You can lead a horse to water, but you can’t make it drink: Does a needs assessment tool increase discussion of psychosocial concerns of people with advanced cancer?

You can lead a horse to water, but you can’t make it drink: Does a needs assessment tool increase discussion of psychosocial concerns of people with advanced cancer?

You can lead a horse to water, but you can’t make it drink: Does a needs assessment tool increase discussion of psychosocial concerns of people with advanced cancer? (#262)

Tom Bellamy ¹ , Sylvie Lambert ² ³ , Afaf Girgis ²

Lake Macquarie Mental Health Service, Charlestown, NSW, Australia
Psycho-oncology Research Group, Ingham Institute for Applied Medical Research, UNSW Sydney, Liverpool, NSW, Australia
Ingram School of Nursing, McGill University, Montreal, Quebec

Aims: This study examined 1) approaches used by health professionals to administer an unmet needs assessment tool in the consultation setting, 2) potential of this tool to facilitate discussion of psychosocial issues, and 3) whether use of the tool by clinicians alters the length of consultations with patients with advanced cancer.

Methods: Anaudiotaping sub-study was undertaken as part of an interrupted time series study of the impact of systematic utilisation of the Palliative Care Needs Assessment Tool (PC-NAT) on the health outcomes and service utilisation of individuals with advanced cancer and their caregivers. The main trial included 219 outpatients across four hospitals in NSW who were diagnosed with advanced cancer and aged 18 years or older. Of 45 patients at one site who were asked for consent to audio-tape their consultations, 20 agreed (oncologist also agreed). Audio-recording were transcribed and thematic analysis was undertaken; and the mean length of consultations in minutes was determined.

Results: Despite an academic detailing approach to introduce the PC-NAT to clinicians, it was not implemented as anticipated, with minimal integration of the tool into the consultation and little explanation of its function given by oncologists. The use of the tool did not increase discussion of psychosocial issues; the majority of consultation time pertained to medical issues. Coding of consultation content revealed comparable empathy levels across medical and psychosocial concerns. However, codes which reflected “dismissing” or “denying” the concern were more frequently recorded for psychosocial concerns compared to medical concerns. The PC-NAT did not significantly lengthen consultations in which it was used.

Conclusions: People with advanced cancer report high unmet psychosocial needs. Staff training to enhance understanding and timely assessment and response to unmet needs as part of routine care is warranted to facilitate use of a needs assessment tool and discussion of psychosocial issues.

Funding: Project - Australian Government Department of Health & Ageing; Professor Girgis - a Cancer Institute NSW grant

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Authors contributing to this presentation.

Prof Afaf Girgis AM [PhD, BSc(Hons)] is Director, Psycho-oncology Research Group, at the Ingham Institute for Applied Medical Research & Faculty of Medicine & Health, University of New South Wales (UNSW Sydney), Australia. Prof Girgis has worked for over 32 years as a Behavioural Scientist in cancer control and psycho-oncology. In 2019, she became a Member (AM) of the Order of Australia, awarded for her significant service to medicine, and to medical education, in the field of cancer control and psycho-oncology. Her national and international standing in behavioural science and psycho-oncology was acknowledged in 2012 with the Clinical Oncology Society of Australia (COSA) Inaugural Psycho-oncology Award, in 2015 with the Lady Mary Fairfax Distinguished Researcher Award, and in 2017 with 4 distinguished awards: South West Sydney Research Hub annual prize, UNSW in the South West Distinguished Research Prize, the South Western Sydney Local Health District Translational Research Award, and the South Western Sydney Local Health District Board Award, and the Australian Council on Healthcare Standards (ACHS) Quality Improvement Award 2018 in Healthcare Measurement. Prof Girgis has published almost 400 peer-reviewed papers, abstracts and book chapters, and contributed to several clinical practice guidelines; and been successful with research funding applications totalling $57.8 Million. Prof Girgis is committed to training and mentoring junior researchers and has successfully supervised 27 research higher degree students and fellowships; and currently supervises 3 PhD, 1 Research Masters and 3 Honours students, and mentors several clinician researchers.

You can lead a horse to water, but you can’t make it drink: Does a needs assessment tool increase discussion of psychosocial concerns of people with advanced cancer? (#262)

Bellamy, T

Lambert, S

Girgis, A

You can lead a horse to water, but you can’t make it drink: Does a needs assessment tool increase discussion of psychosocial concerns of people with advanced cancer? (#262)

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Bellamy, T

Lambert, S

Girgis, A

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