Abstract
BackgroundA significant number of oncological patients are heavily burdened by psychosocial stress. Doctors recommending or referring their patients to psycho-oncologists in the course of routine consultations can positively influence psycho-oncological care. The aim of this study was to analyze the frequency and predictors of such recommendations and to examine the use of these services by patients.Methods4,020 cancer patients (mean age 58 years; 51% women) were evaluated in a multicenter, cross-sectional study in Germany. Data was gathered about doctors’ referral practices, patients’ utilization of psycho-oncological care services, and disease-related symptoms. The PHQ-9 depression scale and the GAD-7 anxiety scale were used to measure psychological burden. Descriptive data analysis was conducted on the basis of subgroup comparisons and multivariable analysis was done using binary logistical regression.Results21.9% of the respondents reported having been given a recommendation or referral for psycho-oncological care by a doctor within the course of their cancer diagnosis and treatment. This comprises 29.5% of the patients identified by screening as being psychologically burdened. Nearly half of the patients who received a recommendation or referral (49.8%) acted on it. Predictors for seeking out psycho-oncological care included: patient desire (OR = 2.0), previous experience with psycho-oncological care (OR = 1.59), and female gender (OR = 1.57). Multivariable analysis indicated that patients’ level of psychological burden (depression, anxiety) had no effect on whether doctors gave them a recommendation or referral.ConclusionsAlong with examining the degree to which patients are burdened (e.g. using screening instruments), determining whether or not patients would like to receive psycho-oncological care is an important aspect of improving referral practices and, by extension, will allow important progress in the field of psycho-oncological care to be made.
Highlights
About 8–24% of cancer patients experience depression and 17–19% suffer from anxiety disorders or other significant mental impairments [1,2,3]
Along with examining the degree to which patients are burdened, determining whether or not patients would like to receive psycho-oncological care is an important aspect of improving referral practices and, by extension, will allow important progress in the field of psycho-oncological care to be made
One in every three cancer patients have a clinically relevant mental health disorder (4-week prevalence) [4] and prevalence rates of psychological comorbidity are estimated at 39.4% [5]
Summary
About 8–24% of cancer patients experience depression and 17–19% suffer from anxiety disorders or other significant mental impairments [1,2,3]. Only a fraction of cancer patients experiencing psychosocial impairments are receiving psychosocial care or psycho-oncological counseling. The discrepancy between the need for psycho-oncological help and the actual use of these services can be explained by barriers from the institutions offering the services or from the patients themselves. Findings on this show that approximately 30% of cancer patients, do want to receive psychosocial help or some comparable form of service and this need has been found to vary greatly based on cancer type or disease stage [9,10,11]. The aim of this study was to analyze the frequency and predictors of such recommendations and to examine the use of these services by patients
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