Barriers to psychosocial oncology service utilization in patients newly diagnosed with head and neck cancer

Cohen, Atika; Ianovski, Lola E.; Frenkiel, Saul; Hier, Michael P.; Zeitouni, Anthony; Kost, Karen; Mlynarek, Alex; Richardson, Keith; Black, Martin J.; MacDonald, Christina; Chartier, Gabrielle; Rosberger, Zeev; Henry, Mélissa

doi:10.1002/pon.4889

Cited by 35 publications

(44 citation statements)

References 36 publications

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“…Previous studies often did not specify a time frame. However, decline rates were similar across the different studies, with decline rates of 68% to 80% in unselected samples and 49% to 71% in patients with significant distress . Thus, the decline rates of our study are quite compatible with the available evidence.…”

Section: Discussionsupporting

confidence: 87%

Factors associated with the decline of psychological support in hospitalized patients with cancer

et al. 2019

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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.

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Section: Discussionsupporting

confidence: 87%

Factors associated with the decline of psychological support in hospitalized patients with cancer

et al. 2019

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“…Second, we did not compare attitudes with other modifiable individual variables like anticipated stigma or mental health literacy. These variables were also recently considered to influence psychological care utilisation of patients with cancer (Cheung et al, ; Cohen et al, ; Rose et al, ). Third, we exclusively assessed patients’ attitudes, although the attitudes of family members or primary caregivers probably influence help‐seeking.…”

Section: Discussionmentioning

confidence: 99%

“…These variables were also recently considered to influence psychological care utilisation of patients with cancer (Cheung et al, 2016;Cohen et al, 2018;Rose et al, 2018). Third, we exclusively assessed patients' attitudes, although the attitudes of family members or primary caregivers probably influence help-seeking.…”

Section: Study Limitationsmentioning

confidence: 99%

Cancer patient utilisation of psychological care in Germany: The role of attitudes towards seeking help

et al. 2019

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Objective Even if significantly distressed, many patients with cancer do not seek psychological help. There is growing evidence that attitudes are central barriers for help‐seeking, and instruments to assess cancer patients’ attitudes towards help‐seeking are urgently needed. This study aimed to evaluate the German Attitudes towards Seeking Help after Cancer Scale (ASHCa‐G) and investigated the relationship between patients’ attitudes and psychological care utilisation. Methods The ASHCa‐G was presented to 270 patients with cancer (age 63.0 ± 12.7 years, 44.8% women). Item analyses, principal component analysis and associations with age, social support, help‐seeking intention and psychological care utilisation were calculated. A hierarchical logistic regression was performed to ascertain the leading role of attitudes in explaining psychological care utilisation. Results Principal component analysis supported a two‐component solution, which showed good internal consistency for the positive attitudes (α = 0.80) and negative attitudes (α = 0.75) subscales. The associations with age, distress and help‐seeking intention confirmed the validity of the ASHCa‐G. Positive attitudes explained most variance of cancer patients’ current psychological care utilisation. Conclusion The ASHCa‐G seems to be a reliable and valid questionnaire for assessing attitudes towards seeking psychological help among patients with cancer. Clinical practice might profit from identifying attitudinal barriers that hinder patients with cancer from seeking psychological help.

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“…10 Other studies describe not expressing needs as a barrier for patients to receive appropriate support, among difficulties in recognizing their needs or negative perceptions of services available. 11,12 Further described are barriers like not being confident in psychosocial support or fear of stigmatization to use psychosocial support. 11,13,14 Overall, there are only few studies about reasons of unexpressed needs.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of cancer patients' unexpressed needs in the admission interview of inpatient rehabilitation

et al. 2020

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Objective: The admission interview in oncological inpatient rehabilitation might be a good opportunity to identify cancer patients' needs present after acute treatment. However, a relevant number of patients may not express their needs. In this study, we examined (a) the proportion of cancer patients with unexpressed needs, (b) topics of unexpressed needs and reasons for not expressing needs, (c) correlations of not expressing needs with several patient characteristics, and (d) predictors of not expressing needs. Methods: We enrolled 449 patients with breast, prostate, and colon cancer at beginning and end of inpatient rehabilitation. We obtained self-reports about unexpressed needs and health-related variables (quality of life, depression, anxiety, adjustment disorder, and health literacy). We estimated frequencies and conducted correlation and ordinal logistic regression analyses. Results: A quarter of patients stated they had "rather not" or "not at all" expressed all relevant needs. Patients mostly omitted fear of cancer recurrence. Most frequent reasons for not expressing needs were being focused on physical consequences of cancer, concerns emerging only later, and not knowing about the possibility of talking about distress. Not expressing needs was associated with several health-related outcomes, for example, emotional functioning, adjustment disorder, fear of progression, and health literacy. Depression measured at the beginning of rehabilitation showed only small correlations and is therefore not sufficient to identify patients with unexpressed needs. Conclusions: A relevant proportion of cancer patients reported unexpressed needs in the admission interview. This was associated with decreased mental health. Therefore, it seems necessary to support patients in expressing needs.

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Barriers to psychosocial oncology service utilization in patients newly diagnosed with head and neck cancer

Abstract: Future outreach interventions in patients with HNC could address stigma in an attempt to enhance PSO integration into routine clinical care.

Cited by 35 publications

References 36 publications

Factors associated with the decline of psychological support in hospitalized patients with cancer

Factors associated with the decline of psychological support in hospitalized patients with cancer

Cancer patient utilisation of psychological care in Germany: The role of attitudes towards seeking help

Prevalence and predictors of cancer patients' unexpressed needs in the admission interview of inpatient rehabilitation

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