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Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
software also autoscores all items on completion and prints a one-page summary of scored data for immediate staff use and incorporation into patient charts. Raw data are automatically deposited into an Excel data file for later processing with standard statistical packages. PSSCAN is available at no cost (Linden et al., 2005).9
Other screening tools also exist and have been subjected to or are in various stages of testing. Some of these are simple checklists to identify psychosocial health needs (Pruyn et al., 2004). Although there are reports on pilot tests of the feasibility of these checklists, they have not undergone further testing for their validity, reliability, or predictive value as screens. However, a review of six studies of the use of checklists to identify psychosocial health needs in cancer care found that use of these screening tools positively influenced health care providers to pay attention to psychosocial health needs, talk with their patients about these needs, and make referrals to providers of psychosocial health services (Kruijver et al., 2006).
In the absence of a common definition of needs assessment and descriptions of how it relates to screening,10 in this report psychosocial needs assessment is defined as the identification and examination of the psychological, behavioral, and social problems of patients that interfere with their ability to participate fully in their health care and manage their illness and its consequences. Needs assessment contrasts with screening in that the latter is a brief process for identifying the risk for having psychosocial health needs, while needs assessment is a more in-depth evaluation that confirms the presence of such needs and describes their nature. Needs assessment thus requires more time than screening.
Full understanding of each individual’s psychosocial problems and resulting needs is frequently cited as an essential precursor to ensuring that cancer patients receive the necessary psychosocial health services (NICE,
Personal communication, Wolfgang Linden, PhD, University of British Columbia, March 1 and 2, 2007.
There appears to be no commonly accepted definition of the process of needs assessment across systematic reviews of the process (Thompson and Briggs, 2000; Gilbody et al., 2006a), reviews of tools for assessing the health needs of patients with cancer (Wen and Gustafson, 2004) and other conditions (Asadi-Lari and Gray, 2005), and clinical practice guidelines (NICE, 2004). Indeed, none of the preceding reviews includes a definition of needs assessment. Although this may be because the process is so well understood that it needs no definition, evidence suggests otherwise. Asadi-Lari and Gray (2005) pointedly note the sometimes interchangeable use of the terms “needs” and “health status” and “health-related quality of life” in some reviews. Discussion of how needs assessment relates to screening also is absent. At least one tool (Kazak et al., 2001) is simultaneously identified as a screening tool and assessment instrument.