1
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Birch K, Chung S, Zion SR, MacEwan JP, Malecki MJ. Incremental Health Care Costs of Anxiety and Depression Among Medicare Beneficiaries With Cancer. JCO Oncol Pract 2023; 19:e660-e671. [PMID: 36800552 PMCID: PMC10424903 DOI: 10.1200/op.22.00555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/20/2022] [Accepted: 12/21/2022] [Indexed: 02/19/2023] Open
Abstract
PURPOSE Mental health comorbidities are commonplace among patients with cancer and have been associated with adverse health outcomes and elevated health care costs. Given the rapidly evolving cancer care landscape, an updated understanding of the prevalence and costs of mental health conditions among patients with cancer is needed. This study assessed the incremental costs of anxiety and depression among Medicare beneficiaries with cancer. METHODS This retrospective cohort study used the SEER-Medicare database. Patients diagnosed with melanoma, breast, lung, prostate, or colorectal cancer between July 2013 and December 2017 were followed for at least 12 months and up to 36 months after cancer diagnosis. Patients were categorized on the basis of anxiety/depression (AD) diagnosis: (1) predating cancer, (2) onset after cancer, or (3) no AD. Multivariable regression was used to estimate differences in all-cause incremental costs (before v after cancer) between the three groups. RESULTS Of 230,626 patients, 10% had AD before their cancer diagnosis and 22% were diagnosed after cancer. In the first year after cancer diagnosis, average monthly health care costs were $5,750 in US dollars (USD) for patients with newly onset, $5,208 (USD) for patients with preexisting, and $3,919 (USD) for patients without a diagnosis of AD. The incremental cost of cancer was the greatest among patients with newly onset AD-$1,458 (USD) per month greater than those with no AD. Similar patterns were observed across cancer types and stages. CONCLUSION One in three Medicare beneficiaries with cancer in this study had a diagnosis of anxiety or depression. Newly onset AD is associated with an increase in health care costs of $17,496 (USD) per year. Screening and management of mental health conditions for patients with cancer should be part of coordinated oncology care.
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Acquati C, Miller-Sonet E, Zhang A, Ionescu E. Social Wellbeing in Cancer Survivorship: A Cross-Sectional Analysis of Self-Reported Relationship Closeness and Ambivalence from a Community Sample. Curr Oncol 2023; 30:1720-1732. [PMID: 36826094 PMCID: PMC9955865 DOI: 10.3390/curroncol30020133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Improvements in early screening and treatment have contributed to the growth of the number of cancer survivors. Understanding and mitigating the adverse psychosocial, functional, and economic outcomes they experience is critical. Social wellbeing refers to the quality of the relationship with partners/spouses, children, or significant others. Close relationships contribute to quality of life and self-management; however, limited literature exists about social wellbeing during survivorship. This study examined positive and negative self-reported changes in a community sample of 505 cancer survivors. Fourteen items assessed changes in communication, closeness with partner/children, stability of the relationship, and caregiving burden. An exploratory factor analysis was conducted using a robust weighted least square procedure. Differences by sociodemographic and clinical characteristics were investigated. Respondents were mostly male, non-Hispanic white, and ≥4 years since diagnosis. Two factors, labeled Relationship Closeness and Ambivalence, emerged from the analysis. Women, younger survivors, individuals from minority groups, and those with lower income experienced greater negative changes in social wellbeing. Variations by treatment status, time since diagnosis, and institution were also reported. This contribution identifies groups of cancer survivors experiencing affected social wellbeing. Results emphasize the need to develop interventions sustaining the quality of interpersonal relationships to promote long-term outcomes.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX 77204, USA
- Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77204, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-713-743-4343
| | | | - Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA
| | - Elena Ionescu
- Graduate College of Social Work, University of Houston, Houston, TX 77204, USA
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3
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Wang K, Zhang A, De Fries CM, Hasche LK. Education Moderates the Association between Depressive Symptoms and Self-Rated Health among Older Adults with Cancer. HEALTH & SOCIAL WORK 2022; 48:hlac031. [PMID: 36473056 DOI: 10.1093/hsw/hlac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/01/2021] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
This study examined the association between depressive symptoms and self-rated health (SRH) and whether and how such association varies by education among older adults with cancer. Data came from the 2019 National Health Interview Survey. A total of 2,470 participants aged 65 or older who had been diagnosed with cancer by a doctor or other health professional were included in this study. Ordinal logistic regression was used to examine the association between depressive symptoms and SRH and whether and how such association varies by education among older adults with cancer. More depressive symptoms were associated with worse SRH. Such association became stronger with higher education among older adults with cancer. Findings confirm the associations between depressive symptoms and SRH among older adults with cancer. The differential impact of education on SRH and on the association between depressive symptoms and SRH highlights the importance of considering patients' educational attainment in a more comprehensive way when working with older adults with cancer. When conducting distress screening among cancer survivors, oncology social workers should be aware of the complex relationship between education and depression in relation to cancer survivors' SRH.
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Affiliation(s)
- Kaipeng Wang
- PhD, is assistant professor, Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO 80208-7100, USA
| | - Anao Zhang
- PhD, ACSW, is assistant professor, School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Carson M De Fries
- MSW, is a PhD student, Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Leslie K Hasche
- PhD, is associate professor, Graduate School of Social Work, University of Denver, Denver, CO, USA
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Dibble KE, Kaur M, Connor AE. Disparities in healthcare utilization and access by length of cancer survivorship among population-based female cancer survivors. J Cancer Surviv 2022; 16:1220-1235. [PMID: 34661881 PMCID: PMC9013726 DOI: 10.1007/s11764-021-01110-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/07/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE The current study examined disparities in the associations between medically vulnerable populations and healthcare-related outcomes among population-based female cancer survivors and determined if these associations differed by length of cancer survivorship. METHODS One thousand eight hundred ninety-seven women with a cancer history from the National Health and Nutrition Examination Survey from 1999 to 2016 contributed data. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated with multivariable logistic regression models to measure the associations between the predictors (race/ethnicity, poverty status, education, comorbidity status, US nativity) and outcomes (perceived health, healthcare utilization and access outcomes), overall and by length of survivorship. RESULTS There was an average of 14.3 years (SD = 11.7; range = 2-84) since initial cancer diagnosis, with 25.1% being short-term and 74.9% being long-term survivors. Overall, racial/ethnic minority women were more likely to report poor/fair health status (OR, 2.68; 95% CI 1.73-4.15) and utilizing routine care other than a doctor's office/HMO (OR, 1.61; 95% CI 1.12-2.29) in comparison with NHW survivors. Length of survivorship significantly modified the association between race/ethnicity and odds of seeing a mental health provider in the last year (p-interaction = 0.003), with short-term minority survivors being significantly more likely (OR, 2.63; 95% CI 1.29-5.35) and long-term minority survivors being less likely (OR, 0.68; 95% CI 0.37-1.23). CONCLUSIONS Racial/ethnic disparities exist among female cancer survivors for perceived health status and certain healthcare utilization outcomes, with some differences observed by length of cancer survivorship. IMPLICATIONS FOR CANCER SURVIVORS This study can begin to inform cancer survivorship care for medically vulnerable women along the cancer continuum.
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Affiliation(s)
- Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Maneet Kaur
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, 21205, USA
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5
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Rohan EA, Gallaway MS, Huang GC, Ng D, Boehm JE, Samarasinha R, Stachon K. Disparities in Psychosocial Distress Screening and Management of Lung and Ovarian Cancer Survivors. JCO Oncol Pract 2022; 18:e1704-e1715. [PMID: 35939778 PMCID: PMC9835932 DOI: 10.1200/op.22.00078] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/26/2022] [Accepted: 06/17/2022] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Since 2016, the American College of Surgeons' Commission on Cancer (CoC) has required routine distress screening (DS) of cancer survivors treated in their accredited facilities to facilitate early identification of survivors with psychosocial concerns. Lung and ovarian cancer survivors have relatively low 5-year survival rates and may experience high levels of distress. We examined the extent to which ovarian and lung cancer survivors received CoC-mandated DS and whether DS disparities exist on the basis of diagnosis, sociodemographic factors, or facility geography (urban/rural). METHODS This study included a quantitative review of DS documentation and follow-up services provided using existing electronic health records (EHRs). We worked with 21 CoC-accredited facilities across the United States and examined EHRs of 2,258 survivors from these facilities (1,618 lung cancer survivors and 640 ovarian cancer survivors) diagnosed in 2016 or 2017. RESULTS Documentation of DS was found in half (54.8%) of the EHRs reviewed. Disparities existed across race/ethnicity, cancer type and stage, and facility characteristics. Hispanic/Latino and Asian/Pacific Islander survivors were screened at lower percentages than other survivors. Patients with ovarian cancer, those diagnosed at earlier stages, and survivors in urban facilities had relatively low percentages of DS. Non-Hispanic Black survivors were more likely than non-Hispanic White survivors to decline further psychosocial services. CONCLUSION Despite the mandate for routine DS in CoC-accredited oncology programs, gaps remain in how many and which survivors are screened for distress. Improvements in DS processes to enhance access to DS and appropriate psychosocial care could benefit cancer survivors. Collaboration with CoC during this study led to improvement of their processes for collecting DS data for measuring standard adherence.
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Affiliation(s)
- Elizabeth A. Rohan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - M. Shayne Gallaway
- Arizona Department of Public Health, Phoenix, AZ
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | | | | | - Jennifer E. Boehm
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ruvini Samarasinha
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Karen Stachon
- American College of Surgeons, Commission on Cancer, Chicago, IL
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6
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Falk D, Zebrack BJ. Advancing Health Equity in Cancer-Related Distress: Lessons Learned From the COVID-19 Pandemic on Leveraging Digital Tools and Future Directions. J Natl Compr Canc Netw 2022; 20:850-852. [PMID: 35830890 DOI: 10.6004/jnccn.2022.7043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sutton TL, Koprowski MA, Gold JA, Liu B, Grossblatt-Wait A, Macuiba C, Lehman A, Hedlund S, Rocha FG, Brody JR, Sheppard BC. Disparities in Electronic Screening for Cancer-Related Psychosocial Distress May Promote Systemic Barriers to Quality Oncologic Care. J Natl Compr Canc Netw 2022; 20:765-773.e4. [PMID: 35830889 DOI: 10.6004/jnccn.2022.7015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/25/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Screening for cancer-related psychosocial distress is an integral yet laborious component of quality oncologic care. Automated preappointment screening through online patient portals (Portal, MyChart) is efficient compared with paper-based screening, but unstudied. We hypothesized that patient access to and engagement with EHR-based screening would positively correlate with factors associated with digital literacy (eg, age, socioeconomic status). METHODS Screening-eligible oncology patients seen at our Comprehensive Cancer Center from 2014 through 2019 were identified. Patients with active Portals were offered distress screening. Portal and screening participation were analyzed via multivariable logistic regression. Household income in US dollars and educational attainment were estimated utilizing zip code and census data. RESULTS Of 17,982 patients, 10,279 (57%) had active Portals and were offered distress screening. On multivariable analysis, older age (odds ratio [OR], 0.97/year; P<.001); male gender (OR, 0.89; P<.001); Black (OR, 0.47; P<.001), Hawaiian/Pacific Islander (OR, 1.54; P=.007), and Native American/Alaskan Native race (OR, 0.67; P=.04); Hispanic ethnicity (OR, 0.76; P<.001); and Medicare (OR, 0.59; P<.001), Veteran's Affairs/military (OR, 0.09; P<.01), Medicaid (OR, 0.34; P<.001), or no insurance coverage (OR, 0.57; P<.001) were independently associated with lower odds of being offered distress screening; increasing income (OR, 1.05/$10,000; P<.001) and educational attainment (OR, 1.03/percent likelihood of bachelor's degree or higher; P<.001) were independently associated with higher odds. In patients offered electronic screening, participation rate was 36.6% (n=3,758). Higher educational attainment (OR, 1.01; P=.03) was independently associated with participation, whereas Black race (OR, 0.58; P=.004), Hispanic ethnicity (OR, 0.68; P=.01), non-English primary language (OR, 0.67; P=.03), and Medicaid insurance (OR, 0.78; P<.001) were independently associated with nonparticipation. CONCLUSIONS Electronic portal-based screening for cancer-related psychosocial distress leads to underscreening of vulnerable populations. At institutions using electronic distress screening workflows, supplemental screening for patients unable or unwilling to engage with electronic screening is recommended to ensure efficient yet equal-opportunity distress screening.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Flavio G Rocha
- 4Knight Cancer Institute.,5Division of Surgical Oncology, Department of Surgery, and
| | - Jonathan R Brody
- 1Department of Surgery.,6Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, Portland, Oregon
| | - Brett C Sheppard
- 1Department of Surgery.,6Brenden-Colson Center for Pancreatic Care, Oregon Health & Science University, Portland, Oregon
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8
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Doherty M, Finik J, Blinder V. Work Status Reduction and Cost-Related Nonadherence during Cancer Treatment. HEALTH & SOCIAL WORK 2022; 47:123-130. [PMID: 35253845 PMCID: PMC9226655 DOI: 10.1093/hsw/hlac004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/21/2020] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
Many cancer patients experience a reduction in work status during cancer treatment. Authors analyzed cross-sectional survey data from U.S. cancer patients and survivors to examine the relationship between reduced work status and cost-related nonadherence, defined as skipping or forgoing medical treatments or medications due to cost. Of 381 respondents who were working at the time of diagnosis, 143 reported a reduction in work status during treatment. Age, racial identity, level of education, and treatment type were associated with reductions in work status. Respondents who reduced work status had higher odds of engaging in cost-related nonadherence than those with stable employment. Authors conclude that reduced work status is associated with nonadherence that can undermine treatment benefit and lead to disease progression. This association is troubling given that African American respondents were more likely to report reduced work status during treatment, potentially exacerbating existing cancer health disparities. To reduce treatment nonadherence, social workers should assess for potential employment problems and be prepared to intervene through counseling, community resource referrals, and direct financial assistance. Social workers should be aware of how structural racism is reproduced through inequitable labor policies and practices that have direct implications for health and access to care.
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9
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Fox RS, Fowler B, Carrera JB, Reichek J, Sanford SD. Increasing Access to Psychosocial Care for Adolescents and Young Adults with Cancer by Integrating Targeted Navigation Services. Psychooncology 2022; 31:856-859. [PMID: 35262994 PMCID: PMC9569181 DOI: 10.1002/pon.5916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/20/2022] [Accepted: 02/27/2022] [Indexed: 11/11/2022]
Abstract
This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rina S Fox
- University of Arizona College of Nursing, Tucson, AZ, USA.,University of Arizona Cancer Center, Tucson, AZ, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brynn Fowler
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.,Anne and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Jennifer Bourneuf Carrera
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.,Anne and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Jennifer Reichek
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA.,Anne and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Stacy D Sanford
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
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10
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Wells-Di Gregorio S, Deshields T, Flowers SR, Taylor N, Robbins MA, Johnson R, Dwyer M, Siston A, Cooley ME, Kayser K. Development of a psychosocial oncology core curriculum for multidisciplinary education and training: Initial content validation using the modified Delphi Method. Psychooncology 2021; 31:130-138. [PMID: 34523775 DOI: 10.1002/pon.5791] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/21/2021] [Accepted: 08/11/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Despite its four decade history, the multidisciplinary specialty of psychosocial oncology (PSO) has no official consensus on core content. In 2014, the American Psychosocial Oncology Society (APOS) Board charged the APOS Professional Education Committee with outlining curricular content needed for core competence. METHODS Content validation was completed using a four-phase modified Delphi Method. During Phase I, a Professional Education Committee subgroup proposed domains and items, which were rated by the APOS Fellows and Board via online survey. During Phase II, Fellows completed a second, revised survey. Phase III incorporated early career members. Developmental and diversity items were integrated into each domain. In Phase IV, a larger group of subject matter experts were surveyed, with feedback incorporated. Validation across phases involved average rating thresholds, intraclass correlations, and final percent agreement. RESULTS The Delphi Method supported 12 content domains: Cancer Basics, Psychosocial Oncology, Professional Development, Ethics, Emotional/Psychological Concerns, Sexuality and Relationship Concerns, Spiritual/Religious Concerns, Healthcare Communication and Decision Making, Social/Practical Problems, Caregiver Concerns, Cognitive Concerns, Physical Symptoms and Psychosocial Assessment/Treatment. High levels of agreement were achieved across domains (86%-100%) and items, with no significant rating differences by discipline. CONCLUSIONS This proposed core content can enhance and standardize education and training in PSO including APOS' Virtual Psychosocial Oncology Core Curriculum, focused on broadly expanding the PSO workforce, particularly in underserved areas. Next steps include development of core competencies and establishment of online training modules based on this content validation.
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Affiliation(s)
- Sharla Wells-Di Gregorio
- Department of Internal Medicine, Division of Palliative Medicine, The Ohio State University Wexner Medical Center, James Cancer Hospital, Columbus, Ohio, USA
| | - Teresa Deshields
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Stacy R Flowers
- Department of Family Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA
| | - Nicole Taylor
- Graduate School of Professional Psychology, University of Denver, Denver, Colorado, USA
| | - Mona A Robbins
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rhonda Johnson
- Department of Internal Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA
| | - Meagan Dwyer
- Department of Psychiatry & Behavioral Sciences and Department of Internal Medicine, Division of Oncology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Amy Siston
- Department of Psychiatry & Behavioral Neurosciences, University of Chicago Medicine, Chicago, Illinois, USA
| | - Mary E Cooley
- Phyllis F Cantor Center Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Karen Kayser
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
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11
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Deshields TL, Wells-Di Gregorio S, Flowers SR, Irwin KE, Nipp R, Padgett L, Zebrack B. Addressing distress management challenges: Recommendations from the consensus panel of the American Psychosocial Oncology Society and the Association of Oncology Social Work. CA Cancer J Clin 2021; 71:407-436. [PMID: 34028809 DOI: 10.3322/caac.21672] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 12/11/2022] Open
Abstract
Distress management (DM) (screening and response) is an essential component of cancer care across the treatment trajectory. Effective DM has many benefits, including improving patients' quality of life; reducing distress, anxiety, and depression; contributing to medical cost offsets; and reducing emergency department visits and hospitalizations. Unfortunately, many distressed patients do not receive needed services. There are several multilevel barriers that represent key challenges to DM and affect its implementation. The Consolidated Framework for Implementation Research was used as an organizational structure to outline the barriers and facilitators to implementation of DM, including: 1) individual characteristics (individual patient characteristics with a focus on groups who may face unique barriers to distress screening and linkage to services), 2) intervention (unique aspects of DM intervention, including specific challenges in screening and psychosocial intervention, with recommendations for resolving these challenges), 3) processes for implementation of DM (modality and timing of screening, the challenge of triage for urgent needs, and incorporation of patient-reported outcomes and quality measures), 4) organization-inner setting (the context of the clinic, hospital, or health care system); and 5) organization-outer setting (including reimbursement strategies and health-care policy). Specific recommendations for evidence-based strategies and interventions for each of the domains of the Consolidated Framework for Implementation Research are also included to address barriers and challenges.
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Affiliation(s)
- Teresa L Deshields
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Sharla Wells-Di Gregorio
- Department of Internal Medicine, Division of Palliative Medicine, The Ohio State University Wexner Medical Center, James Cancer Hospital, Columbus, Ohio
| | - Stacy R Flowers
- Department of Family Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| | - Kelly E Irwin
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ryan Nipp
- Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lynne Padgett
- Department of Psychology, Veterans Affairs Medical Center, Washington, District of Columbia
| | - Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Michigan
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12
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Granek L, Nakash O, Shapira S, Ariad S, Ben-David MA. "We are a transit station here": The role of Israeli oncology social workers in responding to mental health distress and suicidality in patients with cancer. SOCIAL WORK IN HEALTH CARE 2020; 60:225-239. [PMID: 33342392 DOI: 10.1080/00981389.2020.1867287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/05/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
Social workers have a prominent role in responding to cancer patients' mental health needs. Given the risk of mental health distress in cancer patients, and given that social workers are responsible for responding to these needs, the purpose of this study was to explore how social workers describe their role in responding to mental health distress and suicidality in people with cancer. The Grounded Theory method of data collection and analysis was used. Eighteen social workers were recruited and interviewed. Social workers saw themselves and acted as an interprofessional hub for their patients. This approach was based on the values of holistic care, multiple treatment modalities, interpersonal consultation, and continuity of care. From this standpoint, social workers offered their patients (and at times, their families) comprehensive services providing emotional, behavioral and practical support within the hospital setting, but also outside of it in the patient's communities. Consideration should be paid to promote systemic changes to acknowledge and compensate oncology socials workers' invisible labor that includes both emotional carryover and continuous engagement in their role as liaison and intermediaries for their patients.
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Affiliation(s)
- Leeat Granek
- School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada
| | - Ora Nakash
- Smith School for Social Work, Northampton, United States
| | - Shahar Shapira
- Department of Gender Studies, Simon Fraser University, Burnaby, British Columbia
| | - Samuel Ariad
- Department of Oncology, Soroka University Medical Center,Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Merav A Ben-David
- Department of Radiation Oncology and Sackler School of Medicine, Assuta Medical Center
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13
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Oktay JS, Rohan EA, Burruss K, Callahan C, Schapmire TJ, Zebrack B. Oncology social work intervention index (OSWii): An instrument to measure oncology social work interventions to advance research. J Psychosoc Oncol 2020; 39:143-160. [PMID: 33481691 PMCID: PMC8790712 DOI: 10.1080/07347332.2020.1857897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND/PURPOSE There is much interest in screening for and treating psychosocial distress in cancer patients; however, little is known about if and how psychosocial services are provided for patients demonstrating significant levels of distress. Oncology social workers (OSWs) are the primary providers of psychosocial care for cancer patients and their families, yet there is no widely-used and empirically-validated instrument that captures the range of interventions provided by OSWs. The purpose of this paper is to describe the development of the Oncology Social Work Intervention Index (OSWii), designed to measure interventions provided by OSWs, and the results of testing the instrument. METHODS We conducted a content analysis of data collected by the Association of Oncology Social Work's Project to Assure Quality Cancer Care (APAQCC). We analyzed 3,194 responses from an open-ended question that described social work interventions following a distress screen. Five investigators coded the data in an iterative process to enhance instrument validity. The resulting instrument measuring OSWii was piloted with 38 oncology social workers across 156 individual cases. RESULTS OSWs who piloted the OSWii spent a majority of time (72%) engaging in clinical interventions. The user assessment revealed that data entry was rapid, the instrument was easy to use, and the content was relevant to the cancer treatment setting. CONCLUSIONS AND IMPLICATIONS Using a standardized instrument that reflects OSWs' clinical interventions is critical for researchers to examine the impact of psychosocial interventions on patient outcomes. This index may also advance the translation of scientific findings into patient-centered psychosocial cancer care. This pilot test suggests that the OSWii is both scalable and useful.
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Affiliation(s)
| | - Elizabeth A. Rohan
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, GA, USA
| | - Karen Burruss
- University of Maryland School of Social Work, Baltimore, MD, USA
| | | | - Tara J. Schapmire
- University of Louisville Schools of Medicine and Social Work, Louisville, KY, USA
| | - Brad Zebrack
- University of Michigan School of Social Work, Ann Arbor, MI, USA
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Courtnage T, Bates NE, Armstrong AA, Seitz MK, Weitzman TS, Fann JR. Enhancing integrated psychosocial oncology through leveraging the oncology social worker's role in collaborative care. Psychooncology 2020; 29:2084-2090. [DOI: 10.1002/pon.5582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/21/2020] [Accepted: 10/07/2020] [Indexed: 01/18/2023]
Affiliation(s)
- Tiffany Courtnage
- Department of Psychosocial Oncology Seattle Cancer Care Alliance Seattle Washington USA
| | - Nicole E. Bates
- Department of Psychosocial Oncology Seattle Cancer Care Alliance Seattle Washington USA
- Department of Psychiatry and Behavioral Sciences University of Washington Seattle Washington USA
| | - Anne A. Armstrong
- Department of Psychosocial Oncology Seattle Cancer Care Alliance Seattle Washington USA
| | - M. Katherine Seitz
- Department of Psychosocial Oncology Seattle Cancer Care Alliance Seattle Washington USA
| | - Tammy S. Weitzman
- Department of Psychosocial Oncology Seattle Cancer Care Alliance Seattle Washington USA
| | - Jesse R. Fann
- Department of Psychosocial Oncology Seattle Cancer Care Alliance Seattle Washington USA
- Department of Psychiatry and Behavioral Sciences University of Washington Seattle Washington USA
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Mendonça AB, Pereira ER, Magnago C, Costa Rosa Andrade Silva RM, Meira KC, de Oliveira Martins A. Distress and the religious and spiritual coping of Brazilians living with cancer: A cross-sectional study. Eur J Oncol Nurs 2020; 48:101825. [DOI: 10.1016/j.ejon.2020.101825] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/21/2020] [Accepted: 08/03/2020] [Indexed: 12/19/2022]
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Kayser K, Brydon DM, Moon H, Zebrack B. Institutional capacity to provide psychosocial care in cancer programs: Addressing barriers to delivering quality cancer care. Psychooncology 2020; 29:1995-2002. [DOI: 10.1002/pon.5488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/16/2020] [Accepted: 07/06/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Karen Kayser
- Kent School of Social Work University of Louisville Louisville Kentucky USA
| | - Daphne M. Brydon
- School of Social Work University of Michigan Ann Arbor Michigan USA
| | - Heehyul Moon
- Kent School of Social Work University of Louisville Louisville Kentucky USA
| | - Brad Zebrack
- School of Social Work University of Michigan Ann Arbor Michigan USA
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17
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Suh J, Williams S, Fann JR, Fogarty J, Bauer AM, Hsieh G. Parallel Journeys of Patients with Cancer and Depression: Challenges and Opportunities for Technology-Enabled Collaborative Care. ACTA ACUST UNITED AC 2020; 4. [PMID: 32656502 DOI: 10.1145/3392843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Depression is common but under-treated in patients with cancer, despite being a major modifiable contributor to morbidity and early mortality. Integrating psychosocial care into cancer services through the team-based Collaborative Care Management (CoCM) model has been proven to be effective in improving patient outcomes in cancer centers. However, there is currently a gap in understanding the challenges that patients and their care team encounter in managing co-morbid cancer and depression in integrated psycho-oncology care settings. Our formative study examines the challenges and needs of CoCM in cancer settings with perspectives from patients, care managers, oncologists, psychiatrists, and administrators, with a focus on technology opportunities to support CoCM. We find that: (1) patients with co-morbid cancer and depression struggle to navigate between their cancer and psychosocial care journeys, and (2) conceptualizing co-morbidities as separate and independent care journeys is insufficient for characterizing this complex care context. We then propose the parallel journeys framework as a conceptual design framework for characterizing challenges that patients and their care team encounter when cancer and psychosocial care journeys interact. We use the challenges discovered through the lens of this framework to highlight and prioritize technology design opportunities for supporting whole-person care for patients with co-morbid cancer and depression.
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Affiliation(s)
- Jina Suh
- University of Washington, USA and Microsoft Research, USA
| | | | - Jesse R Fann
- University of Washington, USA and Seattle Cancer Care Alliance, USA
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18
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Pirl WF, Greer JA, Gregorio SWD, Deshields T, Irwin S, Fasciano K, Wiener L, Courtnage T, Padgett LS, Fann JR. Framework for planning the delivery of psychosocial oncology services: An American psychosocial oncology society task force report. Psychooncology 2020; 29:1982-1987. [PMID: 32390322 DOI: 10.1002/pon.5409] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/23/2020] [Accepted: 04/29/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE While screening for psychosocial distress is now the standard of care in oncology, little guidance is available on how best to deliver services in response to identified needs. The American Psychosocial Oncology Society (APOS) convened a task force with the goal of creating a framework that could aid in planning services and justifying requests for resources. METHODS Ten experts from multiple disciplines within psychosocial oncology served on the task force, first meeting together as a larger group over 2 days to set an agenda and then subsequently working in smaller teams to execute the goals. The task force used consensus methods for developing recommendations. RESULTS Three principles were identified for the framework. First, psychosocial oncology is a key component of population health, and population-based approaches to care delivery are required. Second, several key parameters shape psychosocial oncology services: resources, aims, and scope. To guide resource allocation, example priorities were identified for the aims and scope of services. Finally, cancer care centers should strive to ensure the delivery of high-quality psychosocial oncology care across all components of care. A range of practices was ranked by their potential contributions to achieving that goal. CONCLUSIONS This framework may aid in planning, evaluating, and refining the delivery of responsive psychosocial oncology services.
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Affiliation(s)
- William F Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph A Greer
- Harvard Medical School, Boston, Massachusetts, USA.,Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Teresa Deshields
- Supportive Oncology, Rush University Cancer Center, Chicago, Illinois, USA
| | - Scott Irwin
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Health System, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California, USA
| | - Karen Fasciano
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Lori Wiener
- Pediatric Oncology Branch, National Cancer Institute, Center for Cancer Research, Bethesda, Maryland, USA
| | - Tiffany Courtnage
- Psychosocial Oncology, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Lynne S Padgett
- Department of Psychology, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, USA
| | - Jesse R Fann
- Psychosocial Oncology, Seattle Cancer Care Alliance, Seattle, Washington, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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Gonzalez BD. Promise of Mobile Health Technology to Reduce Disparities in Patients With Cancer and Survivors. JCO Clin Cancer Inform 2019; 2:1-9. [PMID: 30652578 DOI: 10.1200/cci.17.00141] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Despite recent advances in cancer control, numerous disparities exist in the areas of patient access to care, self-management, and quality of life. However, mobile health technology shows promise as a tool to reduce disparities among patients with cancer and cancer survivors by overcoming such barriers as limited access to providers, difficulty communicating with providers, and inadequate communication between patients and providers regarding symptoms. This narrative review draws on the literature in cancer and noncancer populations to identify factors that create or maintain disparities and to describe opportunities for mobile health technology to reduce disparities.
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Riba MB, Donovan KA, Andersen B, Braun II, Breitbart WS, Brewer BW, Buchmann LO, Clark MM, Collins M, Corbett C, Fleishman S, Garcia S, Greenberg DB, Handzo RGF, Hoofring L, Huang CH, Lally R, Martin S, McGuffey L, Mitchell W, Morrison LJ, Pailler M, Palesh O, Parnes F, Pazar JP, Ralston L, Salman J, Shannon-Dudley MM, Valentine AD, McMillian NR, Darlow SD. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 17:1229-1249. [PMID: 31590149 PMCID: PMC6907687 DOI: 10.6004/jnccn.2019.0048] [Citation(s) in RCA: 348] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Distress is defined in the NCCN Guidelines for Distress Management as a multifactorial, unpleasant experience of a psychologic (ie, cognitive, behavioral, emotional), social, spiritual, and/or physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Early evaluation and screening for distress leads to early and timely management of psychologic distress, which in turn improves medical management. The panel for the Distress Management Guidelines recently added a new principles section including guidance on implementation of standards of psychosocial care for patients with cancer.
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Affiliation(s)
| | | | - Barbara Andersen
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - IIana Braun
- Dana-Farber/Brigham and Women's Cancer Center
| | | | | | | | | | | | | | | | - Sofia Garcia
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | - Laura Hoofring
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | | | | | | | | | | | | | | | | | | | - Janice P Pazar
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Laurel Ralston
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
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21
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CaringGuidance™ after breast cancer diagnosis eHealth psychoeducational intervention to reduce early post-diagnosis distress. Support Care Cancer 2019; 28:2163-2174. [PMID: 31414245 PMCID: PMC7083810 DOI: 10.1007/s00520-019-05028-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/06/2019] [Indexed: 12/16/2022]
Abstract
Purpose Significant cancer-related distress affects 30–60% of women diagnosed with breast cancer. Fewer than 30% of distressed patients receive psychosocial care. Unaddressed distress is associated with poor treatment adherence, reduced quality of life, and increased healthcare costs. This study aimed to evaluate the preliminary efficacy of a new web-based, psychoeducational distress self-management program, CaringGuidance™ After Breast Cancer Diagnosis, on newly diagnosed women’s reported distress. Methods One-hundred women, in five states, diagnosed with breast cancer within the prior 3 months, were randomized to 12 weeks of independent use of CaringGuidance™ plus usual care or usual care alone. The primary multidimensional outcome, distress, was measured with the Distress Thermometer (DT), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Impact of Events Scale (IES) at baseline and months 1, 2, and 3. Intervention usage was continually monitored by the data analytic system imbedded within CaringGuidance™. Results Although multilevel models showed no significant overall effects, post hoc analysis showed significant group differences in slopes occurring between study months 2 and 3 on distress (F(1,70) = 4.91, p = .03, η2 = .065) measured by the DT, and depressive symptoms (F(1, 76) = 4.25, p = .043, η2 = .053) favoring the intervention. Conclusions Results provide preliminary support for the potential efficacy of CaringGuidance™ plus usual care over usual care alone on distress in women newly diagnosed with breast cancer. This analysis supports and informs future study of this self-management program aimed at filling gaps in clinical distress management.
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Acquati C, Kayser K. Addressing the psychosocial needs of cancer patients: a retrospective analysis of a distress screening and management protocol in clinical care. J Psychosoc Oncol 2019; 37:287-300. [PMID: 30938622 DOI: 10.1080/07347332.2018.1523822] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND A growing recognition of the impact of distress on the quality of life and adherence to treatment of cancer patients has been documented. As a result, national guidelines and standards of care mandate providers to implement distress screening protocols to connect patients with psychosocial services. However, limited literature has examined whether distressed patients are referred to care and their needs addressed. This article assessed differences in rates of referral and psychosocial services by demographic factors, clinical characteristics, and distress severity. Potential predictors of these two outcomes were investigated. METHODS A retrospective analysis of patient data abstracted from electronic medical records of a NCI-designated Academic Comprehensive Cancer Center was conducted. Of the 399 cases meeting the inclusion criteria, 302 (75.7%) were screened for distress with the Distress Thermometer. Differences were examined with chi-square, t-tests, and ANOVAs. Predictors were identified with multivariate logistic regressions. RESULTS Overall, patients who were identified as distressed were referred to a psychosocial provider (71.4%) and psychosocial services were delivered in approximately 64% of the cases. Referrals and service delivery rates varied by age group, clinic, health insurance coverage, distress severity, and presence of psychosocial issues. Only the distress score predicted the likelihood of being referred, and of a provider intervention to occur. Conclusions and implications for psychosocial providers: Although the protocol appeared to facilitate referral and service delivery to patients scoring above the cutoff for distress, our results suggest that patients were more likely to not have their distress and psychosocial needs addressed if they were older, without insurance coverage, and were seen in clinics where a social worker was not consistently available. Future studies able to monitor patient outcomes in terms of quality of life, satisfaction with care, and service utilization are recommended.
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Affiliation(s)
- Chiara Acquati
- a Graduate College of Social Work , University of Houston , Houston , Texas , USA
| | - Karen Kayser
- b Kent School of Social Work , University of Louisville , Louisville , Kentucky , USA
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23
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Lally RM, Bellavia G, Gallo S, Kupzyk K, Helgeson V, Brooks C, Erwin D, Brown J. Feasibility and acceptance of the CaringGuidance web-based, distress self-management, psychoeducational program initiated within 12 weeks of breast cancer diagnosis. Psychooncology 2019; 28:888-895. [PMID: 30803084 DOI: 10.1002/pon.5038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 02/17/2019] [Accepted: 02/21/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Limited clinical resources create barriers to quality management of cancer-related distress. CaringGuidance After Breast Cancer Diagnosis is a web-based, patient-controlled, psychoeducational program of cognitive-behavioral, coping and problem-solving strategies aimed at early post-diagnosis distress reduction without clinical resources. This study evaluated the feasibility of recruiting and retaining newly diagnosed women to 12 weeks of CaringGuidance and program acceptance. METHODS Women with stage 0 to II breast cancer diagnosed within the prior 3 months were recruited from clinics and communities in four states, from 2013 to 2015 and randomized to 12 weeks of CaringGuidance plus usual care (n = 57) or usual care alone (n = 43). Recruitment, retention, and program use were tracked. Using standard and study-derived measures, demographic and psychological variables were assessed at baseline and monthly and program satisfaction at 12 weeks. RESULTS Of 139 women screened, 100 enrolled, five withdrew, and 12 were lost to follow-up (83% retention rate). Total program engagement was positively associated with greater baseline intrusive/avoidant thoughts. Intervention participants (92%) believed CaringGuidance would benefit future women and was easy to use. Sixty-six percent believed CaringGuidance helped them cope. Women used program content to change thoughts (49%) or behaviors (40%). Stress in the previous year was positively associated with reports that CaringGuidance was reassuring and helpful. CONCLUSIONS Feasibility and acceptance of CaringGuidance was demonstrated pointing to the program's potential as a cancer-distress self-management intervention. Future research will explore program feasibility and acceptability in other regions of the United States, leading to clinical implementation trials.
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Affiliation(s)
- Robin M Lally
- University at Buffalo School of Nursing, Buffalo, New York.,University of Nebraska Medical Center College of Nursing, Omaha, Nebraska.,Fred & Pamela Buffett Cancer Center, Omaha, Nebraska
| | | | - Steven Gallo
- University at Buffalo, Center for Computational Research, Buffalo, New York
| | - Kevin Kupzyk
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
| | | | | | | | - Jean Brown
- University at Buffalo School of Nursing, Buffalo, New York
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Carlson LE, Zelinski EL, Toivonen KI, Sundstrom L, Jobin CT, Damaskos P, Zebrack B. Prevalence of psychosocial distress in cancer patients across 55 North American cancer centers. J Psychosoc Oncol 2018; 37:5-21. [DOI: 10.1080/07347332.2018.1521490] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Linda E. Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Erin L. Zelinski
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Laura Sundstrom
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Chad T. Jobin
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Penny Damaskos
- Association of Oncology Social Work, Oakbrook Terrace, IL, USA
| | - Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
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25
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Peterson EB, Chou WYS, Falisi A, Ferrer R, Mollica MA. The role of medical social workers in cancer clinical trial teams: A group case study of multidisciplinary perspectives. SOCIAL WORK IN HEALTH CARE 2018; 57:688-704. [PMID: 29856290 DOI: 10.1080/00981389.2018.1477899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Social workers collaborate with a wide range of healthcare providers in clinical trial teams, yet their roles may not always be understood or supported by team members. It is currently unknown how social workers and multidisciplinary team members perceive social workers' roles in the clinical trial context. METHODS Using a group case-study approach, social workers, core medical team members, and allied healthcare workers (n = 19) completed in-depth interviews to discuss the roles of social workers in a cancer clinical trial setting. FINDINGS Social workers discussed their role as primarily patient-centered, perceiving themselves to be a counselor, patient advocate, and conduit. They also described areas of perceived limited role contribution. Other members of the multidisciplinary teams viewed the roles of social workers to be focused on being a conduit and coordinator. DISCUSSION We found discordance in the way that social workers and their team members view the roles of social workers in clinical trials. Our data suggest that structural and interpersonal barriers may prevent social workers from working to the full extent of their license in a clinical trial context. Implications, future research, and suggestions for interventions to more fully integrate social workers into clinical trial settings are discussed.
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Affiliation(s)
- Emily B Peterson
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Wen-Ying Sylvia Chou
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Angela Falisi
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Rebecca Ferrer
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Michelle A Mollica
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
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Reblin M, Ketcher D, Forsyth P, Mendivil E, Kane L, Pok J, Meyer M, Wu YP, Agutter J. Outcomes of an electronic social network intervention with neuro-oncology patient family caregivers. J Neurooncol 2018; 139:643-649. [PMID: 29808340 PMCID: PMC6126960 DOI: 10.1007/s11060-018-2909-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 05/19/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Informal family caregivers (FCG) are an integral and crucial human component in the cancer care continuum. However, research and interventions to help alleviate documented anxiety and burden on this group is lacking. To address the absence of effective interventions, we developed the electronic Support Network Assessment Program (eSNAP) which aims to automate the capture and visualization of social support, an important target for overall FCG support. This study seeks to describe the preliminary efficacy and outcomes of the eSNAP intervention. METHODS Forty FCGs were enrolled into a longitudinal, two-group randomized design to compare the eSNAP intervention in caregivers of patients with primary brain tumors against controls who did not receive the intervention. Participants were followed for six weeks with questionnaires to assess demographics, caregiver burden, anxiety, depression, and social support. Questionnaires given at baseline (T1) and then 3-weeks (T2), and 6-weeks (T3) post baseline questionnaire. RESULTS FCGs reported high caregiver burden and distress at baseline, with burden remaining stable over the course of the study. The intervention group was significantly less depressed, but anxiety remained stable across groups. CONCLUSIONS With the lessons learned and feedback obtained from FCGs, this study is the first step to developing an effective social support intervention to support FCGs and healthcare providers in improving cancer care.
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Affiliation(s)
- Maija Reblin
- Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL, USA.
| | - Dana Ketcher
- Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL, USA
| | - Peter Forsyth
- Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL, USA
| | | | | | - Justin Pok
- University of Utah, Salt Lake City, UT, USA
| | | | - Yelena P Wu
- University of Utah, Salt Lake City, UT, USA
- Hunstman Cancer Institute, Salt Lake City, UT, USA
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Rahouma M, Kamel M, Abouarab A, Eldessouki I, Nasar A, Harrison S, Lee B, Shostak E, Morris J, Stiles B, Altorki NK, Port JL. Lung cancer patients have the highest malignancy-associated suicide rate in USA: a population-based analysis. Ecancermedicalscience 2018; 12:859. [PMID: 30174721 PMCID: PMC6113987 DOI: 10.3332/ecancer.2018.859] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Previous studies have reported that psychological and social distresses associated with a cancer diagnosis have led to an increase in suicides compared to the general population. We sought to explore lung cancer-associated suicide rates in a large national database compared to the general population, and to the three most prevalent non-skin cancers [breast, prostate and colorectal cancer (CRC)]. METHODS The Surveillance, Epidemiology and End Results (SEER) database (1973-2013) was retrospectively reviewed to identify cancer-associated suicide deaths in all cancers combined, as well as for each of lung, prostate, breast or CRCs. Suicide incidence and standardised mortality ratio (SMR) were estimated using SEER*Stat-8.3.2 program. Suicidal trends over time and timing from cancer diagnosis to suicide were estimated for each cancer type. RESULTS Among 3,640,229 cancer patients, 6,661 committed suicide. The cancer-associated suicide rate was 27.5/100,000 person years (SMR = 1.57). The highest suicide risk was observed in patients with lung cancer (SMR = 4.17) followed by CRC (SMR = 1.41), breast cancer (SMR = 1.40) and prostate cancer (SMR = 1.18).Median time to suicide was 7 months in lung cancer, 56 months in prostate cancer, 52 months in breast cancer and 37 months in CRC (p < 0.001).We noticed a decreasing trend in suicide SMR over time, which is most notable for lung cancer compared to the other three cancers. In lung cancer, suicide SMR was higher in elderly patients (70-75 years; SMR = 12), males (SMR = 8.8), Asians (SMR = 13.7), widowed patients (SMR = 11.6), undifferentiated tumours (SMR = 8.6), small-cell lung cancer (SMR = 11.2) or metastatic disease (SMR = 13.9) and in patients who refused surgery (SMR = 13). CONCLUSION The cancer-associated suicide rate is nearly twice that of the general population of the United States of America. The suicide risk is highest among the patients with lung cancer, particularly elderly, widowed, male patients and patients with unfavourable tumour characteristics. The identification of high-risk patients is of extreme importance to provide proper psychological assessment, support and counselling to reduce these rates.
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Affiliation(s)
- Mohamed Rahouma
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Mohamed Kamel
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Ahmed Abouarab
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Ihab Eldessouki
- Vontz Molecular Center, Hemato-oncology Department, University of Cincinnati, Cincinnati, OH 45220, USA
| | - Abu Nasar
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Sebron Harrison
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Benjamin Lee
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Eugene Shostak
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - John Morris
- Vontz Molecular Center, Hemato-oncology Department, University of Cincinnati, Cincinnati, OH 45220, USA
| | - Brendon Stiles
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Nasser K Altorki
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
| | - Jeffrey L Port
- Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 14853 USA
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Soanes L, Gibson F. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer. Int J Nurs Stud 2018; 81:40-48. [DOI: 10.1016/j.ijnurstu.2018.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 01/16/2018] [Accepted: 01/17/2018] [Indexed: 12/15/2022]
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Zebrack B, Kayser K, Oktay J, Sundstrom L, Mayer Sachs A. The Association of Oncology Social Work's Project to Assure Quality Cancer Care (APAQCC). J Psychosoc Oncol 2017; 36:19-30. [DOI: 10.1080/07347332.2017.1397832] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Karen Kayser
- School of Social Work, Dr. LaRocca Chair in Oncology Social Work, University of Louisville, Kent School of Social Work, Louisville, KY, USA
| | - Julianne Oktay
- School of Social Work, University of Maryland, College Park, MD, USA
| | - Laura Sundstrom
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Alison Mayer Sachs
- Community Outreach & Cancer Support Services, Eisenhower Lucy Curci Cancer Center, Rancho Mirage, CA, USA
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Reblin M, Wu YP, Pok J, Kane L, Colman H, Cohen AL, Mendivil E, Warner EL, Meyer M, Agutter J. Development of the Electronic Social Network Assessment Program Using the Center for eHealth and Wellbeing Research Roadmap. JMIR Hum Factors 2017; 4:e23. [PMID: 28855149 PMCID: PMC5597796 DOI: 10.2196/humanfactors.7845] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/12/2017] [Accepted: 07/29/2017] [Indexed: 11/13/2022] Open
Abstract
Background The number of Web-based psychological and behavioral interventions is growing. Beyond their theoretical underpinnings, a key factor to the success of these interventions is how they are designed and developed to ensure usability over a new method of delivery. Our team has adapted ecomapping, a tool for visualizing family caregiver social network resources, for the Web. Here, we describe how we designed and developed the electronic Social Network Assessment Program (eSNAP) Web-based tool using a framework of the Center for eHealth and Wellbeing Research (CeHRes) Roadmap for Web-based intervention development. The CeHRes Roadmap is still new in terms of tool development and we showcase an example of its application. Objective The aim of our study was to provide an example of the application of the Web-based intervention development process using the CeHRes Roadmap for other research teams to follow. In doing so, we are also sharing our pilot work to enhance eSNAP’s acceptance and usability for users and the feasibility of its implementation. Methods We describe the development of the eSNAP app to support family caregivers of neuro-oncology patients. This development is based on the 5 iterative stages of the CeHRes Roadmap: contextual inquiry, value specification, design, operationalization, and summative evaluation. Research activities to support eSNAP development prior to implementation included literature review, focus groups, and iterative rounds of interviews. Results Key lessons learned in developing the eSNAP app broadly fell under a theme of translating theoretical needs and ideas to the real world. This included how to prioritize needs to be addressed at one time, how the modality of delivery may change design requirements, and how to develop a tool to fit within the context it will be used. Conclusions Using the CeHRes Roadmap to develop Web-based interventions such as eSNAP helps to address potential issues by outlining important intervention development milestones. In addition, by encouraging inclusion of users and other stakeholders in the process, Web-based intervention developers using the Roadmap can identify what will work in the real world and increase feasibility and effectiveness.
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Affiliation(s)
- Maija Reblin
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Yelena P Wu
- University of Utah, Salt Lake City, UT, United States.,Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Justin Pok
- University of Utah, Salt Lake City, UT, United States
| | - Lauren Kane
- University of Utah, Salt Lake City, UT, United States
| | - Howard Colman
- University of Utah, Salt Lake City, UT, United States.,Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Adam L Cohen
- Huntsman Cancer Institute, Salt Lake City, UT, United States
| | | | - Echo L Warner
- University of Utah, Salt Lake City, UT, United States
| | - Miriah Meyer
- University of Utah, Salt Lake City, UT, United States
| | - James Agutter
- University of Utah, Salt Lake City, UT, United States
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Jacobsen PB. New Challenges in Psycho-Oncology Research II: A health care delivery, dissemination, and implementation research model to promote psychosocial care in routine cancer care. Psychooncology 2017; 26:419-423. [PMID: 28398012 DOI: 10.1002/pon.4428] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Paul B Jacobsen
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Bradford NK, Chan RJ. Health promotion and psychological interventions for adolescent and young adult cancer survivors: A systematic literature review. Cancer Treat Rev 2017; 55:57-70. [DOI: 10.1016/j.ctrv.2017.02.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/22/2017] [Accepted: 02/26/2017] [Indexed: 01/08/2023]
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Pirl WF, Lennes IT. Quality of psychosocial services in cancer centers: Today and tomorrow. Cancer 2016; 122:1807-8. [DOI: 10.1002/cncr.30018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 03/09/2016] [Indexed: 11/09/2022]
Affiliation(s)
- William F. Pirl
- Center for Psychiatric Oncology and Behavioral Sciences; Massachusetts General Hospital Cancer Center; Boston Massachusetts
| | - Inga T. Lennes
- Division of Hematology and Oncology; Massachusetts General Hospital Cancer Center; Boston Massachusetts
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