Psychosocial Needs Assessment of Prostate Cancer Patients at an Urban Academic Cancer Center
Alyson B. Moadel-Robblee, Ph.D., Evelyn Kolidas, Ph.D., Reza Ghavamian, M.D.
Presenting Author: Alyson Moadel-Robblee, Ph.D.
Introduction & Objective: The American College of Surgeons' Commission on Cancer has recommended national standards for cancer centers to meet that include studies of quality of care and outcomes for cancer patients (Standard 4.7). In its commitment to meet such standards, the Montefiore Einstein Center for Cancer Care (MECCC), has conducted several of these studies including one in the area of psychosocial screening for prostate cancer patients. Among prostate cancer patients, identifying patient needs for psychosocial intervention can be critical to preserving quality of life (QoL), and in turn, ensuring optimal medical care, follow up, and outcomes. We report findings of a psychosocial needs assessment among a convenience sample of 37 prostate cancer outpatients relative to 240 men with other cancers at MECCC.
Methods: Patients were approached in oncology waiting rooms or by telephone via referral to psychosocial services and administered a brief assessment that included the Distress Thermometer (DT), a QoL symptom checklist covering physical, emotional, spiritual, and sexual domains, and interest in a range of psychosocial interventions.
Results: The sample of 37 prostate cancer patients was comprised of 47% African American, 31% Hispanic, 22% Caucasian, 19% Spanish-speaking, Mean Age=68+-10.43 (48-91) years, and Mean years since diagnosis=3+-3.74 (.04-14.80). No significant differences emerged in the number of moderate to severe QoL symptoms between men with prostate vs other types of cancer, 4.67 vs 3.66 (p<0.12). However, prostate cancer patients reported more sadness (44% vs 29%; p<0.05), and a trend towards more sexual dysfunction (41% vs 27%; p<0.06). On the DT, prostate cancer patients were marginally more likely to endorse clinical distress; 53% vs 37% (p<0.06), and significantly more problems with urination; 39% vs 19% (p<0.02). Prostate cancer patients were nearly twice as likely to endorse an interest in counseling, 48% vs 25% (p<0.01). An inquiry into psychosocial preferences highlights specific interventions of interest among this subpopulation including: mind-body programs (87%), health education/fitness (70%), support groups (53%), complementary medicine (44%), creative arts (39%), and smoking cessation programs (12%). Up to 16% wanted a “Treatment Buddy” and 24% reported an interest in volunteering to help other cancer patients.
Conclusions: This quality of care needs assessment study suggests that underserved prostate cancer patients may be more emotionally vulnerable and receptive to psychosocial intervention than those with other cancers. Further this assessment highlights several types of interventions that may be of greatest support to this population, including individual counseling, mind-body therapies and health and fitness promotion. Future research will prospectively examine psychosocial needs of prostate cancer patients from point of diagnosis to one year, while distress screening efforts will ensure that such patients are screened appropriately, triaged to needed psychosocial care, and evaluated regularly.