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Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
upon conceptual model for HRQOL, although these instruments frequently address physical, psychological, social, and spiritual domains.
Need for Face Validity
The committee sought a definition that, in addition to being conceptually sound, would have face validity to cancer patients and oncology practitioners. In numerous reports on cancer care reviewed by the committee, cancer patients, their families and informal caretakers, health care providers, and researchers identify many nonbiological adverse consequences of cancer and its treatment, and describe cancer survivors’ need for various types of nonmedical assistance in addressing these consequences. These problems and needs were used to inform the committee’s development of a definition of psychosocial services for the present study. These problems and needs, discussed in Chapter 1 of this report, include emotional and mental health problems, developmental problems, cognitive problems, problems in performing activities of daily living, problems in fulfilling family and social roles and relationships, problems in employment, financial and health insurance issues, spiritual and existential needs, problems in adopting and maintaining good health behaviors, and other needs.
The committee considered and deliberated on the above varying definitions and conceptual frameworks at and subsequent to its first meeting. The committee acknowledged that there is a vast array of adverse psychological and social events in people’s lives, but that not all of these events may have implications for health or health care. For example, engagement in illegal activity is a serious social problem but may not have implications for patients’ health care (unless, for example, they are incarcerated or suffer emotional distress as a result of their activity). Many people also receive psychosocial services for reasons unrelated (or less directly related) to health care. For example, children in the juvenile justice and child welfare systems receive psychosocial services partly in an effort to help them avoid prosecution and the repetition of illegal behaviors and to strengthen their family.
The committee determined that, to be understandable across multiple health and human services sectors, its definition should refer to the subset of psychosocial services that can help improve health and health care. Accordingly, the committee adopted the following as its definition:
Psychosocial health services are psychological and social services and interventions that enable patients, their families, and health care providers to