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Pages 283-328

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From page 283... ... and other standards-setting organizations (e.g., National Quality Forum, National Committee for Quality Assurance, URAC, the Joint Commission) to determine the extent to which they have: – Created oversight mechanisms used to measure and report on the quality of ambulatory cancer care (including psychosocial health care) Read the entire page →
From page 284... ... For the committee's recommendation on standardized nomenclature and research priorities (see Chapter 3 and this chapter, respectively) , DHHS could: • Determine whether NIH/AHRQ had completed development of a taxonomy and nomenclature for psychosocial health services. Read the entire page →
From page 288... ... Blum served as a social work supervisor at Memorial Sloan-Kettering Cancer Center and the Dana Farber Cancer Institute. Co-founder of the National Alliance of Breast Cancer Organizations, she is a founder of National Breast Cancer Awareness Month and serves as editor-in-chief of People Living with Cancer, the American Society of Clinical Oncology's (ASCO) Read the entire page →
From page 289... ... At the Jonsson Cancer Center, she directs the UCLA Family Cancer Registry and Genetic Evaluation Program. Her other major areas of research include cancer survivorship and late effects of cancer treatment, cancer in the elderly, and quality of care for cancer patients. Read the entire page →
From page 290... ... The IOM elected her as a member in 1995, and she served on its National Cancer Policy Board. In 2000, she received the American Psychiatric Association's PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 291... ... Matthews, PhD, is a clinical psychologist and associate professor in the Department of Public Health, Mental Health, and Administrative Nursing at the University of Illinois at PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 292... ... She has conducted funded research studies examining information seeking and treatment decision making among newly diagnosed African American cancer patients, factors associated with quality of life in lesbian women with breast cancer, prevalence and predictors of anxiety among survivors of breast cancer, evaluation of a education program on breast and cervical cancer education targeting African American lesbian and bisexual women, and mental illness stigma in members of the African American community. Ruth McCorkle, PhD, has over 28 years of experience in cancer control and psychosocial oncology research. Read the entire page →
From page 293... ... He is founder and medical director for the Baptist Centers for Cancer Care Cancer Genetics Program and the Stem Cell Transplant Program. He also serves as chair of the Baptist Comprehensive Breast Center multidisciplinary program. Read the entire page →
From page 295... ... These definitions and their varying conceptual underpinnings are presented below. Review of Existing Definitions "Psychosocial support" is identified by multiple parties as an essential component of quality cancer care (American Psychosocial Oncology Society, undated; National Breast Cancer Centre and National Cancer Control Initiative, 2003; IOM and NRC, 2004; President's Cancer Panel, 2004; The Association of Community Cancer Centers, 2006) Read the entire page →
From page 296... ... 212) but does not clarify which spiritual issues are and are not to be addressed (National Breast Cancer Centre and National Cancer Control Initiative, 2003) Read the entire page →
From page 298... ... Clinical Practice Guidelines for Distress Management The IOM report Meeting Psychosocial Needs of Women with Breast Cancer (IOM and NRC, 2004) indicates that psychosocial services are those services intended to alleviate "psychosocial distress." It defines psychosocial distress in cancer as "an unpleasant emotional experience that may be psychological, social, or spiritual in nature [emphasis added] Read the entire page →
From page 299... ... Need for Face Validity The committee sought a definition that, in addition to being conceptually sound, would have face validity to cancer patients and oncology practitioners. In numerous reports on cancer care reviewed by the committee, cancer patients, their families and informal caretakers, health care providers, and researchers identify many nonbiological adverse consequences of cancer and its treatment, and describe cancer survivors' need for various types of nonmedical assistance in addressing these consequences. Read the entire page →
From page 300... ... For the reasons given above, this definition uses the wording "psychosocial health services" to make clear that it refers to services that "enable patients, their families, and health care providers to optimize biomedical health care and to manage the psychological, social, and behavioral aspects of illness" as opposed those psychosocial services that might enable individuals to meet other goals, such as strengthening family functioning or avoiding incarceration. The committee also decided to adopt the wording "psychological/behavioral" because of the lack of consistent usage of "psychological" and "behavioral" in the scientific community; for example, the American Psychological Association subsumes behavior under psychology, while others use "behavioral" as the umbrella term. Read the entire page →
From page 301... ... Department of Health and Human Services. From this literature, the committee was able to distinguish among the psychosocial health problems encountered by cancer patients and their families. Read the entire page →
From page 302... ... making use of existing systematic reviews, where available. TABLE B-1 Serial Search Strategies Intervention Tested in Populations with Other Intervention Tested in Conditions Cancer Survivors Type of Study Meta-analyses and Systematic Reviews Strategy A Strategy B Single Controlled or Observational Studies Strategy B Strategy C Each search first sought to identify meta-analyses and systematic reviews pertaining to the effectiveness of the intervention when provided to cancer survivors (Strategy A) Read the entire page →
From page 303... ... The committee notes that, as discussed in Chapters 1 and 2, 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 304... ... have been used to deliver psychosocial health services consistent with the committee's definition, and (2) have been evaluated and found effective in improving patient outcomes. Read the entire page →
From page 305... ... – Provider capacity – How services are paid for in various community settings Analysis of reimbursement issues and development of recommendations for change • PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 306... ... The committee encountered a few instances in which it was not possible to provide the specific outcome requested in certain tasks. For example, Task 6, pertaining to the workforce, requested "estimates of overall capacity required in the community in order to meet need, via modeling or other methods, using existing health workforce data and prevalence data of psychosocial problems." In Chapter 7, the committee describes the absence of reliable data on the knowledge and expertise of various disciplines in the delivery of psychosocial health care. Read the entire page →
From page 309... ... psychosocial services needed by cancer patients and their families in community settings. The study will produce a report that includes: 1. Read the entire page →
From page 310... ... Washington, DC: The National Academies Press. National Breast Cancer Centre and National Cancer Control Initiative. Read the entire page →
From page 311... ... . The committee also will include in its review community service entities, such as Cancer Care, Inc. Read the entire page →
From page 312... ... not affiliated with cancer treatment centers. The goal is to understand what training may be needed for people who neither work in cancer clinics or centers nor routinely provide psychosocial services to survivors or their family members, but who might care for cancer patients /survivors/family members in the course of their work.] Read the entire page →
From page 314... ... :1217–1223. National Breast Cancer Centre and National Cancer Control Initiative. Read the entire page →
From page 317... ... 2003. New Recommendation 2.4 Create a Comprehensive State Mental Health Plan Freedom PREPUBLICATION COPY: UNCORRECTED PROOFS 317 Read the entire page →
From page 318... ... Recommendation 4.1 Promote the mental health of young children. Breast cancer care clinicians, such as oncologists and other medical Meeting Psychosocial professionals, responsible for the care of women with breast cancer should Needs of incorporate planning for psychosocial management as an integral part of Women with treatment. Read the entire page →
From page 319... ... Providers of cancer care should meet the standards of psychosocial care Meeting Psychosocial developed by the American College of Surgeon's Commission on Cancer and Needs of follow the National Comprehensive Cancer Center Network's (NCCN) Read the entire page →
From page 320... ... Recommendation 5-2. To facilitate the delivery of coordinated care by Improving the Quality of primary care, mental health, and substance-use treatment providers, Health Care government agencies, purchasers, health plans, and accreditation for Mental organizations should implement policies and incentives to continually and PREPUBLICATION COPY: UNCORRECTED PROOFS 320 Read the entire page →
From page 321... ... Patient education and illness self-management Recommendation 2. Procedures should be established within diverse patient Living Beyond care settings to better inform patients/survivors and their caregivers about Cancer: available legal and regulatory protections and resources [e.g., pertaining to Finding a PREPUBLICATION COPY: UNCORRECTED PROOFS 321 Read the entire page →
From page 322... ... Recommendation 5c. Providers should include psychosocial services routinely as part of comprehensive cancer care treatment and follow-up care PREPUBLICATION COPY: UNCORRECTED PROOFS 322 Read the entire page →
From page 323... ... Insurers and payors of health care should recognize survivorship care as an essential part of cancer care and design benefits, payment policies, and reimbursement mechanisms to facilitate coverage for evidence-based aspects of care. Support of informal caregivers Recommendation 5b. Read the entire page →
From page 324... ... Cancer care providers should inform families of cancer patients about supportive services, including special camps for families and siblings. Recommendation 12a. Read the entire page →
From page 325... ... should support Needs of continuing education programs by designing, recommending, or funding PREPUBLICATION COPY: UNCORRECTED PROOFS 325 Read the entire page →
From page 327... ... • Studies that assess the relative effectiveness of various psychosocial interventions, using population-based patient samples of adequate size, the timing and duration of intervention, and innovative and inexpensive modes of administration (e.g., internet-based approaches) ; • 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 PREPUBLICATION COPY: UNCORRECTED PROOFS 327 Read the entire page →
From page 328... ... . ♦ The cost-effectiveness of alternative models of survivorship care and community-based psychosocial services including: o Survivors' and caregivers' attitudes and preferences regarding outcomes and survivorship care; o Needs of racial, ethnic groups, residents of rural areas, and other potentially underserved groups, o Supportive and rehabilitation programs ♦ Interventions to improve the quality of life, including: o Family and caregiver needs and access to supportive services o Mechanisms to reduce financial burdens of survivorship care (e.g.: the new Medicare prescription drug benefit should be carefully monitored to evaluate its impact, especially how PREPUBLICATION COPY: UNCORRECTED PROOFS 328 Read the entire page →

From page 283...

... and other standards-setting organizations (e.g., National Quality Forum, National Committee for Quality Assurance, URAC, the Joint Commission) to determine the extent to which they have: – Created oversight mechanisms used to measure and report on the quality of ambulatory cancer care (including psychosocial health care)