The National Academies Press

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From page 1... ... All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. This report recommends ten actions that oncology providers, health policy makers, educators, health insurers, health plans, quality oversight organizations, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met. Read the entire page →
From page 4... ... As a result, patients' psychosocial needs frequently remain unacknowledged and unaddressed in cancer care. Cancer Care Is Often Incomplete Many people living with cancer report that their psychosocial health care needs are not well addressed in their care. Read the entire page →
From page 5... ... FINDINGS GIVE REASON FOR HOPE In carrying out its charge, the IOM Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting found multiple reasons to be optimistic that improvements in the psychosocial health care provided to oncology patients and their families can be quickly achieved. First, there is good evidence of the effectiveness of a variety of services in relieving the emotional distress -- even the debilitating depression and anxiety -- experienced by cancer patients. Read the entire page →
From page 6... ... All components of the health care system that are involved in cancer care should explicitly incorporate attention to psychosocial needs into their policies, practices, and standards addressing clinical health care. These policies, practices, and standards should be aimed at ensuring the provision of psychosocial health services to all patients who need them. Read the entire page →
From page 8... ... • Supplemental financial grants a Family members and friends and other informal sources of support are key providers of psychosocial health services. This table includes only formal sources of psychosocial support -- those that must be secured through the assistance of an organization or agency that in some way enables the provision of needed services (sometimes at no cost or through volunteers) Read the entire page →
From page 9... ... All cancer care providers should ensure that every cancer patient within their practice receives care that meets the standard for psychosocial health care. The National Cancer Institute should help cancer care providers implement the standard of care by maintaining an up-to-date directory of psychosocial services available at no cost to individuals / families with cancer. Read the entire page →
From page 10... ... Because policies set by public and private purchasers, oversight bodies, and other health care leaders shape how health care is accessed, what services are delivered, and the manner in which they are delivered, group purchasers of health care coverage and health plans should take a number of actions to support the interventions necessary to deliver effective psychosocial health services. The National Cancer Institute, CMS, and AHRQ also should spearhead the development and use of performance measures to improve the delivery of these services. Read the entire page →
From page 11... ... • Group purchasers should review cost-sharing provisions that affect mental health services and revise those that impede cancer patients' access to such services. • Group purchasers and health plans should ensure that their coverage policies do not impede cancer patients' access to providers with expertise in the treatment of mental health conditions in individuals undergoing complex medical regimens such as those used to treat cancer. Read the entire page →
From page 12... ... • Develop and use performance measures for psychosocial health care in their quality oversight activities. Ultimately, the delivery of cancer care that addresses psychosocial needs depends on having a health care workforce with the attitudes, knowledge, and skills needed to deliver such care. Read the entire page →
From page 13... ... – Screening instruments that can be used to identify individuals with any of a comprehensive array of psychosocial health problems. – Needs assessment instruments to assist in planning psychosocial services. Read the entire page →
From page 14... ... Promoting Uptake and Monitoring Progress. The National Cancer Institute/NIH should monitor progress toward improved delivery of psychosocial services in cancer care and report its findings on at least a biannual basis to oncology providers, consumer organizations, group purchasers and health plans, quality oversight organizations, and other stakeholders. Read the entire page →
From page 15... ... • Assess coverage for psychosocial services for Medicare beneficiaries. For recommendation 6 on quality oversight, DHHS could: • Examine the funding portfolios of NIH, CMS, AHRQ and other public and private sponsors of quality-of-care research to evaluate the funding of quality measurement for psychosocial health care as part of cancer care. Read the entire page →
From page 16... ... – Used performance measures of psychosocial health care in their quality oversight activities. For recommendation 7 on workforce competencies, DHHS could: • Monitor and report on actions taken by Congress and federal agencies to support and fund the establishment of a Workforce Development Collaborative on Psychosocial Care during Chronic Medical Illness. Read the entire page →
From page 17... ... 2007. Patient-centered communication in cancer care: Promoting healing and reducing suffering. Read the entire page →
From page 21... ... Numerous cancer survivors and their caregivers report that cancer care providers did not understand their psychosocial needs, failed to recognize and adequately address depression and other symptoms of stress, were unaware of or did not refer them to available resources, and generally did not consider psychosocial support to be an integral part of quality cancer care. In response to a request from the National Institutes of Health, this report puts forth a plan delineating actions that cancer care providers, health policy makers, educators, health insurers, health plans, researchers and research sponsors, and consumer advocates should take to better respond to the psychological and social stresses faced by people with cancer, and thereby maximize their health and health care. Read the entire page →
From page 22... ... . Figure 1-1: Cancer Care Trajectories Cancer-Free Survival Recurrence/ Recurrence/ Second Cancer Second Cancer Managed Chronic or Treatment With Intermittent Intent to Cure Disease Diagnosis and Diagnosis and Staging Staging Treatment Failure Palliative Palliative Treatment Survivorship Care Treatment Late effects management and surveillance for recurrence Death Death and second cancers Source: Adapted from: From Cancer Patient to Cancer Survivor: Lost in Transition (IOM and NRC, 2006) Read the entire page →

From page 1...

... All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. This report recommends ten actions that oncology providers, health policy makers, educators, health insurers, health plans, quality oversight organizations, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.