Identifying caregivers and their meaning for patients with metastatic solid tumors: A prospective study at a community-based oncology group practice in Germany.

Abstract

e19637 Background: Relief of psycho-social distress is an important aspect in the treatment of patients with metastatic cancer. Therefore it is important to find out which persons are called on most frequently to find help in dealing with this situation. We also evaluated to what extend the patients considered these persons as actually helpful. Methods: 202 patients with metastatic solid tumors visiting the practice between April and July 2009 were screened for psycho-social distress using the Distress Thermometer (DT) and Problem List (PL). Thereafter a standardized personal interview was held where patients were asked to name their important contact persons. For each contact person the patient was asked to indicate if this contact was helpful or not and if yes, in which way it was helpful. Results: The 202 observed patients showed a mean distress level of 4.4 with 29% of patients indicating a distress score > 5.0. 92% named physical problems as a source of distress while emotional, practical, familial, or spiritual problems were causing distress in 63%, 14%, 12% and 4% respectively. 84% of patients named their oncologist as an important person to help them with their distress. Partner, children, friends and general practitioner were important persons for 71%, 64%, 53% and 52% respectively. 97% of patients seeking help from their oncologist described this as helpful. 24 patients (12%) had contacted a psychologist. This was helpful for 17 (71%) of these patients. There is a correlation between distress level and number of different persons contacted. (r=.305; p<0.001). The most helpful aspect for all contact persons was “Listening” except for oncologists (“Therapy”) and Cancer Counselling Service (“Information/Advice”). Conclusions: Psycho-social distress in patients with metastatic solid tumors is mostly caused by physical and by emotional problems. Most patients treated in an oncology practice reported a network of care-giving persons as helpful in the coping process. Thus it is of utmost importance to identify patients without care care giving persons and to improve support for main care givers. No significant financial relationships to disclose.