title: Patient and health professional's perceived barriers to the delivery of psychosocial care to adults with cancer: a systematic review.
abstract: OBJECTIVE
  To explore the barriers experienced and perceived by health professionals and patients in the delivery of psychosocial care to adults with cancer.
  
  
  METHODS
  Systematic searches were undertaken using the PsychInfo, Medline and CINAHL electronic databases, up to October 2013. Research reporting health professional or patient experiences and perceptions of barriers to psychosocial care are included in the review. The systematic review includes studies that have non-experimental, exploratory and observational designs, as is appropriate to answer the review question. Included studies were critically appraised. The results of individual quantitative studies were aggregated. Qualitative content analysis was used to analyse the qualitative results.
  
  
  RESULTS
  Twenty-five papers met the pre-specified inclusion criteria for the final review. The most commonly perceived barrier for patients relates to receiving adequate support from elsewhere and a lack of perceived need for psychosocial care. Health professionals report barriers at an organisational level most frequently followed by cultural and then individual clinician-related barriers.
  
  
  CONCLUSIONS
  Barriers exist on a variety of levels. People with cancer need clear appropriate information and communication about psychosocial services, including information about the role of psychosocial care in addition to existing supports. Interventions that target the complex interplay of individual, organisational and cultural factors need to be developed. Strategies that improve health professional communication skills, identify clear referral pathways, improve acceptability of interventions and clearly identify the need for services could address many of the barriers identified in this review.
authors: School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia.
authors: Sophie
authors: S
authors: Dilworth
authors: Isabel
authors: I
authors: Higgins
authors: Vicki
authors: V
authors: Parker
authors: Brian
authors: B
authors: Kelly
authors: Jane
authors: J
authors: Turner
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D006297:Health Services Accessibility; D006801:Humans; D008605:Mental Health Services; D009369:Neoplasms / Q000523:psychology*; D010342:Patient Acceptance of Health Care
keywords: barriers; cancer; oncology; psychosocial care; systematic review