Abstract
BackgroundThe diagnosis and treatment of cancer are associated with psychological distress that often leads to a significant reduction in emotional and physical well-being and quality of life. Early detection of psychological distress is therefore important. This study aims to assess the psychological distress of inpatient cancer patients using routine clinical data. Furthermore, variables and problems most strongly associated with psychological distress should be identified.Materials and MethodsN = 1,869 inpatients were investigated (mean age = 60.89 years; 35.94% female) using the National Comprehensive Cancer Network Distress Thermometer and problem checklist to assess distress as well as multiple possible problem areas. Visceral oncological cancer (31.6%) was the most common tumor diagnosis, followed by skin cancer (26.2%) and urological cancer (21.7%).Results65.9% of the sample experienced high levels of distress (Distress Thermometer ≥ 5). Female sex, stage 4 of disease, and visceral and head and neck cancer emerged as risk factors for high distress. A younger age (<65 years) was significantly correlated with higher distress. The most frequently self-reported problems were fears (50.1%), worry (49.9%), and fatigue (49.1%). Patients with all 3 of these problems had 24 times higher risk [odds ratio (OR) = 23.9] for high levels of distress than patients without these problems. Women reported significantly more practical, emotional, and physical problems than men. Younger (<50 years) and middle-aged patients (50–64 years) reported increased levels of practical, family, and emotional problems compared with older patients (≥65 years).DiscussionAlmost two-thirds of the sample reported high levels of distress. The most frequently reported problem areas were emotional and physical problems. These results can help to identify patients with high risk for psychological distress and, therefore, be used to optimize psychosocial and psycho-oncological care for patients with cancer.
Highlights
The incidence of cancer continues to increase worldwide, with 18.1 million cases per year (Bray et al, 2018)
According to the recommendation of the S3-Guideline of the German Cancer Society (Deutsche Krebsgesellschaft and Deutsche Krebshilfe, 2014), standardized screening for psychological distress is conducted with cancer inpatients at Hannover Medical School as routine clinical care
This study aimed to investigate the prevalence of high distress in a large sample of cancer inpatients and to identify risk factors most strongly associated with high psychological distress, as well as the prevalence of common problems experienced by cancer patients
Summary
The incidence of cancer continues to increase worldwide, with 18.1 million cases per year (Bray et al, 2018). Mortality is decreasing due to improvements in medical treatment and early detection, which improves the life expectancy and survival rate of cancer patients (Siegel et al, 2019). The diagnosis and treatment of cancer remain a major stressful life event that can lead to high levels of psychological distress (Meggiolaro et al, 2016; Kim et al, 2017; Mehnert et al, 2018). Distress in cancer patients is associated with reduced quality of life and functional status (Kendall et al, 2011), lower treatment adherence, and pain (Brown et al, 2003; Kim et al, 2017). The diagnosis and treatment of cancer are associated with psychological distress that often leads to a significant reduction in emotional and physical well-being and quality of life. Variables and problems most strongly associated with psychological distress should be identified
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