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Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
care and to manage the psychological/behavioral and social aspects of illness and its consequences so as to promote better health. We note that some level of psychosocial support (e.g., providing emotional support and information about one’s illness) accompanies much of routine health care. Family members and other informal supports also meet many emotional and logistical needs in times of illness. However, when this level or type of support is insufficient to address a patient’s needs, more formal services are needed. Definitions and descriptions of these services and the extent of evidence supporting their effectiveness in meeting identified patient needs are discussed below.
In addition to these services to address problems that arise at the level of the patient (the need for which will likely vary among individuals), psychosocial interventions are needed on a more uniform basis within clinical practices to address problems arising at the level of the health care system, such as failure to identify patients’ psychosocial needs, to link patients to effective services, and to support them in managing their illness and health. These more consistently needed provider- and system-level interventions to deliver effective psychosocial services are discussed in Chapters 4 and 5.
EVIDENCE OF EFFECTIVENESS
The effectiveness of some psychosocial health services has been substantiated through research. Others (such as the provision of transportation or financial assistance to purchase medications) have such long-standing and wide acceptance that they have not been the subject of much research interest. Others addressed in more recent effectiveness research appear promising, but require further study to clarify the extent of their effectiveness. Interest remains high in still others that have not yet shown effectiveness in research studies as multiple parties seek effective ways to meet pressing needs. This variation in the extent to which psychosocial health services are evidence based is similar to the variation seen in research findings supporting the effectiveness of individual biomedical health care services (Neumann et al., 2005; IOM, 2007). The approach used by the committee to evaluate the effectiveness of individual psychosocial health services is described in Appendix B.
Limitations in Taxonomy and Nomenclature
A serious problem encountered by the committee as it sought to identify and evaluate evidence of the effectiveness of psychosocial health services is the lack of a taxonomy and nomenclature for referring to these services. This is manifest in the controlled vocabularies of major bibliographic databases and other indexing services. For example, the term “psychosocial”