Claudia Lasys, MSW, LCSW, OSW-C Clinical Therapist/Oncology Social Worker Ashley Pollock, BSN, RN, OCN Oncology Resource Coordinator Krista Veihl Breast Cancer Survivor Three Perspectives of Psychosocial Needs of Oncology Patients

Overview The needs of the oncology patient can often times be daunting for the health care provider, not to mention for the patient who is trying to navigate her way through diagnosis, treatment and post treatment issues. One of the initial needs of the patient is to be “heard.” Many times as health care providers we try to fix what ails the patient when in reality all the patient really wants is to tell her story, to be understood and to identify what she views as her needs. It is important to think of the entire person in providing care: physical, emotional, spiritual and the concrete needs.

Active Listening n Definition According to the University of Colorado, Conflict Research Consortium, “Active listening is a way of listening and responding to another person that improves mutual understanding”. Often times the patient wants to be able to tell her story as a way to reveal concerns, fears and needs. Active listening is a structured form of listening and responding that focuses the attention on the speaker. The listener must take care to attend to the speaker fully, and then repeats, in the listener’s own words, what she thinks the speaker has communicated. It is important to understand that the listener does not have to agree with the speaker, rather, she must simply state what she thinks she heard the speaker say. This type of listening enables the speaker to find out whether the listener really understood her message. If the listener misunderstood, the speaker can clarify her message.

Benefits of Active Listening n Forces people to listen attentively to others. n Decreases or avoids misunderstandings, as individuals have to confirm that they understand what the other person has said. n It allows for more open conversation between the individuals. n If the speaker feels like the listener is attuned to her concerns and wants to listen, she is likely to explain in detail how she is feeling and be able to identify her needs. See Basic Communication Techniques Handout.

Active Listening - Discussion n Importance of active listening n Impact of active listening

Communicating Impact of Cancer Diagnosis and Treatment n Active listening in communicating impact n Empathy n Allow patient to guide n Patient perspective

Assisting patients with response to diagnosis, treatment & adjustment n Quality of Life n Financial Concerns n Work related issues n Family dynamics n Intimacy/ Relationship n Spiritual

Quality of Life n Side Effects from treatment n Impact of cancer n Therapeutic management ideas

Financial Concerns n Insurance related questions n Continue to have an income n Co-pay n Bill payment n Insurance difficulties following treatment

Work Related Issues n Ability to continue working n Flexibility of employer

Family Dynamics n Who will be impacted by this diagnosis? n Is patient the primary caregiver for family? n What family members will be directly involved?

Intimacy/Relationship n Impact of cancer on relationships n Impact of treatment on intimacy

Spiritual n What is spirituality to the patient? n What thoughts or items bring comfort?

Identifying and Managing Distress Many accrediting bodies for hospitals and cancer centers are instituting new standards of care for patients, specifically in the arena of psychosocial care. The Commission on Cancer most recently issued that by 2012, in order for Cancer Centers to maintain accreditation, a measure for distress has to be in place and given to all new patients. This measure is the Distress Thermometer. See NCCN Guidelines Version of the Distress Management Handout.

Closing Points n Try to meet the patient where they are; if this area is uncomfortable for you ask for assistance. n Remember active listening doesn’t mean agreeing with patient; rather you support and validate her point of view. n Look for creative ways to assist the patient on the “whole-person” approach; mind-body-soul.

Resources n AOSW.org (Association of Oncology Social Workers n Cancer.org (American Cancer Society) n Cancer.Net n LIVESTRONG.org/cancersupport n LIVESTRONG.org/cancertopics n LIVESTRONG.org/forprofesionals n Onconurse.com n RXAssist.org

Blessing Hospital Resources n Joyce Hildebrand, RN, OCN Community Outreach Educator x7718 n Claudia Lasys, MSW, LCSW, OSW-C Oncology Social Worker/Clinical Therapist x7717 n Ashley Pollock, BSN, RN, OCN Oncology Resource Coordinator x7705 n Krista Veihl, Survivor or cell n Lori Wilkey, RN, Manager Breast Center x4280