Understanding help-seeking behaviour in relation to psychosocial support services among Japanese cancer patients

Abstract

Background There are various psychosocial support services for cancer patients in Japan; however, their utilization rate is lower than in Western countries. The aim of this study was to investigate the actual status of the utilization of such services and the related factors of their use, using the transtheoretical model. Methods We conducted an Internet survey of cancer outpatients. They were asked for information on their demographics, physical status and the usage of and intention to use psychosocial support services, and to answer the Hospital Anxiety and Depression Scale. Results Data of 712 participants were analyzed; 111 had made use of psychosocial support services (15.6%). Participants who were younger, female, had breast cancer, experience with hormone therapy and did not have a good performance status (Karnofsky Performance Scale) more often used such services when comparing users/experiencers with non-users/inexperienced. Of the inexperienced, 538 were in the Precontemplation stage (89.5%), 62 were in the Contemplation stage (10.3%) and one was in the Preparation stage (0.2%). Approximately 35% of those in the Precontemplation stage would correspond to adjustment disorders or major depression. Conclusions We showed the degree of cancer patients who have used the psychosocial support services and its contents and revealed the factors related to the utilization of such services in Japan. Our study supports previous reports that cancer patients with high levels of distress do not necessarily seek support, and thus future studies should also examine other modifiable factors considering the medical settings.

Examination of factors contributing to help‐seeking behavior in accessing psychosocial support services among Japanese cancer patients: An application of the segmentation approach

“…1,18 When medical staff makes recommendations to patients for use, it is expected that communication would be performed based on factors affecting HSB of each stage and the characteristics of the stages. 33 This same framework is also important when developing an intervention promoting the utilization of psychosocial support services among cancer patients, such as by creating posters and flyers or establishing a promoting system. That is, such factors and the characteristics of the stages were expected to be considered rather than addressing everyone in the same way.…”

“…This study found more users of psychosocial support services in the Contemplation than in the Precontemplation stages. As an individual moves from one stage to another according to TTM, 28 and high awareness of the problem is an important factor of HSB, than the other stages, 33 and, as high extroversion leads to active and adaptive coping, 34,35 these participants might have been able to use services as needed.…”

“…Further, the subscales of attitude toward using psychosocial support services excluding expectations for positive results after use, personalities, and social support at Time 1 differed depending on the stage. 33 Therefore, the characteristics of the stages should be considered when developing interventions promoting utilization as well factors contributing to use in this study.…”

“…The present study aimed to examine factors contributing to HSB regarding use of psychosocial support services among cancer patients at each stage according to TTM 28 and previous studies 10,29 : Precontemplation without adjustment disorder or major depression (w/o ADMD); Precontemplation with them (w/ ADMD); and Contemplation. Additionally, we qualitatively examined triggers contributing to the use of such services.…”

“…Therefore, various psychological support services, such as psychiatric care, counseling, group therapy, and consulting support centers, have been available for cancer patients in Japan. However, such services are not used often, even for severe problems or despite being recommended 8‐11 . The utilization rate of such services is 10.8%–15.6% among the cancer patients in Japan, 10,12,13 which is lower than the Western rate of nearly 30% 14,15 .…”