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. ---This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Zusammenfassung Seroepizootologische Untersuchungen über die Ätiologie des Zwingerhustens zeigten, daß in der Bundesrepublik Deutschland Parainfluenza 1‐ und 3‐Infektionen sowie Reo‐1‐ und –2‐Infektionen in den Hundepopulationen wenig verbreitet sind. Gehäuft können dagegen Reo‐3‐ (64,9 % — 87,8 %) und Influenza A 2/Hongkong‐Infektionen (4,4 % — 66,2 %) beobachtet werden. Dabei liegt der prozentuale Anteil dieser Infektionen in Hundehaltungen mit Zwingerhusten im Vergleich zu gesunden Hundepopulationen signifikant höher. Die Serumtiter bei gesunden und hustenkranken Tieren sowie die Ergebnisse der Serumpaaruntersuchungen lassen die Vermutung zu, daß der Zwingerhusten der Hunde in Deutschland hauptsächlich durch eine Mischinfektion mit Reovirus, Serotyp 3 und Influenza A 2/Hongkong hervorgerufen wird. Pathogenetisch scheinen die ubiquitär verbreiteten Reo‐3‐Infektionen die Basis zu bilden, auf der sich nach Einschleppung von Influenza A 2/Hongkong Mischinfektionen entwickeln, die durch nichtmikrobielle Faktoren, wie Trächtigkeit, Milieuwechsel, Futterumstellung, Erkältung, usw. in Krankheiten unter dem klinischen Bild des Zwingerhustens übergeführt werden. Summary Serological studies on the occurrence of viral infections in healthy dogs and dogs with kennel cough Sero‐epizootiological studies on the aetiology of kennel cough showed that in the Federal Republic of Germany Parainfluenza 1‐ and 3‐infections, as well as Reo 1‐ and 2‐infections are very little disseminated among the dog population. In contrast, Reo 3‐ (64.9 % — 87.8 %) and Influenza A 2/Hongkong infections (4.4 % — 66.2 %) are frequent. The percentage of animals with these infections is significantly higher in kennels with kennel cough than in healthy dog populations. The serum titres of healthy and coughing dogs, as well as the results with paired serum samples, suggest that kennel cough in Germany is caused mainly by mixed infection with Reovirus serotype 3 and Influenza A 2/Hongkong. From the point of view of pathogenesis, infection with the ubiquitous Reo 3 virus may form the basis for infection with Influenza A 2/Hongkong, after which non‐microbial factors such as pregnancy, change of environment, change of food, exposure to cold etc. may lead to progression to the clinical picture of kennel cough. Résumé Recherches sérologiques sur l'apparition d'infections virales chez des chiens sains et atteints de la toux des chenils Des recherches séroépizootologiques sur l'étiologie de la toux des chenils ont montré que des infections à Parainfluenza 1 et 3 ainsi que des infections à Reo 1 et 2 sont peu répandues dans les populations canines en République fédérale allemande. Par contre, des infections à Reo 3 (64,9 % — 87,8 %) et Influenza A 2/Hongkong (4,4 % — 66,2 %) ont été observées. Le pourcentage de ces infections est nettement plus élevé dans les populations canines atteintes de toux des chenils. Le titre sérologique chez des animaux sains et atteints de toux ainsi que les résultats des recherches sur paires de sérums laissent supposer que la toux de...

Objective To improve allocation of psychosocial care and to provide patient‐oriented support offers, identification of determinants of elevated distress is needed. So far, there is a lack of evidence investigating the interplay between individual disposition and current clinical and psychosocial determinants of distress in the inpatient setting. Methods In this cross‐sectional study, we investigated 879 inpatients with different cancer sites treated in a German Comprehensive Cancer Center. Assessment of determinants of elevated distress included sociodemographic, clinical and psychosocial characteristics as well as dimensions of personality. Multiple linear regression was applied to identify determinants of psychosocial distress. Results Mean age of the patients was M = 61.9 (SD = 11.8), 48.1% were women. In the multiple linear regression model younger age (β = −0.061, p = 0.033), higher neuroticism (β = 0.178, p = <0.001), having metastases (β = 0.091, p = 0.002), being in a worse physical condition (β = 0.380, p = <0.001), depressive symptoms (β = 0.270, p = <0.001), not feeling well informed about psychological support (β = 0.054, p = 0.046) and previous uptake of psychological treatment (β = 0.067, p = 0.020) showed significant associations with higher psychosocial distress. The adjusted R2 of the overall model was 0.464. Conclusion Controlling for sociodemographic characteristics and dispositional vulnerability, that is neuroticism, current clinical and psychosocial characteristics were still associated with hospitalized patients' psychosocial distress. Psycho‐oncologists should address both, the more transient emotional responses, such as depressive symptoms, as well as more enduring patient characteristics, like neuroticism.