Influence of a Cancer Diagnosis on Oncology Social Workers' Prioritization of Patient Needs

Background and Purpose:  The American Cancer Society [1] estimates that there are 13.7 million cancer survivors in the United States today, many living through and beyond their cancer treatment.  This number is expected to increase to 18 million by 2022.  A systematic review of 64 studies published between 2000 and 2009 found that overall 63.5% of adult cancer survivors returned to work [2]. Given the prevalence of cancer survivors who return to work, it may be reasonable to expect that some oncology social workers (OSWs) come to, or remain in the field, after receiving a cancer diagnosis. The purpose of this secondary data analysis was to investigate differences in clinical judgment between the two groups.

Methods: This study used a dataset comprised of responses from 322 OSWs who provided direct care to individuals diagnosed with cancer in a medical setting [3]. Data for this original study was collected via an on-line survey distributed through the Association of Oncology Social Workers’ listserv. Human subjects approval was received from the University of Texas at Austin. The original data collection was supported by a grant from the American Cancer Society, DSW-06-222-01.

Results: Slightly more than 10% (n=33) reported a cancer diagnosis.  An independent samples t-test was conducted to test if OSWs who have had a cancer diagnosis prioritized the psychosocial needs of a patient diagnosed with cancer differently from OSWs who have never been diagnosed with cancer. The test was found to be statistically significant, (t (64) = -4.149, p < .000); d = 1.02. The effect size for this analysis (d = 1.02), exceeded Cohen’s [4] convention for a large effect (d = .80).

Conclusion: Analysis of the dataset suggests that OSWs who have had a cancer diagnosis prioritized patients’ needs differently from OSWs who have never been diagnosed with cancer. OSWs who have had a cancer diagnosis prioritized patient’s functional needs higher than psychological/emotional needs.  OSWs’ who have never been diagnosed with cancer prioritized emotional/psychological needs higher.

Implications: Differences in clinical judgment based on whether or not an OSW has been diagnosed with cancer may be conceptualized several ways; OSWs with a cancer diagnosis may have “insider knowledge” that could be useful to their colleagues without a cancer diagnosis, OSWs with a cancer diagnosis may prioritize psychological/emotional needs lower based on their own emotional experience, a bit of both, or something else.  Due to the limited sample size and other constraints inherent in secondary data analyses, additional research is warranted to verify results and to further explore differences in care.

1.            American Cancer Society, Cancer treatment and survivorship: Facts & figures 2012-2013, 2013, American Cancer Society: Atlanta, GA.

2.            Mehnert, A., Employment and work-related issues in cancer survivors. Critical reviews in oncology/hematology, 2011. 77(2): p. 109-130.

3.            [Author, 2013]

4.            Cohen, J., Statistical power analysis for the behavioral sciences. 2 ed. 1988, Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.