Academic journal article Health and Social Work

Cancer Patients' Use of Social Work Services in Canada: Prevalence, Profile, and Predictors of Use

Academic journal article Health and Social Work

Cancer Patients' Use of Social Work Services in Canada: Prevalence, Profile, and Predictors of Use

Article excerpt

An estimated 145,500 Canadians were diagnosed with cancer in 2004 (Canadian Cancer Society, 2004). Being diagnosed with a severe illness such as cancer affects every aspect of a person's life, including relationships with family members, friends, coworkers, and the community at large. Receiving medical care is often intimidating and stress provoking to the whole family even though medical advances continue to reduce cancer mortality and prolong the lives of many cancer patients. Surviving cancer, thus, has brought with it mixed blessings. Nowadays the diagnosis of cancer signals, in many cases, years of living with a chronic, life-threatening illness, and sometimes a disability, requiring constant or intermittent treatment, with the possibility of recurrence hanging over the patients' head (Cwikel & Behar, 1999a).


Social workers are trained to recognize and assist with the psychosocial needs of cancer patients and their families. They have the knowledge and skills required to assist cancer patients and their families with emotional, practical, and administrative issues in a variety of ways. They can facilitate individual and group counseling and ensure that clients are referred to appropriate services (Cwikel & Behar, 1999b). Social workers can also promote the exchange of information. Such information can be the main focus of educational interventions, or it can occur naturally in the context of providing emotional support. They can teach clients self-advocacy, a skill that has been identified as essential for cancer survivors (Walsh-Burke & Marcusen, 1999). Finally, social workers can assist with arranging tangible forms of support, such as transportation, assistance with meals, and leisure activities (Lillquist & Abramason, 2002).

Psychosocial interventions with cancer patients have a positive influence on coping, psychological functioning, and quality of life of cancer patients at all stages of the disease process (Davis, 2004; Lillquist & Abramason, 2002). Using a vote-count review of 40 psychosocial oncology intervention studies, Cwikel and Behar (1999b) found 36 that documented some positive outcomes from treatments, and they found no studies that had negative results.

The vast majority of social workers in Canada are employed by publicly funded, nonprofit social welfare agencies, hospitals, and other health care facilities. Increasingly, social and health services are being provided to Canadians using the integrated service delivery (ISD) model. ISD is a multidisciplinary team-based and client-focused model that enables people to access services from a variety of providers in one location. Social workers play a key role in the provision of health care services by being part of multidisciplinary teams in hospitals, local medical clinics, community health centers, and specialized care agencies.


The most frequently cited framework for predicting patients' use of health care services is the behavioral model developed by Anderson (1995). In this model, Anderson integrates individual, environmental, and provider characteristics associated with the use of health care services. Among individual characteristics, factors such as age, gender, education, ethnicity, and health care beliefs affect individuals' perceived need of health care services. To prompt individuals in need of health care services to actually use them, the services must be available and accessible to them. Characteristics of health care providers, such as their gender and training, may also interact with users' characteristics and influence service use patterns.

Very little, if any, information is available on the extent of cancer patients' use of, or access to, social work services in Canada. A representative profile of social work users among cancer patients is also unknown. The identification of current clients of psychosocial oncology services in Canada provides the basis for identifying their needs and for planning adequate services to meet those needs. …

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