Joseph M. Hyland

Psychosocial aspects of oncology: challenges and problems of research in a radiotherapy center of a community hospital.

This paper describes the vicissitudes of psychosocial research in a radiotherapy center. The project described evaluates the efficacy of counseling techniques in patients with early stage breast cancer receiving radiotherapy. The problems involved are discussed. They include the effects of: 1) introducing a psychosocial program into a medical setting; 2) research, specifically psychological, on staff and treatment in a nonresearch center; 3) asking patients to participate in a project the relevance of which is not immediately apparent; and 4) working under such conditions on the research itself. Conclusions and recommendations derived from this experience are made.

The Psychosocial Team and the Difficult-to-Treat Patient

The main focus of investigations, treatment programs, and strategies for managing the problems of cancer patients and their families has been on how individual health care staff members treat individual patients and families. This article discusses the issues involved in organizing a psychosocial team, the teams functions and responsibilities, its strengths and weaknesses, and how team members work together to treat difficult patients. Models of team approaches in three settings-a radiotherapy center, an oncology unit, and the oncologists office-are provided, and case vignettes are used to illustrate problems presented by difficult patients as well as those related to unresolved issues such as team leadership.