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.
Social Work’s Contribution to Research on Cancer Prevention, Detection, Diagnosis, Treatment and Survivorship
IASWR Report to the National Cancer Institute, September 2003
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.
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 Toolkit.
Selected Cancer Research
- 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.
- 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.
- 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
- Bourjolly, J.N. (1998). Differences in religiousness among black and white women with breast cancer. Social Work in Health Care. 28(1), 21-39.
- BrintzenhofSzoc, K., Smith, E. D., & Zabora, J., (1999). Screening to predict complicated grief in spouses of cancer patients. Cancer Practice. 7 (5), 233-239.
- 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].
- 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.
- 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.
- 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.
- Ell, K. (1996). Final report: A Symposium on Psychosocial Intervention Research: Social Work’s Contribution.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- National Cancer Institute. (2002). The Nation’s Investment in Cancer Research: A Plan and Budget Proposal for Fiscal Year 2004. Bethesda, MD: Author.
- 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.
- 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.
- Walsh-Burke, K., & Marcusen, C., (1999). Self-advocacy training for cancer survivors: The Cancer Survival Toolbox®. Cancer Practice. 7(6), 297-301.
- Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001).
The prevalence of psychological distress by cancer site. Psychooncology. 10(19), 19-28.
- 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.