Routine assessment of social difficulties in cancer patients: are we opening Pandora's box?

Living with cancer impacts on the social aspects of the lives of the patient and their families, causing problems that can remain undetected. The Social Difficulties Inventory (SDI) has been shown as an effective screening tool, but concerns exist that detecting more problems may increase the workload for clinic staff and related services. The aim of this analysis is to assess the level of unmet need for social difficulties and to identify any potential increase in required interventions that may occur as a result of detailed assessment.

A previous cross-sectional interview study was conducted to establish the clinical utility of the SDI. Adult patients were recruited from oncology, haematology and chest medicine clinics. They completed the SDI and a semi-structured interview by a social worker, who was blind to the SDI results. With participant agreement, interventions were made for the detected problems. This paper reports on a secondary descriptive analysis of intervention data, which was performed to examine the details of the interventions and referral patterns.

No intervention was necessary for 108 (59%) of patients, 42 (23%) received information, 33 (15%) were referred to another service and five (3%) received both information and a referral. Most information was provided about holiday insurance. The majority of referrals were made to Social Work (55% of all referrals) with the main reason being related to benefits or finances.

Increased referral rate was observed following a social work interview, when comparing with local audit data. However, the majority of needs could be met by increasing accessibility of information.