Theresia Pichler1,2, Andreas Dinkel3, Birgitt Marten-Mittag3, Kerstin Hermelink4, Eva Telzerow1,5, Ulrike Ackermann6, Claus Belka7, Stephanie E Combs8, Christian Gratzke9,10, Jürgen Gschwend11, Nadia Harbeck12, Volker Heinemann1,5, Kathleen Herkommer11, Marion Kiechle6, Sven Mahner4, Steffi Pigorsch8, Josefine Rauch7, Christian Stief10, Jürgen Beckmann2,13, Pia Heußner5,14, Peter Herschbach1,3. 1. Comprehensive Cancer Center, Munich, Germany. 2. Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany. 3. School of Medicine, Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany. 4. Department of Gynaecology and Obstetrics, University Hospital of Munich, Munich, Germany. 5. Department of Internal Medicine III, University Hospital of Munich, Munich, Germany. 6. School of Medicine, Klinikum rechts der Isar, Department of Gynaecology and Obstetrics, Technical University of Munich, Munich, Germany. 7. Department of Radiation Oncology, University Hospital of Munich, Munich, Germany. 8. School of Medicine, Klinikum rechts der Isar, Department of Radiation Oncology, Technical University of Munich, Munich, Germany. 9. Department of Urology, University Hospital of Freiburg, Freiburg, Germany. 10. Department of Urology, University Hospital of Munich, Munich, Germany. 11. School of Medicine, Klinikum rechts der Isar, Department of Urology, Technical University of Munich, Munich, Germany. 12. Breast Center, Department of Gynaecology and Obstetrics, University Hospital of Munich, Munich, Germany. 13. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia. 14. Cancer Center Oberland, Garmisch-Partenkirchen General Hospital, Garmisch-Partenkirchen, Germany.
Abstract
OBJECTIVE: Many distressed cancer patients do not want or, finally, do not use psychological support. This study aimed at identifying factors associated with the decline of psychological support during hospital stay. METHODS: This cross-sectional study included inpatients with different cancer diagnoses. Distress was assessed using the short form of the Questionnaire on Stress in Cancer Patients-Revised (QSC-R10) and the Distress Thermometer (DT). Multivariable logistic regression was used to identify factors associated with decline. RESULTS: Of 925 patients, 71.6% (n = 662) declined psychological support. Male sex (OR = 2.54, 95% CI = 1.69-3.80), low psychosocial distress (OR = 3.76, CI = 2.50-5.67), not feeling depressed (OR = 1.93, CI = 1.24-2.99), perceived overload (OR = 3.37, CI = 2.19-5.20), no previous psychological treatment (OR = 1.88, CI = 1.25-2.83), and feeling well informed about psychological support (OR = 1.66, CI = 1.11-2.46) were associated with decline. Among the patients who indicated clinical distress (46.2%), 53.9% declined psychological support. Male sex (OR = 2.96, CI = 1.71-5.12), not feeling depressed (OR = 1.87, CI = 1.12-3.14), perceived overload (OR = 5.37, CI = 3.07-9.37), agreeableness (OR = 0.70, CI = 0.51-0.95), and feeling well informed about psychological support (OR = 1.81, CI = 1.07-3.07) were uniquely associated with decline in this subgroup. CONCLUSIONS: Decline of psychological support is primarily due to psychological factors. Feeling well informed about support emerged as a relevant factor associated with decline. Thus, design of informational material and education about available psychological services seem crucial.
OBJECTIVE: Many distressed cancerpatients do not want or, finally, do not use psychological support. This study aimed at identifying factors associated with the decline of psychological support during hospital stay. METHODS: This cross-sectional study included inpatients with different cancer diagnoses. Distress was assessed using the short form of the Questionnaire on Stress in CancerPatients-Revised (QSC-R10) and the Distress Thermometer (DT). Multivariable logistic regression was used to identify factors associated with decline. RESULTS: Of 925 patients, 71.6% (n = 662) declined psychological support. Male sex (OR = 2.54, 95% CI = 1.69-3.80), low psychosocial distress (OR = 3.76, CI = 2.50-5.67), not feeling depressed (OR = 1.93, CI = 1.24-2.99), perceived overload (OR = 3.37, CI = 2.19-5.20), no previous psychological treatment (OR = 1.88, CI = 1.25-2.83), and feeling well informed about psychological support (OR = 1.66, CI = 1.11-2.46) were associated with decline. Among the patients who indicated clinical distress (46.2%), 53.9% declined psychological support. Male sex (OR = 2.96, CI = 1.71-5.12), not feeling depressed (OR = 1.87, CI = 1.12-3.14), perceived overload (OR = 5.37, CI = 3.07-9.37), agreeableness (OR = 0.70, CI = 0.51-0.95), and feeling well informed about psychological support (OR = 1.81, CI = 1.07-3.07) were uniquely associated with decline in this subgroup. CONCLUSIONS: Decline of psychological support is primarily due to psychological factors. Feeling well informed about support emerged as a relevant factor associated with decline. Thus, design of informational material and education about available psychological services seem crucial.