Mary Ann Burg

Current unmet needs of cancer survivors: Analysis of open-ended responses to the American Cancer Society Study of Cancer Survivors II

Cancer survivors may continue to experience psychosocial and physical needs related to their cancer experience for many years after treatment. The specification of these needs across cancer types and by survivor characteristics may lead to better prevention approaches and clinical responses. Mixed methods were used to examine responses to an open‐ended question about current unmet needs from a survey of 2‐, 5‐, and 10‐year cancer survivors.

The Potential of Survivorship Care Plans in Primary Care Follow-up of Minority Breast Cancer Patients

ABSTRACTBACKGROUNDWhen the clinical care of minority breast cancer survivors is transferred from oncology settings to primary care, quality of care may be compromised if their primary care providers do not have adequate cancer treatment records and follow-up care guidelines. Survivorship care plans (SCPs) given to survivors before they transition to primary care settings are designed to improve the transfer of this information. This study examined these issues in a sample of minority breast cancer survivors.DESIGNDuring four focus groups with minority breast cancer survivors, data were collected about the types of information survivors remember receiving from their oncologists about follow-up health care needs. Survivors were also asked their opinions on the value and content of a survivorship care plan.RESULTSMinority breast cancer survivors received variable amounts of information about their cancer treatments. They were dissatisfied with the amount of information they received on cancer-related side-effects, including race-specific information. The American Society of Clinical Oncology’s breast cancer survivorship care plan was viewed as important, but too highly technical and limited in information on side-effects and self-care approaches.CONCLUSIONSSurvivorship care plans may help increase information transfer from oncologists to patients and primary care providers, but the content of care plans needs to be adapted to minority patients’ concerns. Primary care physicians may be challenged by survivors to explain recommended surveillance guidelines and to respond to untreated physical and psychosocial problems.

Distress Screening: An Opportunity for Enhancing Quality Cancer Care and Promoting the Oncology Social Work Profession

Throughout its history, social work has played a critical role in major client/patient care initiatives because of its unique perspective, wisdom, and skills. The new screening standards set forth by the American College of Surgeons’ Commission on Cancer place oncology social workers at the forefront of developing and implementing procedures for distress screening. Our profession is again challenged to work across disciplines and change systems of care to improve the health and welfare of patients with cancer and their families. Indeed, emerging research suggests that the use of psychosocial screening instruments results in reductions in emotional distress, better quality of life, and improved patient–provider communication. As an introduction to this special issue on distress screening, this article offers a brief overview of issues related to distress screening that are covered by papers authored in this special issue by Association of Oncology Social Work members. Topics addressed include a review of the historical context driving distress screening implementation, barriers and challenges to oncology social workers trying to implement distress screening, statistical and cultural considerations for selecting screening tools, best practice models, and future considerations. This special issue is intended to be a primer and serves to promote oncology social workers’ involvement and leadership in the development and implementation of distress screening.

Oncology Social Worker Competencies and Implications for Education and Training

ABSTRACT A mailed and online survey of 622 members of the Association of Oncology Social Workers (AOSW) indicated their proportion of time committed to certain aspects of practice and to certain population groups, and the extent to which they feel competent in various practice areas. Respondents indicated high levels of competence in 17 topic areas, including promotion of patient coping skills, end-of-life issues, and group work. Topic areas in which at least one third of respondents indicated little to no competence included pain assessment and management, cognitive behavioral therapy, complementary and alternative practices, and political advocacy. Although respondents indicated that they spend approximately 10% of their time with non-English-speaking populations, 50% of the sample indicated that they have little to no competence working with this population. Differences in levels of competence by years of experience and work setting were noted across many areas. Findings from this survey may be useful in the development of curriculum for preparing oncology social workers for practice in todays changing health care environment.

Complementary and alternative medicine use among HIV-infected patients attending three outpatient clinics in the Southeastern United States.

Eisenberg and colleagues’ 1993 survey publicized the widespread use of ‘unconventional’ therapies in the USA. Subsequent surveys confirmed that approximately 20–63% of the population used complementary and alternative medicine (CAM). It is reasonable to expect that certain subgroups would be more likely to try CAM, particularly persons with illnesses that are unresponsive to mainstream therapies. This has been found in studies of patients with cancer, autoimmune diseases, arthritis, and pain. HIV-infected individuals might also be expected to use CAM at a high rate to strengthen immunity and alleviate symptoms. Most studies of CAM use during HIV/AIDS have found rates similar to the general population (i.e. between 30% and 50%), but some have found much higher CAM rates. In the general population, CAM is typically used by persons with college education, larger incomes, and poorer health status, but these associations have not been consistently replicated in HIV/AIDS studies. CAM use among HIV/AIDS persons was associated with being gay or bisexual, greater social support, and assertiveness. Physical health and illness measures have not predicted CAM use, with the exception of a study that found a positive association with duration of seropositivity. In the present study, we report rates of CAM use, types of CAM therapies used, and the intensity of use of multiple CAM therapies among HIVinfected men. We examine the correlates of CAM use. Our focus is to discover conditions under which CAM use is most prevalent and to delineate the characteristics among HIV-infected CAM users. Methods

The effect of lecture and a standardized patient encounter on medical student rape myth acceptance and attitudes toward screening patients for a history of sexual assault.

Background: Most physicians fail to routinely screen patients for a history of sexual assault. Purposes: This study aimed to gauge medical student support for routinely screening patients for a history of sexual assault, examine potential barriers to screening, and determine if attitudes can be changed through educational interventions. Methods: One hundred three 2nd-year medical students completed a survey before and after a lecture on sexual assault (response rate = 94/103 and 90/103, respectively). The questionnaire was administered a third time following a standardized patient encounter with a female rape victim (response rate = 102/103). Results: Most medical students agreed that patients should be screened for sexual victimization. Students showed low levels of rape myth acceptance. Agreement with rape myths correlated with increased screening hesitancy. Statistically significant gender differences were observed. Following educational sessions, students expressed less rape myth acceptance and more comfort screening. Conclusions: Sexual assault education can diminish rape myth acceptance and promote screening for sexual assault.

Enhancing Home Care Staff Safety Through Reducing Client Aggression and Violence in Noninstitutional Care Settings A Systematic Review

The problematic occurrence of client violence and patient aggression toward health care workers is pervasive, with studies and reports finding that home health care workers experience one of the highest rates of client violence than any other career field. With the recent passage of the Patient Protection and Affordable Care Act in 2010, traditional health care delivery in institutional care settings is increasingly shifted to service delivery venues in noninstitutional care settings. During this transition, greater numbers of health care workers are providing services in patients’ private homes, increasing the potential risk to staff safety and well-being in these settings.

An Analysis of Social Work Oncology Network Listserv Postings on the Commission of Cancer's Distress Screening Guidelines

This is a qualitative study of listserv postings by members of the Social Work Oncology Network (SWON) in response to the Commission on Cancers 2011 guidelines for distress screening of cancer patients. Archived listserv postings for the period of December 2010 to November 2011 were deidentified and a sample was derived by a list of keywords for the analysis. Aims of the study included describing the general categories and themes of the postings devoted to the new distress screening standard and examining the process of facilitation of mutual support and information exchange by oncology social workers in response to the new screening standards. During the 12-month timeframe there were 242 unique listserv postings sampled for the analysis. Oncology social worker (OSW) discussion of the distress screening guidelines remained a constant topic over the 12 months, and major themes that emerged from the data included processes of implementation of distress screening in cancer centers, screening policies and protocols, screening tool choice, and oncology social worker professional identity. The SWON listserv members used the listserv as a mechanism to post their requests for information on screening, to share their experiences in the beginning stages of implementing the guidelines, and to build support for legitimizing oncology social workers as the lead profession in the implementation of the guidelines in member cancer centers.