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Social Work And Cancer Research
Social
workers practice and conduct research in cancer-related services
and concerns including treatment adherence, survivorship, caregiver
issues, and cancer-related health care policy. Two recent research
reports and tools are noted below. Also, NASW has developed a report
on practioners’ use of cancer related research. (NASW NCI report) Additional resource references provide an array
of social work research endeavors. (Cancer-Related References)
This
overview includes recommendations for future social work cancer-related
research stemming from a “snapshot” of current literature,
and includes an annotated list of references. The Executive Summary
states:
Social work makes important contributions across the Cancer Control
Continuum - from prevention, detection, and diagnosis to treatment
and survivorship, assisting “the whole person in the context
of the behavioral, social and environmental factors that influence
cancer” (NCI, 2002). Social workers support the health and
well-being of individuals, families, groups and communities by addressing
the psychosocial dimension of care: identifying and mobilizing strengths,
supporting coping capacities, linking people to necessary resources
and alleviating environmental stressors. The social work profession’s
commitment to meeting the needs of the most vulnerable and oppressed
members of society is particularly important in the cancer context,
serving an essential role in the efforts to eliminate health disparities.
Social workers are key members of the health care team and intervene
at multiple levels and in multiple systems to optimize quality of
life and quality of care.
Beyond direct practice, social workers are engaged in research that
address many of the priority areas outlined in The Nation’s
Investment in Cancer Research (2002) including:
- Health status and quality of life in cancer survivorship
- The interface
of cancer and aging
- Elimination of health disparities
- Improving the quality of cancer
care
- Enhancing cancer communications to health care providers
- Strengthening
interdisciplinary research
- Improving palliative care
- Genetic factors and cancer
Social work research addresses the cancer experience across the
lifespan, focusing on psychosocial interventions (e.g., support groups,
educational groups, family groups, case management, telephone outreach,
computer-mediated support groups); assessment of psychosocial stressors;
community-based health promotion and cancer prevention strategies;
outreach to high-risk communities to assist with screening, early
detection, response to diagnosis, access to services and adherence;
transitions between cancer stages and treatments as well as between
the cancer experience and the “other” life; dealing with
end of life and grief; long-term survivorship issues; mental health
screening and services; and caregiver support and resources.
Social workers study the impact of spirituality and cultural and
ethnic heritage on the cancer experience and develop interventions
that have real-world applicability.
2. PROJECT SAFe
The Institute for the Advancement of Social Work Research has produced
an evidence-based toolkit to improve patient screening follow-up
adherence through research conducted through a cooperative agreement
with the Centers for Disease Control (CDC), 1997- 2002. Principal
Investigator was Kathleen Ell. Betsy Vourlekis was Co-Investigator,
and Deborah Padgett, Investigator.
This project tested a systematic evidence-based case management
approach to improve patient cancer screening follow-up adherence.
The target population was medically under-served low-income, ethnic
minority women with abnormal breast and cervical screens. Controlled
clinical trials had demonstrated the efficacy of interactive health
education counseling and systems navigation for improving abnormal
screening follow-up adherence.
The SAFe [Screening Adherence Follow-up] project adapted these interventions
for delivery in different service systems and diverse populations,
added mental health screening and assessment, and included more intensive
psychosocial counseling for women with special needs. Key study questions
concerned the effectiveness, feasibility and utility of SAFe case
management and identification of patient, provider and health systems
barriers and facilitating processes to implementing SAFe in “real
world” health care systems.
Tested in three separate studies in multiple sites, SAFe case management
improved patient adherence significantly over site baseline rates,
non-enrollee rates, and control group rates, with adherence rates
improving from 6 percent to 25 percent. The project developed the
PROJECT SAFe Tool Kit for dissemination. CD copies of the Tool Kit
may be ordered through iaswr@naswdc.org or viewed and downloaded
at www.iaswresearch.org (Click on Project SAFe.)
NASW Cancer Resources
SELECTED CANCER-RESEARCH REFERENCES
- Altpeter, M., Earp, J.A.L, & Schopler, J.H. (1998). Promoting
breast cancer screening in rural, African American communities:
The "science and art" of community health promotion. Health
and Social Work. 23(2), 104-115.
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- Berkman, B., Walker, S, Bonander, E., & Holmes, W. (1992). Early
unplanned readmissions to social work of elderly patients: factors
predicting who needs follow-up services. Social Work in Health
Care. 17 (4): 103-19.
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- Bourjolly, J. N.; Kerson, T. S.; Nuamah, I. F. (1999). A comparison
of social functioning among black and white women with breast cancer. Social
Work in Health Care. 28 (3), 1-20. Retrieved from Social
Work Abstracts via www.lib.ua.edu on March 6, 2003
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- Bourjolly, J.N. (1998). Differences in religiousness among black
and white women with breast cancer. Social Work in Health Care.
28(1), 21-39.
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- BrintzenhofSzoc, K., Smith, E. D., & Zabora, J., (1999). Screening
to predict complicated grief in spouses of cancer patients. Cancer
Practice. 7 (5), 233-239.
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- Carlson, L.E., & Bultz, B. (2003). Benefits of psychosocial oncology
care: Improved Quality of Life and Medical Cost Offset. Health
and Quality of Life Outcomes. 1(1) 8. [Online].
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- Clark, E. J. (2001). The importance of research in oncology social
work. In M. Lauria, E.J. Clark, J. Hermann & N. Stearns (Eds.) Social
Work in Oncology, (pp. 193-210). Atlanta, GA: American Cancer
Society.
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- Cwikel, J. G., & Behar, L. C. (1999). Social work with adult
cancer patients: A vote-count review of intervention research. Social
Work in Health Care. 29(2), 39-67.
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- Csikai, E. L., & Bass, K. (2000). Health care social workers’
views of ethical issues, practice, and policy in end-of-life care. Social
Work in Health Care. 32 (2), 1-23.
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- Ell, K. (1996). Final report: A Symposium on Psychosocial
Intervention Research: Social Work's Contribution.
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- Ell, K., Vourlekis, B., Nissly, J., Padgett, D., Pineda, D.,
Sarabia, O., Walther, V. Blumenfield, S., & Lee, P-J. (2002). Integrating
mental health and abnormal cancer screening follow-up: An intervention
to reach low-income women. Community Mental Health Journal.
38 (4), 311-315.
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- Fobair, P. (1998). Cancer support groups and group therapies.
In K. Ell & J. Williams (Eds.), Advances In Mental Health
Research (pp. 365-398), Washington DC: NASW Press.
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- Gilbar, O., Lowenstein, A., Naravitz, A., Steiner, M. (2001).
Elderly cancer patients and elders who do not have cancer: do they
differ in quality of life? Journal of Gerontological Social
Work. 35 (3), 3-16.
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- Goldstein, E. (1995). Psychosocial approach. In R.L. Edwards
(Ed.-in-Chief), Encyclopedia of Social Work (19th ed.,
Vol. 3, pp.1948-1954). Washington, DC: NASW Press.
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- Kovacs, P. J., & Bronstein, L. R.(1999). Preparation for oncology
settings: What hospice social workers say they need. Health
and Social Work. 24(1), 57-65.
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- Leigh, S. A., & Clark, E. J. (1997). Psychosocial aspects of
cancer survivorship. In A. Berg (Ed.), Principles and Practice
of Supportive Oncology. (pp. 909-917). Philadelphia, PA: Lippincott,
Williams & Wilkins.
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- Lillquist, P., & Abramson, J. (2002). Separating the apples and
oranges in the fruit cocktail: The mixed results of psychosocial
interventions on cancer survival. Social Work in Health Care.
36(2), 65-79.
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- Magen, R. H., &. Glajchen, M., (1999). Cancer support groups:
Client outcome and the context of group process. Research on
Social Work Practice. 9 (5), 541-554.
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- Meyer, T. J., & Mark, M. M. (1995). Effects of psychosocial
intervention with adult cancer patients: A meta-analysis of randomized
experiments. Health Psychology. Vol. 14, No. 2, 101-108.
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- National Cancer Institute. (2002). The Nation’s Investment
in Cancer Research: A Plan and Budget Proposal for Fiscal Year
2004. Bethesda, MD: Author.
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- Social Work Summit on Palliative and End-of-Life Care.
(March, 2002). Social Workers Set Goals to Strengthen Care for
the Dying and the Bereaved.
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- Task Force on Social Work Research. (1991, November). Building
social work knowledge for effective services and policies: A
plan for research development: A report of the task force
on social work research. Available from IASWR, 750 First
Street, NE, Suite 700, Washington, DC 20002-4241.
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- Walsh-Burke, K., & Marcusen, C., (1999). Self-advocacy training
for cancer survivors: The Cancer Survival Toolbox®. Cancer Practice. 7(6), 297-301.
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- Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi,
S. (2001).
The prevalence of psychological distress by cancer site. Psychooncology.
10(19), 19-28.
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- Zebrack, B., & Chesler, M. (2001). Health-related worries, self-image,
and life outlooks of long-term survivors of childhood cancer. Health
and Social Work. 26 (4), 245-256.
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