve clinical practice: Breast cancer care clinicians, such as oncologists and other medical professionals, responsible for the care of women with breast cancer should incorporate planning for psychosocial management as an integral part of treatment.
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The NCI, the American Cancer Society (ACSJ, and professional organizations (e.g., American Society of Clinical Oncology, American College of Surgeons, American Association of Colleges of Nursing, American Psychosocial Oncology Society, American Society of Social Work, American Society for Therapeutic Radiology and Oncology, Oncology Nursing SocietyJ need to partner with advocacy groups (e.g., National Breast Cancer Coalition, National Alliance of Breast Cancer Organizations,Wellness Community, NCCSJ to focus attention on psychosocial needs of patients and resources that provide psychosocial services in local communities and nationally. Organizations with effective outreach to cancer constituencies shouicI be assisted in making resource directories available to providers anti patients; these directories wouicI identify the range of supportive services, from the free services of advocacy groups to services proviclecI by mental health professionals.
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l o improve research opportunities: Research sponsors (e.g., NCI, ACSJ and professional organizations (e.g., American Society of Clinical Oncology, American College of Surgeons, American Association of Colleges of Nursing, American Psychosocial Oncology Society, American Society of Social Work, American Society for Therapeutic Rad.iology and. Oncology, Oncology Nursing SocietyJ need.
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; · A consensus conference to develop a battery of standard instruments for outcome measures to permit comparison of data from studies carried out by different research groups; · Organization of a psychosocial clinical trials group in which a network of researchers could address key questions in multi-center studies that would allow access to large, population-based samples; · Clinical trials of psychosocial interventions that are conducted within routine breast cancer care in which cost and quality of life are outcome measures; · A registry of ongoing psychosocial research/trials to assist researchers in identifying and tracking new areas of study. The NCI should support a special study to ascertain the use of, and unmet need for, cancer-related supportive care services (including psychosocial services)
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