The impact of clinical conditions and social factors on the psychological distress of cancer patients: an explorative study at a consultation and liaison service in a rural general hospital

Abstract

BackgroundIn recent decades, increasing attention has been paid to the subjective dimension of cancer, especially to psychosocial screening procedures, major psychiatric disorders but also psychological and psychosocial distress, and finally to met needs of oncologic patients. This study aims first to describe cancer patients in a rural hospital attended by a psycho-oncological consultation-liaison team, second to assess predictors for psychological distress in cancer patients, and finally to identify predictors for recommendation of further psychosocial support.MethodsThe sample (n = 290) comprises a full survey of patients at breast and bowel cancer services (n=209) and patients referred by other medical and surgical services because of psychosocial impairment (n = 81). All patients were assessed by means of the PO-Bado (Psycho-Oncological Basic Documentation) expert rating scale. Assessment of predictors for psychological distress was conducted by multivariate regression models and assessment for predictors for need for outpatient psychosocial support by a logistic regression analysis. All analyses were conducted using STATA 12.ResultsMost members of the assessed sample (average age 65, 82% women) were not severely impaired from a functional and psychological point of view. A total of 14% had received psychiatric treatment before. Mood swings, anxiety, grief, and fatigue were the most important distress symptoms. Selectively referred patients vs. full survey patients of cancer centres, as well as bowel vs. breast cancer patients show a higher level of psychological and physical distress. Fatigue, assessed metastases, and functional limitations were the best predictors for psychological burden. Referral mode, gender, age, family problems, fatigue, and previous psychiatric treatment were associated with further need of psychosocial support.ConclusionsPsycho-oncological consultation and liaison services may offer support to patients in an early stage of cancer, especially in cancer centres. Because of selectively referred patients show a higher burden, the use of basic screening instruments could be meaningful. Fatigue, metastases status, and functional limitations may better predict psychological distress than pain, duration of illness, psychosocial conditions or previous psychiatric treatment. More attention has to be paid to outpatient follow-up with older cancer patients, those with family problems, and those suffering from significant fatigue.

Cytokine gene variations associated with trait and state anxiety in oncology patients and their family caregivers

“…In addition, consistent with previous reports [62,63], participants who reported poorer functional status scores reported higher levels of trait and state anxiety scores. For each 10-point decrease in KPS scores (which equates with a clinically meaningful decrement in functional status), both trait and state anxiety scores increased by approximately 2 points.…”

Psycho‐oncologic interventions to reduce distress in cancer patients: a meta‐analysis of controlled clinical studies published in People's Republic of China

“…Therefore, it is becoming more and more important to explore the psychological adjustment problems and residual conditions of the cancer diagnosis and its treatment, since the formal beginning of psycho‐oncology in the mid‐1970s . Numerous studies illustrated that most of the adult cancer patients and survivors are more distressed in terms of levels of anxiety and depression and have more psychosocial impairment than the healthy population . Patients in end stage of cancer usually have lower quality of life and their depression levels are higher .…”

Women With Breast Cancer: Self-Reported Distress in Early Survivorship

“…Since the 1990s, the breast cancer population has been heavily studied compared to other cancer types (Moorey, 2013; Valdes-Stauber, Vietz, & Kilian, 2013). The relationship between the level and source of distress and time periods in the cancer survivorship trajectory has been understudied, particularly in controlled homogenous samples.…”