Identifying priorities of psychosocial need in cancer patients

Abstract

Inconsistent findings on the efficacy of psychosocial interventions in cancer may be due to their lack of specificity. The aim of this study was to identify priorities of psychosocial need among cancer patients currently receiving treatment in Western Sydney (NSW) as a prelude to targeted intervention. A sample of 188 patients (129 female, median age 52 years, median time since diagnosis 12 months), with various solid tumours, completed a self-report ranking questionnaire listing eight major areas of psychosocial need based on a literature search of relevant studies. The resulting ranking of priorities was: family (1), dealing with emotional stress (2), getting information (3), money (4), work (5), social life (6), sex life (7), and dealing with hospital staff (8). These priorities were independent of demographic characteristics, including time since diagnosis, suggesting that support in the areas of major need may be just as important during follow-up as it is at diagnosis. Males reported less distress than females, and patients with cancer of the head/neck or breast reported most distress. To be maximally effective, psychosocial intervention for cancer patients should focus on the principal areas of family interaction, effective stress management, and access to information.

Unmet psychosocial needs in haematological cancer: a systematic review

“…Fear of recurrence was highlighted as an unmet need by three of the included studies [22,23,26]. Most of these papers did not separate participant responses according to diagnosis bar the study conducted by Liang [24]. This study found that patients with lymphoma reported higher levels of need in the areas of 'sex' and 'work' than other participants and reported the lowest levels of needs in relation to 'stress'.…”

“…Within this category, concerns about the worries of those close to patients was raised twice [22,23], by 26% and 50% of respective samples; a third study highlighted family-oriented needs as the area associated with the highest levels of unmet need at both whole-sample and lymphoma sub-sample level of analysis [24]. Fear of recurrence was highlighted as an unmet need by three of the included studies [22,23,26].…”

“…The study conducted by Liang et al [24] assessed for psychological need as a single type of unmet need and Boyes et al [20] reported their results as 'needs within the psychological domain' but did not specify further as to what those needs were. We therefore recognise the relevance of this category to those with a diagnosis of haematological cancer but it is not clear when needs are classified in this way what exactly it is that participants were meaning when they identified psychological needs as being important to them, limiting the clinical utility of the finding.…”

“…Five studies assessed unmet psychosocial needs during active treatment [22][23][24][25][26][27]. Within this category, concerns about the worries of those close to patients was raised twice [22,23], by 26% and 50% of respective samples; a third study highlighted family-oriented needs as the area associated with the highest levels of unmet need at both whole-sample and lymphoma sub-sample level of analysis [24].…”

Use of distress and depression thermometers to measure psychosocial morbidity among southern European cancer patients

“…[1] However, far less than 30% of cancer patients showing psychosocial problems are recognized in clinical settings by oncologists and thus referred to proper sources of psychological support [2,3]. Several psychometric instruments, such as the Hospital and Anxiety Depression Scale (HADS) [4][5][6], the Brief Symptom Inventory (BSI) [7], the Profile of Mood States (POMS) [8], and the Zung Depression Inventory [9] have been suggested as clinical tools to be routinely used in cancer settings in order to improve the detection of psychosocial morbidity, especially depression, and the referral of patients who resulted as "cases" [10,11]. Lack of time and lack of self-confidence in exploring psychosocial dimensions and in using psychometric instruments have been raised by cancer physicians as the most frequent barriers for not detecting and referring patients [12].…”