Psychosocial Needs of Community-Dwelling Seniors: A Qualitative Study

To explore the experience of nurses and physicians regarding psychosocial needs of patients with cancer and to describe their perception according to professional category and clinical setting. A qualitative descriptive study. 14 nurses and 12 physicians were selected from three hospital clinical units and four primary care centers in northern Spain. Data were collected using semistructured interviews. Content analysis was performed using open coding. Reporting of findings followed the COREQ checklist. Four themes were identified: the needs of patients with cancer, psychosocial care provided by health professionals, difficulties addressing psychosocial needs, and available resources. According to nurses and physicians, being diagnosed with cancer involves a radical life-changing process, with a profound impact at the psychosocial level. Within the field of psychosocial care, the role perceived by each profession was different. Thus, nurses highlighted the need for these patients to receive emotional support and care, although limited importance is given to psychosocial needs. The role of physicians was more focused on referring these patients to other health professionals. The lack of training or time was one of the main difficulties perceived by the professionals. The family is a fundamental resource and, overall, patients are provided with limited information about other psychosocial resources. At the hospital, the emphasis is placed on physical needs and health professionals experience greater burnout and fear of compassion fatigue. Primary care teams could, therefore, have a primary role in addressing psychosocial needs due to their understanding of each person's context and personal circumstances. It is essential for nurses and physicians to consider the psychosocial needs of patients with cancer. However, these needs are not always adequately addressed. Further resources are required to reduce the workload, increase the training of health professionals, and introduce organizational changes to consider psychosocial needs during routine care.

BackgroundPsychosocial support is considered a central component of nursing care but it remains unclear as to exactly how this is implemented in practice. The aim of this study was to provide a descriptive exploration of how psychosocial needs (PNs) of patients in a hospice ward are expressed and met, in order to develop an understanding of the provision of psychosocial support in practice.MethodsAn embedded mixed-methods study was conducted in one hospice ward. Data collection included observations of patients’ expressions of PNs and nurses’ responses to those expressed PNs, shift hand-overs and multi-disciplinary meetings. Interviews about the observed care were conducted with the patients and nurses and nursing documentation pertaining to psychosocial care was collated. Descriptive statistical techniques were applied to quantitative data in order to explore and support the qualitative observational, interview and documentary data.ResultsDuring the 8-month period of observation, 227 encounters within 38 episodes of care were observed among 38 nurses and 47 patients. Within these encounters, 330 PNs were expressed. Nurses were observed immediately responding to expressed PNs in one of four ways: dealing (44.2 %), deferring (14.8 %), diverting (10.3 %) and ducking (30.7 %). However, it is rare that one type of PN was clearly expressed on its own: many were expressed at the same time and usually while the patient was interacting with the nurse for another reason, thus making the provision of psychosocial support challenging. The nurses’ response patterns varied little according to type of need.ConclusionsThe provision of psychosocial support is very complex and PNs are not always easily recognised. This study has allowed an exploration of the actual PNs of patients in a hospice setting, the way in which they were expressed, and how nurses responded to them. The nurses faced the challenge of responding to PNs whilst carrying out the other duties of their shift, and the fact that nurses can provide psychosocial support as an inherent component of practice was verified. The data included in this paper, and the discussions around the observed care, provides nurses everywhere with an example against which to compare their own practice.

Background:In Iranian women, the use of hookah is the most common method of tobacco smoking. This study aimed to find the role of psycho-social needs and gaps as a possible risk factor for hookah smoking initiation in women.Methods:This qualitative study was conducted during 2012–2013 in Tehran, Iran. Thirty-six women participated in the study. They were current or former users of hookah. Data were collected through in-depth individual interviews and was analyzed through content analysis.Results:Four main categories were identified from the data. This study focused on the category: Psycho-social needs and gaps. This category has five sub-categories which explain why women begin to smoke hookah including curiosity; desire for non-feminine, forbidden, and negative activities; need for amusement and recreation; for others: To show off; attract attention; satisfy and join others and protection.Conclusions:From this study, a variety of factors which contribute to the initiation of hookah smoking among women have been identified. Keeping young girls and women away from seemingly happy gatherings of hookah smokers; Providing appropriate recreational facilities for young women and training families on how to help their children in the event of a crisis-like intention to take up smoking behavior, can be some effective ways for reducing hookah smoking initiation among women.

ABSTRACTAimWeight management is a core area of dietetic primary practice. Understanding the behavioural drivers that influence dietitians' weight management practice is essential for gaining insight into how to better support dietitians in this area. This study used the Capability, Opportunity, Motivation‐Behaviour (COM‐B) model, a behavioural framework, to explore how dietitians' practice is influenced by their skills and knowledge (capability), environmental factors (opportunity) and professional desires and habits (motivation).MethodsThis qualitative descriptive study used an interpretivist approach guided by social constructionism. Primary care dietitians practising in Australia were recruited through purposive and snowball sampling for semi‐structured interviews. Interviews were audio‐recorded, transcribed verbatim, and analysed using content analysis. Constructed content categories were then mapped to the COM‐B model to understand the behavioural factors shaping dietitians' weight management practice.ResultsFourteen primary care dietitians participated in the study; 13 were women, 11 were aged between 20 and 50 years, and 8 had over 9 years dietetic practice experience. Eight content categories were constructed and mapped against the COM‐B components. Aligned with Capability, dietitians demonstrated comprehensive ‘Understanding [of] Weight Management Complexity’ and employed ‘Holistic Practice Approaches’ in their care delivery, though they found ‘Navigating Clients’ Psychosocial Needs’ challenging. Opportunity was shaped by ‘System Constraints’ that influenced care provision, ‘Multidisciplinary Care Environment[s]’ that had varied impacts on collaborative care delivery, and ‘Digital Solutions’ that offered service delivery advantages. Motivation was characterised by dietitians exhibiting strong ‘Professional Drive’ and commitment to ‘Client‐centred Strategies’.ConclusionSupporting primary care dietitians requires targeted interventions across all COM‐B components. Potential approaches include enhancing capability through behaviour change counselling training, improving opportunity with integration of digital technologies, and sustaining motivation through established clinical pathways that align with dietitians’ client‐centred values.

The number of individuals of South Asian origin receiving health care in the United States is rapidly growing, yet little is known about their psychosocial needs. To better inform the provision of culturally competent social work services for this patient population, researchers sought to describe U.S. health care providers' perceptions of the psychosocial needs of seriously ill patients of South Asian origin. To do so, they conducted a multimethod qualitative descriptive study, collecting data during focus groups and individual interviews of health care providers (N = 57) and analyzing them via directed content analysis. Identified patient needs included addressing financial and legal problems, challenges completing activities of daily living, spiritual or existential concerns, psychosocial experiences of unresolved physical symptoms, and psychological distress. Providers also emphasized the importance of supporting patients' family members to aid in their caregiving abilities and to enhance their quality of life. As social workers in U.S. health care settings encounter a growing number of patients of South Asian origin, a more comprehensive understanding of their psychosocial needs is imperative. Study findings suggest that health social workers should provide psychosocial care that encompasses culture-specific needs and psychosocial care that can be provided in a culturally responsive manner.

Adolescents and young adults with cancer (AYACs) have become recognized as a unique group in recent years. The unique developmental context and related challenges of being a young person with a cancer diagnosis can lead to a distinct and diverse set of psychosocial issues. Existing research has attempted to explore these psychosocial needs and challenges and to develop appropriate and individualized interventions. However, the needs of this group remain unmet, with ongoing calls for individualized support. This systematic review addressed the research question, "what are the psychosocial needs of AYACs aged 15-24 years?." PubMed, PsycINFO, and CINAHL databases were searched to identify relevant studies from January 2000 to December 2022 (inclusive). Qualitative, quantitative, and mixed methods designs were included and 29 studies met inclusion criteria. Findings provide an overview of needs from the existing literature and support the idea of a changing constellation of psychosocial needs for AYACs in areas such as identity, relationships, mental health, autonomy, and occupation. The main implications for theory and future research include the importance of the developmental context and consideration of discrepancies in the age range used within the literature to define this group.

The interventions used in cancer-survivorship care do not always address outcomes important to survivors. This study sought to understand stakeholders’ views on the key concerns of cancer survivors after treatment and the interventions needed to meet survivors’ and families’ psychosocial needs after completing cancer treatment. We conducted a descriptive qualitative study using semi-structured interviews with stakeholders (survivors, family/friend caregivers, oncology providers, primary care providers, and cancer system decision-/policy-makers) from across Canada. For the data analysis, we used techniques commonly employed in descriptive qualitative research, such as coding, grouping, detailing, and comparing the data. There were 44 study participants: 11 survivors, seven family/friend caregivers, 18 health care providers, and eight decision-/policy-makers. Stakeholder-relevant interventions to address survivors’ psychosocial needs were categorized into five groups, as follows: information provision, peer support, navigation, knowledge translation interventions, and caregiver-specific supports. These findings, particularly interventions that deliver timely and relevant information about the post-treatment period and knowledge translation interventions that strive to integrate effective tools and programs into survivorship care, have implications for future research and practice.

PurposeCancer has a major impact on the individual patient and their family, especially children. However, little is known about the needs of adolescents (10–19 years) whose parent is diagnosed with cancer, especially breast cancer. Insights into psychosocial needs are important to develop appropriate guidance and support for these adolescents. The aim of this study is to explore the psychosocial needs of adolescents whose parent is diagnosed with breast cancer to improve the support for these adolescents. Data sourcesThis is an exploratory, qualitative study. In-depth interviews were conducted, and an interview guide was designed with the following topics: experiences, needs, and support. Participants were selected purposively and approached via the parent(s) after consultation. Interviews were audiotaped, transcribed, and thematically analyzed by using the software program NVivo. ConclusionFourteen adolescents (12–19 years) were interviewed, which resulted in five themes: distraction, support, being able to talk about it, information, and continuing a normal life. Adolescents whose parent is diagnosed with breast cancer need the best possible preservation of their normal lives. It is important for them to be able to share their story and find support from someone close to them. Implication for Nursing PracticeThe route to the adolescent is always through the parent. Healthcare professionals can discuss the well-being of the adolescent during regular consultation with the parent. If there are concerns, healthcare professionals can advise the parent about the possible needs of the adolescent and could coach the parent in supporting the adolescent to discuss their needs.

BackgroundThis study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals.MethodsAn exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes.ResultsNine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral.ConclusionThe findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.

Objective . Research reporting the unmet needs of individuals with haematological cancers under watch‐and‐wait is scarce, despite reports of elevated levels of psychological distress. This qualitative study aimed to explore the psychosocial needs of these individuals, and when these were met, if so at all. Methods . A longitudinal design using semistructured interviews was used. Individuals with a diagnosis of haematological cancer living under watch‐and‐wait were recruited through online support groups. Participants were each invited to two semistructured interviews, six months apart. Interviews took place in March 2022 and September 2022 and were therefore in the context of the COVID‐19 pandemic. All interviews were recorded and transcribed verbatim. Reflexive thematic analysis and pattern‐oriented longitudinal analysis were used to analyse the data. Results . Of the fifteen participants interviewed initially, twelve attended a second interview. The sample was predominantly White and female. Across participants and time points, a theme was generated that individuals experienced a “Psychological battle of watch‐and‐wait.” Under this overarching theme, four themes were constructed: “Understanding the impossible: Cancer that does not require treatment;” “Sense of abandonment under watch and wait;” “The importance of peer connection;” and “Trying to live after COVID‐19.” The themes were understood to predominantly represent needs for information, communication, peer support, and emotional support and were most often met when individuals engaged with relevant charities. Conclusion . People living with haematological cancer under watch‐and‐wait may be at risk of having unmet needs across domains, and without support, these needs will likely remain unmet over time. The findings add to the growing literature base how Oncology and Haematology services can holistically support individuals with indolent cancers to live well alongside their diagnosis.

Introduction:Iran is one of the ten most earthquake prone countries in the world. Earthquakes not only cause new psychological needs among the population but particularly so when one considers vulnerable groups. This in - depth study was conducted with the aim of assessing psychosocial needs six months after an earthquake happened in the west of the county in Lorestan province.Methods:This is a qualitative study using focus group discussion that focuses mainly on the vulnerable groups (women, children, elderly and disabled people) after an earthquake in Boz-azna; a village in Lorestan province in western part of Iran.Findings:Results of the psychosocial assessment indicated feelings of anxiety and worries in four vulnerable groups. Horror, hyper-excitement, avoidance and disturbing thoughts were observed in all groups with the exception of the elderly. Educational failures, loneliness and isolation were highlighted in children. All groups encountered socio-economic needs that included loss of assets and sense of insecurity and also reproductive problems were reported in women's group.Discussion and Conclusion:Modification of a protocol on psychosocial support considering the context of the rural and urban areas with emphasis on the specific needs of the vulnerable groups is an appropriate strategy in crisis management. It seems that appropriate public awareness regarding assistance programs can be effective in reducing stress and needs of disaster survivors.

This article describes a qualitative research study that examined the educational experiences of refugee students who have immigrated to Canada. Many children from war-affected countries have been denied basic human entitlements, and their immigration to Canada represents hope for their futures. Evidence suggests that these students are further marginalized by an educational system that does not recognize their unique psychosocial needs and does not provide culturally sensitive support. Purposeful steps should be taken by school leaders to address the needs of newcomers and to facilitate pedagogical practices that make schools more equitable and socially just.

The number of people with dementia living alone is predicted to double by 2039. People with dementia may live alone through choice and others due to life events like bereavement. There are unique challenges to living alone for people with dementia, their care partners and services supporting those individuals. The current review sought to summarise the psychosocial needs reported by people with dementia who live alone. Searches were completed accessing Academic Search Ultimate, MEDLINE, CINAHL Ultimate, APA PsycArticles and APA PsycInfo. Eligible articles explored the needs or experiences of people with dementia living alone through qualitative or mixed methods. The data was synthesized narratively, and the National Institute of Care and Health Excellence's quality appraisal checklist was used to assess all included studies. Needs were identified across all domains of Kitwood's model; love, identity, attachment, inclusion, occupation and comfort. The data revealed overlapping needs between those with dementia who live alone and those who live with others but importantly, needs that were distinct or exacerbated by living alone with dementia. Specifically, threat to personhood without others to maintain stories about identity and the management of living at home with the recognition that this would eventually end. The heterogeneity of people with dementia who live alone was highlighted and the gaps in the representation of the needs of specific groups in the research were considered such as individuals from the LGBTQ + community. Thus, the need for an intersectional and person-centred approach to future research and clinical practice was discussed.

Objective:Today, it is thought that the elderly may encounter many psychosocial problems. The research aims to determine these psychosocial needs by the elderly themselves. Method:Data were collected through focus group interviews, which are a qualitative research method. Twenty elderly people aged 65 and above were interviewed on a voluntary basis. There were six to eight people in each focus group. A questionnaire developed by the researchers was utilized during the interviews. Results:After the focus group interview, we divided the results into 4 categories (psychological, spiritual, physical, and social needs) and 12 sub-themes: the psychological category contained losses and emotional loneliness, risk of depression, and adaptation to being elderly; the spiritual category contained anxiety about death and beliefs, values, and culture; the social category contained a change in roles, change in expectations, family problems, and loneliness; and the physical category contained physical impairment due to elderliness and illnesses. Conclusion:Psychosocial problems determined by the elderly themselves will help to plan nursing services for these individuals. Thus, the elderly will be provided with the opportunity to be active in their lives and to control their lives, to increase their quality of life, and to reveal and maintain their existing potential in a positive way.

Lung cancer is common in males as well as females and is one of the most common causes of cancer related deaths worldwide. To gain an in-depth understanding of the ‘pedagogy of suffering’ (Frank, 1995: 145), the lived experiences of 12 adult patients in Northern Ireland diagnosed with advanced lung cancer were captured during two qualitative interviews with each patient (one month apart), which were audio-recorded. This article outlines analysis which used Frank’s (1995) narrative structures of restitution, chaos and quest, to provide rich insights into how patients narrated their ‘suffering’ over time. Findings revealed frustration and loss of faith in medical physicians due to a delayed diagnosis; resignation regarding treatment options and outcomes; externalisation of a disease that society fears, curbs life expectancy and causes biographical disruption; and powerlessness underpinned by a heroic return to put affairs in order, encourage others and share hopes for the future. In an era of health and social work practitioners experiencing increasing bureaucracy and caseloads, these findings highlight the importance of prioritising the psychosocial needs of patients, supporting patients with the emotional and practical challenges of living with a life-limiting illness, and of skilful practitioners promoting peaceful closure in end of life care.