Patient and health professional's perceived barriers to the delivery of psychosocial care to adults with cancer: a systematic review

Dilworth, Sophie; Higgins, Isabel; Parker, Vicki; Kelly, Brian; Turner, Jane

doi:10.1002/pon.3474

Cited by 228 publications

(297 citation statements)

References 82 publications

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“…Even if physicians inquire about emotional distress, for example, many people refuse assistance to avoid the label of mental illness (Corrigan, 2004). Finally, physicians cite a lack of insurance coverage and high cost as major barriers to the adequate provision of and referral to psychosocial, function-oriented supportive care services (Dilworth et al, 2014).…”

Section: Barriers To a Focus On Function In Supportive Carementioning

confidence: 99%

“…In fact, the authors of one study evaluating detection and treatment of functional problems in cancer survivors concluded that "functional problems are prevalent among outpatients with cancer and are rarely documented by oncology clinicians" (Cheville et al, 2009, p. 61). However, even when physicians do screen for functional deficits, health care settings often lack adequate systems for referring cancer patients to psychosocial supportive care services (Dilworth et al, 2014).…”

Section: Barriers To a Focus On Function In Supportive Carementioning

confidence: 99%

“…Education about self-management is also within the scope of practice of occupational therapy and is another common unmet supportive care need reported by cancer patients (Dilworth et al, 2014). Efficacious self-management encompasses the ability to monitor one's own condition and to make changes in the realms of cognition, behavior, and emotion to maintain quality of life (Barlow, Wright, Sheasby, Turner, & Hainsworth, 2002).…”

Section: Focus On Function: Untapped Potential For Occupational Theramentioning

confidence: 99%

“…Despite the wide variety of disciplines involved in supportive oncology care, cancer survivors report widespread dissatisfaction with these services (Dilworth, Higgins, Parker, Kelly, & Turner, 2014). The most commonly reported unmet supportive care needs of adult cancer survivors involve everyday function, including difficulty coping with emotions such as fear, stress, and anxiety and obtaining education about diagnosis and prognosis, treatment, and self-management of symptoms (Adler & Page, 2008;Sanson-Fisher et al, 2000).…”

mentioning

confidence: 99%

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Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

Sleight

Duker

2016

The American Journal of Occupational Therapy

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Section: Barriers To a Focus On Function In Supportive Carementioning

confidence: 99%

Section: Barriers To a Focus On Function In Supportive Carementioning

confidence: 99%

Section: Focus On Function: Untapped Potential For Occupational Theramentioning

confidence: 99%

mentioning

confidence: 99%

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Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

Sleight

Duker

2016

The American Journal of Occupational Therapy

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“…Skills in addressing the emotional, information, and support needs of patients are also lacking (Botti et al, 2006;Dilworth et al, 2014). What skills would be required in the context of EAS?…”

Section: Who Would Be Responsible For Performing Eas and What Would Tmentioning

confidence: 99%

Legalizing physician-assisted suicide and/or euthanasia: Pragmatic implications

Hudson

Philip

et al. 2015

Pall Supp Care

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Objective: Despite the availability of palliative care in many countries, legalization of euthanasia and physician-assisted suicide (EAS) continues to be debated-particularly around ethical and legal issues-and the surrounding controversy shows no signs of abating. Responding to EAS requests is considered one of the most difficult healthcare responsibilities. In the present paper, we highlight some of the less frequently discussed practical implications for palliative care provision if EAS were to be legalized. Our aim was not to take an explicit anti-EAS stance or expand on findings from systematic reviews or philosophical and ethico-legal treatises, but rather to offer clinical perspectives and the potential pragmatic implications of legalized EAS for palliative care provision, patients and families, healthcare professionals, and the broader community.Method: We provide insights from our multidisciplinary clinical experience, coupled with those from various jurisdictions where EAS is, or has been, legalized.Results: We believe that these issues, many of which are encountered at the bedside, must be considered in detail so that the pragmatic implications of EAS can be comprehensively considered.Significance of Results: Increased resources and effort must be directed toward training, research, community engagement, and ensuring adequate resourcing for palliative care before further consideration is given to allocating resources for legalizing euthanasia and physicianassisted suicide.

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Incidence of and Factors Associated With Nonfatal Self-injury After a Cancer Diagnosis in Ontario, Canada

et al. 2021

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IMPORTANCE Psychological distress is a key component of patient-centered cancer care. While a greater risk of suicide among patients with cancer has been reported, more frequent consequences of distress, including nonfatal self-injury (NFSI), remain unknown. OBJECTIVE To examine the risk of NFSI after a cancer diagnosis. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study used linked administrative databases to identify adults diagnosed with cancer between 2007 and 2019 in Ontario, Canada. EXPOSURES Demographic and clinical factors. MAIN OUTCOMES AND MEASURESCumulative incidence of NFSI, defined as emergency department presentation of self-injury, was computed, accounting for the competing risk of death from all causes. Factors associated with NFSI were assessed using multivariable Fine and Gray models. RESULTSIn total, 806 910 patients met inclusion criteria. The mean (SD) age was 65.7 (14.3) years, and 405 161 patients (50.2%) were men. Overall, 2482 (0.3%) had NFSI and 182 (<0.1%) died by suicide. The 5-year cumulative incidence of NFSI was 0.27% (95% CI, 0.25%-0.28%). After adjusting for key confounders, prior severe psychiatric illness, whether requiring inpatient care (subdistribution hazard ratio [sHR], 12.6; 95% CI, 10.5-15.2) or outpatient care (sHR, 7.5; 95% CI, 6.5-8.8), and prior self-injury (sHR, 6.6; 95% CI, 5.5-8.0) were associated with increased risk of NFSI.Young adults (age 18-39 years) had the highest NFSI rates relative to individuals aged 70 years or older (sHR, 5.4; 95% CI, 4.5-6.5). The magnitude of association between prior inpatient psychiatric illness and NFSI was greatest for young adults (sHR, 17.6; 95% CI, 12.0-25.8). Certain cancer subsites were also associated with increased risk, including head and neck cancer (sHR, 1.5; 95% CI, 1.2-1.9). CONCLUSIONS AND RELEVANCEIn this study, patients with cancer had a higher incidence of NFSI than suicide after diagnosis. Younger age, history of severe psychiatric illness, and prior self-injury were independently associated with risk of NFSI. These exposures appeared to act synergistically, placing young adults with a prior mental health history at the greatest risk of NFSI. These factors should be used to identify at-risk patients.

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Patient and health professional's perceived barriers to the delivery of psychosocial care to adults with cancer: a systematic review

Cited by 228 publications

References 82 publications

Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

Toward a Broader Role for Occupational Therapy in Supportive Oncology Care

Legalizing physician-assisted suicide and/or euthanasia: Pragmatic implications

Incidence of and Factors Associated With Nonfatal Self-injury After a Cancer Diagnosis in Ontario, Canada

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