Psycho-oncology
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A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existentially threatening stressor is a long-standing idea. But only recently have researchers studied existential distress more rigorously and begun to identify its distinct impact on health care outcomes. ⋯ Although the two meta-analyses featured in this special issue indicate the progress that has been made, many questions remain unresolved. We suggest how the field may move forward through defining a threshold for clinically significant existential distress, investigating its comorbidity with other psychiatric conditions, and inquiring into adjustment processes and mechanisms underlying change in existential interventions. We hope that this special issue may inspire progress in this promising area of research to improve recognition and management of a central psychological state in cancer care.
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Over the past decade, global action to address the emerging crisis in non-communicable diseases (NCDs) has escalated. Central to these efforts has been the support and influence of the World Health Organisation and the United Nations with the 2000 civil societies represented by the Non-Communicable Disease Alliance. In particular this reached expression in the world's first High Level Meeting on NCDs by the United Nations leading to the 2011 Political Declaration urging a coordinated global response to NCDs. ⋯ This special issue includes research across the illness continuum from cancer prevention to screening and early detection, and then to tertiary prevention with lifestyle considerations for cancer survivors. Importantly this demonstrates the capacity within psycho-oncology to develop new understandings of cancer as not only a disease but also a context linked to individual, community, and society health and well-being. Copyright © 2015 John Wiley & Sons, Ltd.
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Editorial
The changing landscape of cancer care - the impact of psychosocial clinical practice guidelines.
The International Psycho-Oncology Society (IPOS) has championed the need for quality care to incorporate attention to the psychosocial concerns of cancer patients. Widespread international endorsement of distress as the '6th vital sign' is a major step towards improving access to psychosocial care and reducing the isolation and stigma experienced by many affected by cancer. However, the integration of psychosocial care into routine clinical practice also requires active multidisciplinary engagement, and demonstration that evidence-based psychosocial interventions are effective and feasible to deliver in practice. ⋯ Typically, they provide a synthesis and evaluation of existing evidence, critically appraised by stakeholders and clinicians, presented in a way which allows for translation of research evidence into practice. Such guidelines are also tools for informing and educating those who do not have psychosocial expertise, potentially increasing the status of psycho-oncology. This paper describes the background to the development of psychosocial clinical practice guidelines in Australia as a means of understanding the factors that can underpin the evolution of attitudes and integration of psychosocial care in oncology, and considers the current status of psychosocial care in Australia and internationally, including challenges for the future.