title: Perspectives on psychosocial and spiritual cancer support services in New Zealand.
abstract: In New Zealand, support services have been developed in response to patient need but are variable. The benefits of psycho-social-spiritual care in reducing distress and enhancing quality of life for people with cancer and their families are well established yet unmet needs continue to feature. This project aimed to examine how health care professionals assessed for psycho-social-spiritual distress and unmet need, decisions on appropriate support, and identification of barriers in the referral process. A mixed-methods approach was used for this research. The qualitative phase entailed semistructured interviews with health care professionals working in cancer care. The quantitative phase was an online survey of oncologists and nurses. Thematic analysis was carried out by performing a side-by-side analysis of both sets of data. Nurses were most likely to assess for psycho-social-spiritual need and to refer to support services. Despite a clear mandate to provide regular psycho-social-spiritual assessment, there is no consistency of assessment and referral across New Zealand. There are clearly unmet psycho-social-spiritual needs among people affected by cancer in New Zealand, with health care professionals in this study noting structural impediments to adequate supportive care. There is a mismatch between the importance placed on such care and the capacity that is currently available. The results of this study provide evidence that can be used to argue for improvements in the infrastructure, funding allocation and policy that would allow for better psycho-social-spiritual care within the challenging context of increasing numbers of those affected by cancer.
authors.affiliation: a CSNZ Social & Behavioural Research Unit, Te Hunga Rangahau Ārai Mate Pukupuku, Department of Preventive & Social Medicine , Dunedin School of Medicine, University of Otago , Dunedin , New Zealand.
authors.forename: Richard
authors.initials: R
authors.lastname: Egan
authors.forename: Roz
authors.initials: R
authors.lastname: McKechnie
authors.forename: Jan
authors.initials: J
authors.lastname: Jobson
authors.forename: Peter
authors.initials: P
authors.lastname: Herbison
authors.forename: Rose
authors.initials: R
authors.lastname: Richards
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D009520:New Zealand; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012944:Social Support; D026443:Spiritual Therapies / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000175:diagnosis