Psychosocial oncology services in New South Wales
Nicole M. Rankin A G , Jennifer A. Barron B , Lisbeth G. Lane C , Catherine A. Mason D , Sue Sinclair E and James F. Bishop FA Nicole Rankin Consulting, Hutton Avenue, Bulli, NSW 2516, Australia.
B Practical Work Solutions, Cambridge Street, Rozelle, NSW 2039, Australia. Email: jennybarron@ozemail.com.au
C The Wollongong Hospital and The University of Wollongong, Wollongong, NSW 2500, Australia. Email: lisbeth@uow.edu.au
D Sydney West Cancer Network, Westmead Hospital, Westmead, NSW 2145, Australia. Email: masonc@wahs.nsw.gov.au
E Cancer Institute NSW, Australian Technology Park, Central Avenue, Eveleigh, NSW 2015, Australia. Email: sue.sinclair@cancerinstitute.org.au
F Department of Health and Ageing, Australian Government, Canberra, ACT, Australia. Email: jim.bishop@health.gov.au
G Corresponding author. Email: nicolemrankin@hotmail.com
Australian Health Review 35(2) 156-163 https://doi.org/10.1071/AH08730
Submitted: 18 December 2008 Accepted: 22 August 2010 Published: 25 May 2011
Abstract
There is limited published evidence about how psychosocial services should be organised or routinely integrated into cancer services to ensure that cancer patients receive appropriate psychological, social and emotional support during periods of diagnosis, treatment and follow-up. This paper reports on a survey of 26 oncology services in New South Wales, Australia, to examine the current provision of psychosocial oncology services. The aim of the study was to gather baseline data and information about the provision of services and to identify significant challenges associated with the development and implementation of psychosocial oncology services. A total of 42% of staff at psycho-oncology services reported they could provide adequate psycho-oncology services, but 58% of sites said they could provide either only limited (27%) or very limited (31%) services. We found that services frequently identified challenges such as insufficient funding to employ skilled staff to provide psychosocial interventions, inadequate data to demonstrate the effectiveness of psychosocial interventions and, at times, lack of space to allow privacy for patient consultations. Future needs identified were strategic planning of psychosocial oncology services as part of broader cancer service plans, leadership of psychosocial oncology services, cohesive teams using agreed patient pathways or tools and integration into multi-disciplinary cancer teams.
What is known about the topic? Psychosocial oncology services provide vital psychological interventions and social programs that can significantly improve patients’ adjustment to the experience of cancer. Limited evidence from other countries suggests there are significant challenges in developing and delivering quality, evidence-based psychosocial oncology services in a coordinated, cohesive and timely manner. Little is known about these services in the Australian context or the challenges they face.
What does this paper add? This paper presents baseline information about the structure of psychosocial oncology services in NSW and identifies the significant challenges faced by these services. It describes these challenges with regard to service structures, availability and provision of services, screening for patient distress, strategic planning and funding, leadership and delivery-focussed issues.
What are the implications for practitioners? There is a need for strategic planning of psychosocial oncology services as part of broader cancer service plans. Identified leadership of psychosocial oncology services and cohesive psychosocial teams that use agreed patient pathways or tools would be greatly beneficial, as would integration of psychosocial staff into multi-disciplinary teams. The findings may enhance quality improvement efforts in the development and delivery of psychosocial support for cancer patients, their families and carers.
References
[1] National Breast Cancer Centre, National Cancer Control Initiative. Clinical practice guidelines for the psychosocial care of adults with cancer. Sydney: National Breast Cancer Centre; 2003.[2] Devine EC, Westlake SK. The effects of psycho-educational care provided to adults with cancer: meta-analysis of 116 studies. Oncol Nurs Forum 1995; 22 1369–81.
| 1:STN:280:DyaK287itl2lsA%3D%3D&md5=8a125e068c06328f5c72a0528b9dbfddCAS | 8539178PubMed |
[3] Meyer TJ, Mark MM. Effects of psychosocial interventions with adult cancer patients: a meta-analysis of randomized experiments. Health Psychol 1995; 14 101–8.
| Effects of psychosocial interventions with adult cancer patients: a meta-analysis of randomized experiments.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2MzgvFaitw%3D%3D&md5=3c9136b1ca27b12d4ab8377682173d1eCAS | 7789344PubMed |
[4] National Institute for Clinical Excellence. Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer. The Manual. London: National Health Service; 2004.
[5] Coluzzi PH, Grant M, Doroshow JH, Rhiner M, Ferrell B, Rivera L. Survey of the provision of supportive care services at National Cancer Institute – designated cancer centres. J Clin Oncol 1995; 13 756–64.
| 1:STN:280:DyaK2M7ptVGhtQ%3D%3D&md5=8f55f8678a56955b1f1e4deb660a9ce4CAS | 7533828PubMed |
[6] Addington-Hall JM, Weir MW, Zollman C, McIllmurray MB. A national survey of the provision of support services for people with cancer. BMJ 1993; 306 1649–50.
| A national survey of the provision of support services for people with cancer.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3szhtlClsQ%3D%3D&md5=e549a25c7169c22f796fd9c177c8cb9cCAS | 8324434PubMed |
[7] Bunston T, Mings D. Planning psychosocial care for cancer patients: if at first you don’t succeed, shift your paradigm. Soc Work Health Care 1998; 27 67–87.
| Planning psychosocial care for cancer patients: if at first you don’t succeed, shift your paradigm.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3ktVWksA%3D%3D&md5=7b55de766cb0ed4c79ffa8b1debee7b2CAS | 9579017PubMed |
[8] Curry C, Cossich T, Matthews JP, Beresford J, McLachlan SA. Uptake of psychosocial referrals in an outpatient cancer setting: improving service accessibility via the referral process. Support Care Cancer 2002; 10 549–55.
| Uptake of psychosocial referrals in an outpatient cancer setting: improving service accessibility via the referral process.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38vovV2mug%3D%3D&md5=cef9f4034f11d66d96013fa4c4d5b4ebCAS | 12324810PubMed |
[9] McQuellon RP, Hurt GJ, DeChatelet P. Psychosocial care of the patient with cancer. A model for organizing services. Cancer Pract 1996; 4 304–11.
| 1:STN:280:DyaK2s3nsVeqsw%3D%3D&md5=20ecd7c01b69bb79248db498665c5762CAS | 9128482PubMed |
[10] Heiney SP, Dunaway NC, Slade M, Seale DD, Gibson B, Mehard LA, Ruffin J. Planning and organizing a multidisciplinary psychosocial oncology service. Cancer Pract 1995; 3 343–50.
| 1:STN:280:DC%2BD2M3isVCgsg%3D%3D&md5=b2febe908ba864d8da24076c8f735175CAS | 15859164PubMed |
[11] Weir MW, Zollman C, Addington-Hall JM. Developing psychosocial services for people with cancer: a review of 6 centres. J Cancer Care 1995; 4 3–10.
[12] Mitchell W, Clarke S, Sloper P. Survey of psychosocial support provided by UK paediatric oncology centres. Arch Dis Child 2005; 90 796–800.
| Survey of psychosocial support provided by UK paediatric oncology centres.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MzotFektA%3D%3D&md5=e83c78d09ac0d9f3625c26179a64c348CAS | 15855177PubMed |
[13] Tracey EA, Chen S, Baker D, Bishop J, Jelfs P. Cancer in New South Wales: Incidence and Mortality 2004. Sydney: Cancer Institute NSW; 2006.
[14] Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P. The unmet supportive care needs of patients with cancer. Supportive Care Review Group. Cancer 2000; 88 226–37.
| The unmet supportive care needs of patients with cancer. Supportive Care Review Group.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2Fos1OlsA%3D%3D&md5=85a16f47de9a6f1c44cb0fc9cc77ab4eCAS | 10618627PubMed |
[15] Cancer Strategies Group. Priorities for Action in Cancer Control 2001–2003. Canberra: Commonwealth Department of Health and Ageing; 2001.
[16] Sullivan T, Evans W, Angus H, Hudson A. Strengthening the Quality of Cancer Services in Ontario. Cancer Quality Council of Ontario; 2003.
[17] Turner J, Zapart S, Pedersen K, Rankin N, Luxford K, Fletcher J. Clinical practice guidelines for the psychosocial care of adults with cancer. Psychooncology 2005; 14 159–73.
| Clinical practice guidelines for the psychosocial care of adults with cancer.Crossref | GoogleScholarGoogle Scholar | 15669019PubMed |
[18] Sorensen R, Lloyd A, Van Kemenade C, Harnett PR. Managing quality in cancer services: why improvement isn’t easy. Aust Health Rev 2005; 29 406–15.
| Managing quality in cancer services: why improvement isn’t easy.Crossref | GoogleScholarGoogle Scholar | 16255704PubMed |
[19] National Psychosocial Oncology Standards for Cancer. Canadian Association of Psychosocial Oncology; 1999. Available at http://www.capo.ca/eng/finalstandards.asp [verified 5 March 2011]
[20] Mapping Rural and Regional Oncology Services in Australia. Sydney: Clinical Oncological Society of Australia; 2006.
[21] Shepherd L, Goldstein D, Olver I, Parle M. Enhancing psychosocial care for people with cancer in rural communities: what can remote counselling offer? Aust Health Rev 2008; 32 423–38.
| Enhancing psychosocial care for people with cancer in rural communities: what can remote counselling offer?Crossref | GoogleScholarGoogle Scholar | 18666870PubMed |
[22] NSW Cancer Plan 2007–2010. Sydney: Cancer Institute NSW; 2006.
[23] NSW Cancer Plan 2004–2006, Lessening the Impact of Cancer. A Two-Year Progress Report. Sydney: Cancer Institute NSW; 2006.
[24] Fitch M. Supportive care for cancer patients. Hosp Q 2000; 3 39–46.
| 1:STN:280:DC%2BD3Mvjs1Giug%3D%3D&md5=7f1a1f8795afbaf8f3e012a36e50abf1CAS | 11482268PubMed |
