This program will educate 675 nurses and other health professionals working in oncology or radiotherapy offices and clinics in Central Pennsylvania about the physical and psycho-social needs of cancer patients and their family/friend support-persons and will teach how to guide them through a problem solving process in dealing with those needs. Teaching will be organized around problem solving outlines. Participants will learn to use these outlines to guide patients and/or their support-persons through five steps necessary for effective problem solving: 1) problem orientation (attitudes and feelings about the problem solving process, 2) problem definition and formulation; 3) generation of alternatives, 4) decision making and 5) implementation. For physical problems the problem solving sequence is largely specified by medical experts and the problem solver follows a prescribed series of actions. For psychosocial problems the problem solver is guided to provide the information, and alternatives for solving his or her unique problems. The problem solving outlines are written from the patient/support-person's point of view so that, as health professionals learn to use the outlines, they also learn to understand the patient/support-person's perspective. Participants also learn that, when they treat patients and support-persons as problem solvers, they are encouraging initiative and a sense of control. The one day training program will include practice, through role playing, in using the problem solving outlines with patients and family/friend support-persons. Participants will receive copies of the outlines to use or adapt for their settings. Before leaving they will write plans for how they will implement the program. Participants can """"""""earn back"""""""" their tuitions by instructing five patients or care-persons with the problem solving outlines and obtaining their permission to be interviewed. Evaluation will consist of pre and post training questionnaires on knowledge and attitudes toward problem solving, 3 month post training questionnaires about attendee's use of guided problem solving, and interviews with patients and support-persons who received problem solving education. Evaluation data will be reviewed continuously to suggest program changes and to assess the effects of changes that are instituted.
