PDF(Pubmed)
Abstract：
Social determinants of health and unmet social needs are directly related to cancer outcomes, from diagnosis to survivorship. If identified, unmet social needs can be addressed in oncology care by changing care plans in collaboration with patients\' preferences and accounting for clinical practice guidelines (eg, reducing the frequency of appointments, switching treatment modalities) and connecting patients to resources within healthcare organizations (eg, social work support, patient navigation) and with community organizations (eg, food banks, housing assistance programs). Screening for social needs is the first step to identifying those who need additional support and is increasingly recognized as a necessary component of high-quality cancer care delivery. Despite evidence about the relationship between social needs and cancer outcomes and the abundance of screening tools, the implementation of social needs screening remains a challenge, and little is known regarding the adoption, reach, and sustainability of social needs screening in routine clinical practice. We present data on the adoption and implementation of social needs screening at two large academic cancer centers and discuss three challenges associated with implementing evidence-based social needs screening in clinical practice: (1) identifying an optimal approach for administering social needs screening in oncology care, (2) adequately addressing identified unmet needs with resources and support, and (3) coordinating social needs screening between oncology and primary care.
摘要：
健康的社会决定因素和未满足的社会需求与癌症结局直接相关，从诊断到生存。如果确定,未满足的社会需求可以通过与患者偏好和临床实践指南合作改变护理计划来解决肿瘤学护理(例如，减少约会的频率，转换治疗方式)并将患者与医疗机构内的资源联系起来(例如，社会工作支持,患者导航)，以及与社区组织(例如，食品银行,住房援助计划)。筛查社会需求是确定需要额外支持的人的第一步，并且越来越被认为是高质量癌症护理提供的必要组成部分。尽管有证据表明社会需求和癌症结局之间的关系以及大量的筛查工具，社会需求筛查的实施仍然是一个挑战，对收养知之甚少，reach,以及在常规临床实践中社会需求筛查的可持续性。我们提供了两个大型学术癌症中心采用和实施社会需求筛查的数据，并讨论了与在临床实践中实施基于证据的社会需求筛查相关的三个挑战：（1）确定在肿瘤护理中管理社会需求筛查的最佳方法，(2)利用资源和支持充分解决已查明的未满足需求；（3）协调肿瘤学和初级保健之间的社会需求筛查。
