Dr Sophia Smith Discusses Attending to Patients' Psychosocial Needs

Having psychosocial support for patients with cancer, and for their family members, is critical, because patients often feel that their emotional needs are overlooked in busy clinics, said Sophia K. Smith, PhD, MSW, associate professor at the Duke School of Nursing.

Transcript (slightly modified)

How important is psychosocial support for patients with cancer? And is there something that the oncologist can refer patients to as a standard practice?

A lot depends on the institution where the patient is seen. I can speak to how it’s provided at Duke: at the Duke Cancer Institute we have different avenues for psychosocial support. We have the department of social work, and we also have a cancer patient support program that’s funded partially through philanthropy where we provide counseling support for free at no cost to our patients and their family members.

I think for psychosocial support it’s very important to include the whole family in the support. A lot of support for the patient comes through the family. A lot of our caregivers are stressed, they add the financial implications of the treatment. A lot of the caregivers maybe have to miss work to help care for the patient, they’re under tremendous stress, there may be children involved, and we have various programs within our cancer center focused on the patient support system, in addition to the patients themselves.

You know, some of our support groups are disease-specific. Right now, through my research, we’re testing interventions that are delivered online; so a lot of our patients are from out of state and they can access these services if they have a computer, or internet access, or a mobile device, or whatever. So I think, in answer to your question, psychosocial support is critical. Our patients tell us it’s critical. I hear directly from patients that so much attention is gone into curing the disease and extending life, and a lot of people feel that psychosocial needs or emotional needs are often overlooked in busy clinics.

You know your clinical appointment now, your standard appointment, is 15 minutes. It’s so important during that short visit that we collect the PROs so we ask them, just with a distress thermometer or whatever—the tool is less important but the fact that we have the conversation with the patient, and you got to have that conversation each time because the situation changes.

So, yes, it’s very important. I recognize that our nurses and our physicians are very busy during that 15-minute visit, but if we can get that team working together, that multidisciplinary team where we’re administering the PRO, and then the nurse in our institution collects the distress thermometer and then refers to psychosocial care based upon what the patient identifies as their need.