Negotiating concrete needs: short-term training for high-risk cancer patients.

Advances in the diagnosis and treatment of cancer and revisions in health care financing and reimbursement have changed the experience of living with cancer. The disease now is diagnosed earlier and patients are likely to live longer with the disease. Patients and their families, thus, will require more concrete service needs. The authors review the psychosocial oncology literature and the literature on case management theories. They present their findings of a survey of the concrete needs of 413 cancer patients who were undergoing chemotherapy. Based on this survey, they developed a short-term case management intervention model to improve patient problem-solving skills. The intervention is designed to increase patient and family autonomy and mastery, reduce unmet needs, and counteract common feelings of helplessness associated with serious illness.