Developing Antiracist Social Work Practice at a Comprehensive Cancer Center.

The combination of the ongoing violence perpetuated against Black, Brown, and Asian people, and the increased incidence of death of Black, Indigenous, people of color (BIPOC) and Asian Americans and Pacific Islanders (AAPI) at the start of the COVID-19 pandemic, elicited an important response from the field of social work across the nation. This article describes the efforts undertaken by a Social Work Department at a comprehensive cancer center in response to a call to develop antiracist practice. This article recounts the process of creating educational opportunities for oncology social workers to help them identify bias and racism in themselves and throughout the healthcare system, to embrace intentional antiracist practice, and to better advocate for BIPOC/AAPI patients and colleagues. The strategies included the development of an antiracism committee, the use of a social location exercise to influence and disrupt white supremacy, the creation of community guidelines for engaging in conversations about race, and the formulation of a new departmental policy ensuring a commitment to antiracist social work practice. In addition, a forum using multimedia was created to explore racial dynamics and to highlight the narratives of BIPOC and AAPI people. Further, a monthly Antiracist Clinical Case Conference was implemented to explore their role in the context of working with the interdisciplinary team in an oncology setting. This article concludes with recommendations for ongoing antiracist social work practice development that may be applied in various healthcare settings.

Cross-sectional study of patient-reported neurobehavioral problems following hematopoietic stem cell transplant and health-related quality of life.

OBJECTIVE: Although hematopoietic stem cell transplant (HSCT) patients may experience neurocognitive impairment, experiences of neurobehavioral problems (including apathy and disinhibition) are understudied. These experiences reflect behavioral signs and symptoms of neurological dysfunction that can potentially reduce health-related quality of life (HRQOL). Understanding them is important because they may be confused with other diagnoses, including depression, potentially leading to inappropriate treatments. The objectives of this preliminary cross-sectional study were to describe HSCT patients' neurobehavioral functioning pre-HSCT and post-HSCT and to examine relations with HRQOL. METHODS: Patients (n = 42) 9 months to 3 years post-HSCT completed measures of neurobehavioral functioning to report apathy and disinhibition pre-HSCT (retrospectively) and post-HSCT (currently). Paired t-tests and McNemar tests were used to explore differences in the incidence of patient-reported neurobehavioral problems within and across time points. Regression analyses were conducted to examine relations between neurobehavioral functioning and physical and mental HRQOL. RESULTS: Elevated levels of apathy were reported by many patients post-HSCT (36%) and increased significantly from pre-HSCT to post-HSCT (p = 0.001). Hierarchical regression analysis indicated that higher levels of apathy were associated with reduced mental HRQOL (p < 0.05) even after controlling for depressed mood and fatigue. CONCLUSIONS: Findings from this preliminary study highlight the importance of investigating neurobehavioral problems, particularly apathy, in HSCT patients. Because apathy is often confused with other diagnoses and may worsen HRQOL, understanding the nature of these symptoms has implications for interventions. Further research is needed in this important area.

A randomized trial of hypnosis for relief of pain and anxiety in adult cancer patients undergoing bone marrow procedures.

Pain and anxiety are closely associated with bone marrow aspirates and biopsies. To determine whether hypnosis administered concurrently with the procedure can ameliorate these morbidities, the authors randomly assigned 80 cancer patients undergoing bone marrow aspirates and biopsies to either hypnosis or standard of care. The hypnosis intervention reduced the anxiety associated with procedure, but the difference in pain scores between the two groups was not statistically significant. The authors conclude that brief hypnosis concurrently administered reduces patient anxiety during bone marrow aspirates and biopsies but may not adequately control pain. The authors explain this latter finding as indicating that the sensory component of a patient's pain experience may be of lesser importance than the affective component. The authors describe future studies to clarify their results and address the limitations of this study.