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

BMC Psychiatry

Reinhold Kilian³  Eva Vietz¹  Juan Valdes-Stauber² 

[1]Outpatient Clinic, Bezirkskrankenhaus Kaufbeuren, Kaufbeuren, Germany

[2]Zentrum für Psychiatrie Südwürttemberg, Weingartshoferstraße 2, 88214, Ravensburg, Germany

[3]Bezirkskrankenhaus Günzburg, Department of Psychiatry and Psychotherapy II, University of Ulm, Ulm, Germany

关键词: Needs of cancer patients;    Psychosocial support;    Physical distress;    Psychological distress;    Psycho-oncology;    PO-Bado;   

Others  :  1123967
DOI  :  10.1186/1471-244X-13-226

 received in 2012-10-19, accepted in 2013-09-06,  发布年份 2013

【 摘 要 】

Background

In 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.

Methods

The 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.

Results

Most 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.

Conclusions

Psycho-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.

【 授权许可】

   
2013 Valdes-Stauber et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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