Hermann Faller1, Joachim Weis2, Uwe Koch3, Elmar Brähler4, Martin Härter3, Monika Keller5, Holger Schulz3, Karl Wegscheider6, Anna Boehncke2, Bianca Hund7, Katrin Reuter8, Matthias Richard9, Susanne Sehner6, Carina Szalai10, Hans-Ulrich Wittchen11, Anja Mehnert12. 1. Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Klinikstrasse 3, 97070 Würzburg, Germany. Electronic address: h.faller@uni-wuerzburg.de. 2. Department of Psychooncology, Tumor Biology Center, University of Freiburg, Breisacher Strasse 117, 79106 Freiburg, Germany. 3. Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. 4. Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany; Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Untere Zahlbacherstrasse 8, 55131 Mainz, Germany. 5. Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 155, 69120 Heidelberg, Germany. 6. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. 7. Rhein-Jura-Klinik, Bad Säckingen, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. 8. Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany. 9. Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Klinikstrasse 3, 97070 Würzburg, Germany. 10. Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany; Psychosocial Counselling Center for Cancer Patients, Schlobigplatz 23, 08056 Zwickau, Germany. 11. Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technical University Dresden, Chemnitzer Strasse 46, 01187 Dresden, Germany. 12. Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany.
Abstract
OBJECTIVE: Although elevated levels of distress are supposed to constitute a need for psychosocial support, the relation between elevated distress and need for support does not appear to be straightforward. We aimed to determine cancer patients' perceived need for psychosocial support, and examine the relation of need to both self-reported emotional distress and the interview-based diagnosis of a mental disorder. METHODS: In a multicenter, cross-sectional study in Germany, 4020 cancer patients (mean age 58 years, 51% women) were evaluated. We obtained self-reports of need for psychosocial support. We measured distress with the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) and depressive symptoms with the Patient Health Questionnaire (PHQ-9). In a subsample, we evaluated the presence of a mental disorder using the Composite International Diagnostic Interview (CIDI). RESULTS: 32.1% (95%-CI 30.6 to 33.6) of patients perceived a need for psychosocial support. Younger age, female sex, and higher education were associated with more needs, being married and living with a partner with fewer needs, respectively. While up to 51.2% of patients with elevated distress levels reported a need for psychosocial support, up to 26.1% of those without elevated distress levels perceived such a need. Results were similar across distress assessment methods. CONCLUSION: Our findings emphasize that the occurrence of mental distress is one important but not an exclusive factor among different motives to report the need for psychosocial support. We should thus consider multifaceted perspectives, facilitators and barriers when planning and implementing patient-centered psychosocial care services.
OBJECTIVE: Although elevated levels of distress are supposed to constitute a need for psychosocial support, the relation between elevated distress and need for support does not appear to be straightforward. We aimed to determine cancerpatients' perceived need for psychosocial support, and examine the relation of need to both self-reported emotional distress and the interview-based diagnosis of a mental disorder. METHODS: In a multicenter, cross-sectional study in Germany, 4020 cancerpatients (mean age 58 years, 51% women) were evaluated. We obtained self-reports of need for psychosocial support. We measured distress with the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) and depressive symptoms with the Patient Health Questionnaire (PHQ-9). In a subsample, we evaluated the presence of a mental disorder using the Composite International Diagnostic Interview (CIDI). RESULTS: 32.1% (95%-CI 30.6 to 33.6) of patients perceived a need for psychosocial support. Younger age, female sex, and higher education were associated with more needs, being married and living with a partner with fewer needs, respectively. While up to 51.2% of patients with elevated distress levels reported a need for psychosocial support, up to 26.1% of those without elevated distress levels perceived such a need. Results were similar across distress assessment methods. CONCLUSION: Our findings emphasize that the occurrence of mental distress is one important but not an exclusive factor among different motives to report the need for psychosocial support. We should thus consider multifaceted perspectives, facilitators and barriers when planning and implementing patient-centered psychosocial care services.
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