Abstract
BackgroundCancer patients frequently suffer from physical and psychosocial impairments due to their disease and its treatment. Psychooncology (PO) can help to cope with stress resulting from outpatient radiotherapy (RT) treatment. There are currently few data regarding patients’ wishes for PO support. The aim of this study was to investigate the number of patients with a wish for PO, treatment paths, and predictors of the wish for PO among cancer patients at the beginning of RT.MethodsThe results of routine psychological stress screening (Hornheide screening instrument; cut-off ≥ 4) of 944 cancer patients between 2015 and 2017 were analyzed in a retrospective cross-sectional study. Predictors for a wish for PO support were identified by stepwise binary logistic regression, in which sociodemographic and treatment data were included in addition to the screening items.ResultsAround 20% of patients had above-average stress levels and 13% expressed a wish for PO support (participation rate was approximately 55%). Low emotional wellbeing (OR = 11.3) and lack of social support (OR = 9.4) were strong predictors for this treatment wish. Among patients with pancreatic cancer, head and neck tumors, and hematologic disease, there was a substantial difference between the degree of psychological stress and the wish for treatment. Patients with urological (23.5%) and lung tumors (20.9%) most frequently expressed a wish for PO support.ConclusionPatient-reported psychosocial problems were better predictors of a wish for PO support than sociodemographic or clinical data. Stress screening should thus be implemented in clinical routine.
Highlights
Cancer patients frequently suffer from physical and psychosocial impairments due to their disease and its treatment
We addressed the following aims: (a) to assess the number of patients who wish for PO across tumor entities, (b) to identify predictors for the wish for PO, and (c) to describe the referral pathways for PO in clinical routine
We found no significant association of relationship status, parenthood, disease status, previous cancer-related treatments, and two Hornheide Screening Instrument (HSI) items on the dependent variable and did not include these variables in the final model
Summary
Cancer patients frequently suffer from physical and psychosocial impairments due to their disease and its treatment. Available data suggest that psychooncological support (PO) can effectively reduce psychological distress and improve patients’ QoL [12,13,14]. Routine distress screening can significantly increase the number of referrals to PO [18]: when actively offered during radiotherapy, 13–41% of the patients accepted referral [6, 19, 20]. Incorporation of such screening procedures into clinical routine to effectively identify distressed cancer patients to enable quick and adequate PO is recommended [21, 22]. Screening is usually conducted with short, applicable and interpretable questionnaires, followed up by referral to a more specialized healthcare professional if necessary [23]
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