Receipt of Psychosocial Care Among Cancer Survivors in the United States

Abstract

Purpose Given the importance of psychosocial care for cancer survivors, this study used population-based data to characterize survivors who reported a discussion with health care provider(s) about the psychosocial effects of cancer and who reported using professional counseling or support groups (PCSG) and tested associations between receipt of psychosocial care and satisfaction with care. Patients and Methods We examined survivors of adult cancers from the 2010 National Health Interview Survey (N = 1,777). Multivariable logistic regression models examined factors associated with receipt of and satisfaction with psychosocial care. Results Most survivors (55.1%) reported neither provider discussions nor use of PCSG; 31.4% reported provider discussion only, 4.4% reported use of PCSG only, and 8.9% reported both. Non-Hispanic blacks (v non-Hispanic whites), married survivors, survivors of breast cancer (v prostate or less prevalent cancers), those treated with chemotherapy, and survivors reporting past research study/clinical trial participation were more likely to report provider discussion(s) (P < .01). Hispanics (v non-Hispanic whites), survivors age 40 to 49 years (v ≤ 39 years), survivors of breast cancer (v melanoma or less prevalent cancers), those diagnosed ≤ 1 year ago (v > 5 years ago), survivors treated with radiation, and past research participants were more likely to report use of PCSG (P < .05). Survivors reporting any psychosocial care were more likely to be “very satisfied” with how their needs were met (P < .001). Conclusion Many survivors do not report a discussion with providers about the psychosocial effects of cancer, which reflects a missed opportunity to connect survivors to psychosocial services. These data can benchmark the success of efforts to improve access to cancer-related psychosocial care.

Identifying and Addressing the Needs of Adolescents and Young Adults With Cancer: Summary of an Institute of Medicine Workshop

“…Many AYA patients also report unmet practical support needs, such as assistance with health insurance, financial planning, transportation, childcare, and peer support, as well as unmet health care needs, including physical therapy and mental health services [24]. A 2010 National Health Interview Survey indicated that many patients are unaware of what psychosocial services are available [26].Thus it is important to assess and address the unique psychosocial needs of each individual patient. Care providers can also help AYA patients and their family members determine the role of the family in the patients' care.…”

“…Although much of the data comes from studies of survivors of pediatric cancers, there is some evidence that the diets of AYA cancer survivors are suboptimal. Studies find that only between 16 and 54% of such survivors have the recommended amount of fat in their diets [61][62][63][64], 86% are consuming more than the recommended daily intake of sugar [64], and a low percentage are eating 5 or more servings of fruits and vegetables per day [26,[61][62][63].They are also less likely to meet physical activity guidelines than people in the general population, and they are less active and more sedentary than theirsiblings [26,[61][62][63][65][66][67][68].These behaviors are juxtaposed with observational evidence that physical activity not only improves quality of life but is also associated with prolonged survival for some types of cancer [69,70].…”

“…However, because the CCSS does not include survivors of adult-onset carcinomas, such as testicular, cervical, breast, or ovarian cancer, other sources of information are needed. Large national databases, such as Surveillance, Epidemiology, and End Results (SEER) [36] or BRFSS [26,37], can be queried for outcomes of AYA survivors but have limited treatment information. Lastly, several studies have focused on specific cancer groups, such as Hodgkin lymphoma [38] and testicular cancer [39].…”

Adolescent and Young Adult Cancer: Principles of Care

“…Cancer has a significant effect on the psychological wellbeing of ayas, and many of their psychosocial needs remain unmet 17,18 . Compared with their healthy peers, ayas with cancer are at higher risk of experiencing poor psychological well-being and distress that can last for many years after treatment 19 .…”

Florida Initiative for Quality Cancer Care: Changes in Psychosocial Quality of Care Indicators Over a 3-Year Interval

“…Institute of Medicine reports 1,2 and surveys of patients and care providers 3,4 suggest limited progress has been made in implementing recommendations that oncology practices have procedures in place to identify and assist patients who experience psychosocial problems. Efforts to date to improve the quality of psychosocial care have focused mostly on issuance of clinical practice guidelines for distress management 5 and accreditations standards designed to foster greater patient-centered care.…”