Improving Psychosocial Care in Outpatient Oncology Settings

Author: Paul B. Jacobsen PhD
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Psychosocial Care of Cancer PatientsA recent Institute of Medicine (IOM) report, “Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs,” summarized the current status of efforts to provide psychosocial care for people with cancer.1 Among the report's main conclusions was that, despite evidence of the effectiveness of psychosocial services, many patients who could benefit from this type of care do not receive the help they need. According to the report, failure to address these problems causes needless patient and family suffering, obstructs quality health care, and can potentially affect the course of disease. The reasons for this failure are many, and include the tendency of oncology care providers to underestimate distress in patients2 and not link patients to appropriate services when needs are identified.3 To address these problems, the report recommended that provision of appropriate psychosocial services should be adopted as a standard of quality cancer care.1 The report also identified a model for the effective delivery of psychosocial services that specifies implementation of processes for 1) facilitating effective communication between patients and care providers; 2) identifying patients' psychosocial needs; 3) designing and implementing plans that link patients with needed psychosocial services, coordinate their biomedical and psychosocial care, and engage and support them; and 4) systematically following up on, reevaluating, and adjusting the plan.1These recommendations are similar to those described in the Clinical Practice Guidelines in Oncology: Distress Management first issued by the NCCN in 19994 and updated annually.5 These guidelines were developed based on the recognized...

Paul Jacobsen, PhD, is Chair of the Department of Health Outcomes and Behavior at the Moffitt Cancer Center and Professor of Psychology at the University of South Florida. Dr. Jacobsen receives support for research on quality of care from Pfizer, Inc.

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