Skip to main content
Top
Published in: Supportive Care in Cancer 11/2009

01-11-2009 | Original Article

Determinants and implications of cancer patients’ psychosocial needs

Authors: N. Ernstmann, M. Neumann, O. Ommen, M. Galushko, M. Wirtz, R. Voltz, M. Hallek, H. Pfaff

Published in: Supportive Care in Cancer | Issue 11/2009

Login to get access

Abstract

Goals of work

Cancer patients often experience distress. However, the majority of newly diagnosed patients gradually adapt to the crisis. When symptoms of distress and anxiety persist over months, patients require psychosocial support. The aim of the present study was to determine the proportion of cancer patients who indicate the need for psychosocial support and to identify sociodemographic, psychological and illness-related factors predicting the need for psychosocial support in a German sample.

Materials and methods

The cross-sectional retrospective study was administered to 710 cancer patients who had been inpatients at the University Hospital of Cologne. The response rate was 49.5%. Patients suffering from bronchial, oesophageal, colorectal, breast, prostate and skin cancer participated in the study. The severity of depressive symptoms was assessed using the German version of the Major Depression Inventory. The level of anxiety was assessed with the state subscale of the German version of the State-Trait Anxiety Inventory. To measure the functional aspects of health-related quality of life, the scales “physical functioning”, “role functioning”, “emotional functioning”, “cognitive functioning” and “role functioning” of the European Organisation for Research and Treatment of Cancer QLQ-C30 Questionnaire (EORTC QLQ-C30) were used.

Main results

Of the cancer patients, 18.9% indicate an unmet need for psychosocial support and 9.5% are actually using psychosocial services. In a multiple logistic regression, significant indicators of the need for psychosocial support are gender [p = 0.014; standardised effect coefficient (sc) = 1.615] and emotional functioning (p < 0.001; sc = 1.533). The estimated model has a specificity of 92.2% and a sensitivity of 54.0%.

Conclusion

Almost a third of the cancer patient population indicates an unmet need for psychosocial support or is actually using psychosocial services. Emotional functioning is a central predictor of the requirement for psychosocial support. Women are emotionally more affected than men and need more psychosocial support. The prognostic validity of the severity of depression and anxiety is limited.
Literature
1.
go back to reference Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376. doi:10.1093/jnci/85.5.365 CrossRefPubMed Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376. doi:10.​1093/​jnci/​85.​5.​365 CrossRefPubMed
4.
5.
go back to reference Bech P, Rasmussen N-A, Olsen LR, Noerholm V, Abildgaard W (2001) The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord 66(2–3):159–164. doi:10.1016/S0165-0327(00)00309-8 CrossRefPubMed Bech P, Rasmussen N-A, Olsen LR, Noerholm V, Abildgaard W (2001) The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord 66(2–3):159–164. doi:10.​1016/​S0165-0327(00)00309-8 CrossRefPubMed
6.
go back to reference Cayrou S, Dickes P, Gauvain-Piquard A, Roge B (2003) The mental adjustment to cancer (MAC) scale: French replication and assessment of positive and negative adjustment dimensions. Psychooncology 12(1):8–23. doi:10.1002/pon.634 CrossRefPubMed Cayrou S, Dickes P, Gauvain-Piquard A, Roge B (2003) The mental adjustment to cancer (MAC) scale: French replication and assessment of positive and negative adjustment dimensions. Psychooncology 12(1):8–23. doi:10.​1002/​pon.​634 CrossRefPubMed
7.
go back to reference Collegium Internationale Psychiatriae Scalarum (1996) Internationale Skalen für Psychiatrie. In: Collegium Internationale Psychiatriae Scalarum (ed). Beltz Test GmbH, Göttingen. pp 5–234 Collegium Internationale Psychiatriae Scalarum (1996) Internationale Skalen für Psychiatrie. In: Collegium Internationale Psychiatriae Scalarum (ed). Beltz Test GmbH, Göttingen. pp 5–234
8.
go back to reference Costantini M, Musso M, Viterbori P et al (1999) Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer 7(3):121–127. doi:10.1007/s005200050241 CrossRefPubMed Costantini M, Musso M, Viterbori P et al (1999) Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer 7(3):121–127. doi:10.​1007/​s005200050241 CrossRefPubMed
10.
go back to reference Derogatis LR, Morrow GR, Fetting J et al (1983) The prevalence of psychiatric disorders among cancer patients. Psychiatr Disord Cancer 249(6):751–757 Derogatis LR, Morrow GR, Fetting J et al (1983) The prevalence of psychiatric disorders among cancer patients. Psychiatr Disord Cancer 249(6):751–757
11.
go back to reference Dillman DA (1978) Mail and telephone survey. The total design method. Wiley, New York Dillman DA (1978) Mail and telephone survey. The total design method. Wiley, New York
12.
go back to reference Dillman DA (2007) Mail and Internet surveys: the tailored design method—2007. Wiley, New Jersey Dillman DA (2007) Mail and Internet surveys: the tailored design method—2007. Wiley, New Jersey
13.
go back to reference Dillman DA (2000) Mail and Internet surveys: the tailored design method, 2nd edn. Wiley, New York Dillman DA (2000) Mail and Internet surveys: the tailored design method, 2nd edn. Wiley, New York
14.
go back to reference Donovan KA, Jacobsen PB, Holland JC et al (2004) Psychometric properties and correlates of distress thermometer scores. Psychooncology 13:S16 Donovan KA, Jacobsen PB, Holland JC et al (2004) Psychometric properties and correlates of distress thermometer scores. Psychooncology 13:S16
15.
go back to reference Eakin EG, Strycker LA (2001) Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives. Psychooncology 10(2):103–113. doi:10.1002/pon.500 CrossRefPubMed Eakin EG, Strycker LA (2001) Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives. Psychooncology 10(2):103–113. doi:10.​1002/​pon.​500 CrossRefPubMed
16.
go back to reference Ernstmann N, Neumann M, Bollschweiler E, Warm M, Wolf J, Pfaff H (2007) Predicting the need for and actual utilization of psychosocial support in depressive cancer patients using the Major Depression Inventory. Onkologie 30(Suppl. 3):170 Ernstmann N, Neumann M, Bollschweiler E, Warm M, Wolf J, Pfaff H (2007) Predicting the need for and actual utilization of psychosocial support in depressive cancer patients using the Major Depression Inventory. Onkologie 30(Suppl. 3):170
17.
go back to reference Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A (2001) The EORTC QLQ-C30 scoring manual, 3rd edn. European Organization for Research and Treatment of Cancer, Brussels Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A (2001) The EORTC QLQ-C30 scoring manual, 3rd edn. European Organization for Research and Treatment of Cancer, Brussels
18.
go back to reference Fritzsche K, Struss Y, Hammel A, Hertz H, Stein B (2004) Relationship between psychosocial distress, treatment need and use of psychotherapeutic interventions within a psychosomatic liaison service in hematological oncology. Onkologie 27:457–461. doi:10.1159/000080364 CrossRefPubMed Fritzsche K, Struss Y, Hammel A, Hertz H, Stein B (2004) Relationship between psychosocial distress, treatment need and use of psychotherapeutic interventions within a psychosomatic liaison service in hematological oncology. Onkologie 27:457–461. doi:10.​1159/​000080364 CrossRefPubMed
19.
go back to reference Hewitt M, Herdman R, Holland J (2004) Meeting psychosocial needs of women with breast cancer. The National Academies Press, Washington Hewitt M, Herdman R, Holland J (2004) Meeting psychosocial needs of women with breast cancer. The National Academies Press, Washington
21.
go back to reference Holland JC (1998) Societal views of cancer and the emergence of psychooncology. In: Holland JC (ed) Psychooncology. Oxford University Press, New York, pp 3–15 Holland JC (1998) Societal views of cancer and the emergence of psychooncology. In: Holland JC (ed) Psychooncology. Oxford University Press, New York, pp 3–15
22.
go back to reference Jacobsen PB, Donovan KA, Holland JC et al (2004) Multi-center study of the utility of the distress thermometer as a screening instrument in a general cancer population. Psychooncology 13:S42–S43. doi:10.1002/pon.760 Jacobsen PB, Donovan KA, Holland JC et al (2004) Multi-center study of the utility of the distress thermometer as a screening instrument in a general cancer population. Psychooncology 13:S42–S43. doi:10.​1002/​pon.​760
24.
go back to reference Krähenbühl A, Zwahlen D, Knuth A et al (2007) Prävalenz von Angst und Depression bei ambulanten Krebspatienten und deren Angehörigen. Schweiz Rundsch Med Prax 96(24):973–979 Krähenbühl A, Zwahlen D, Knuth A et al (2007) Prävalenz von Angst und Depression bei ambulanten Krebspatienten und deren Angehörigen. Schweiz Rundsch Med Prax 96(24):973–979
26.
go back to reference Lintz K, Moynihan C, Steginga S et al (2003) Prostate cancer patients’ support and psychological care needs: Survey from a non-surgical oncology clinic. Psychooncology 12(8):769–783. doi:10.1002/pon.702 CrossRefPubMed Lintz K, Moynihan C, Steginga S et al (2003) Prostate cancer patients’ support and psychological care needs: Survey from a non-surgical oncology clinic. Psychooncology 12(8):769–783. doi:10.​1002/​pon.​702 CrossRefPubMed
29.
go back to reference McDaniel JS, Musselman DL, Porter MR, Reed DA, Nemerhoff CB (1995) Depression in patients with cancer. Diagnosis, biology, and treatment. Arch Gen Psychiatry 52:89–99PubMed McDaniel JS, Musselman DL, Porter MR, Reed DA, Nemerhoff CB (1995) Depression in patients with cancer. Diagnosis, biology, and treatment. Arch Gen Psychiatry 52:89–99PubMed
30.
go back to reference Mehnert A, Herschbach P, Berg P, Henrich G, Koch U (2006) Progredienzangst bei Brustkrebspatientinnen—Validierung der Kurzform des Progredienzangstfragebogens PA-F-KF. Z Psychosom Med Psychother 52:274–288PubMed Mehnert A, Herschbach P, Berg P, Henrich G, Koch U (2006) Progredienzangst bei Brustkrebspatientinnen—Validierung der Kurzform des Progredienzangstfragebogens PA-F-KF. Z Psychosom Med Psychother 52:274–288PubMed
31.
go back to reference Mehnert A, Lehmann C, Cao P, Koch U (2006) Die Erfassung psychosozialer Belastungen und Ressourcen in der Onkologie—Ein Literaturüberblick zu Screeningmethoden und Entwicklungstrends. Psychother Psychosom Med Psychol 56(12):462–479. doi:10.1055/s-2006-951828 CrossRefPubMed Mehnert A, Lehmann C, Cao P, Koch U (2006) Die Erfassung psychosozialer Belastungen und Ressourcen in der Onkologie—Ein Literaturüberblick zu Screeningmethoden und Entwicklungstrends. Psychother Psychosom Med Psychol 56(12):462–479. doi:10.​1055/​s-2006-951828 CrossRefPubMed
32.
go back to reference Mehnert A, Lehmann C, Schulte T, Koch U (2007) Presence of symptom distress and prostate cancer-related anxiety in patients at the beginning of cancer rehabilitation. Onkologie 30:551–556. doi:10.1159/000108578 CrossRefPubMed Mehnert A, Lehmann C, Schulte T, Koch U (2007) Presence of symptom distress and prostate cancer-related anxiety in patients at the beginning of cancer rehabilitation. Onkologie 30:551–556. doi:10.​1159/​000108578 CrossRefPubMed
33.
go back to reference Mehnert A, Müller D, Lehmann C, Koch U (2006) Die deutsche version desNCCN distress-thermometers. Empirische Prüfung eines Screening-Instruments zur Erfassung psychosozialer Belastung bei Krebspatienten. ZPPP 53(3):213–223 Mehnert A, Müller D, Lehmann C, Koch U (2006) Die deutsche version desNCCN distress-thermometers. Empirische Prüfung eines Screening-Instruments zur Erfassung psychosozialer Belastung bei Krebspatienten. ZPPP 53(3):213–223
35.
go back to reference Morasso G, Costantini M, Baracco G, Borreani C, Capelli M (1996) Assessing psychological distress in cancer patients: validation of a self-administered questionnaire. Oncology 53(4):295–302CrossRefPubMed Morasso G, Costantini M, Baracco G, Borreani C, Capelli M (1996) Assessing psychological distress in cancer patients: validation of a self-administered questionnaire. Oncology 53(4):295–302CrossRefPubMed
36.
go back to reference Mystakidou K, Tsilika E, Parpa E, Smyrniotis V, Galanos A, Vlahos L (2007) Beck Depression Inventory: exploring its psychometric properties in a palliative care population of advanced cancer patients. Eur J Cancer Care (Engl) 16(3):244–250. doi:10.1111/j.1365-2354.2006.00728.x CrossRef Mystakidou K, Tsilika E, Parpa E, Smyrniotis V, Galanos A, Vlahos L (2007) Beck Depression Inventory: exploring its psychometric properties in a palliative care population of advanced cancer patients. Eur J Cancer Care (Engl) 16(3):244–250. doi:10.​1111/​j.​1365-2354.​2006.​00728.​x CrossRef
37.
40.
go back to reference Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Cancer 88(225):236 Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Cancer 88(225):236
43.
go back to reference Shapiro P, Coyne J, Kruss L, Palmers S, Vaugh D, Malkowicz B (2003) Interest in services among prostate cancer patients receiving androgen deprivation therapy. Psychooncology 13(8):512–525. doi:10.1002/pon.769 Shapiro P, Coyne J, Kruss L, Palmers S, Vaugh D, Malkowicz B (2003) Interest in services among prostate cancer patients receiving androgen deprivation therapy. Psychooncology 13(8):512–525. doi:10.​1002/​pon.​769
45.
46.
go back to reference Snyder CF, Dy SM, Hendricks DE et al (2007) Asking the right questions: investigating needs assessments and health-related quality-of-life questionnaires for use in oncology clinical practice. Support Care Cancer 15:1075–1085. doi:10.1007/s00520-007-0223-1 CrossRefPubMed Snyder CF, Dy SM, Hendricks DE et al (2007) Asking the right questions: investigating needs assessments and health-related quality-of-life questionnaires for use in oncology clinical practice. Support Care Cancer 15:1075–1085. doi:10.​1007/​s00520-007-0223-1 CrossRefPubMed
47.
go back to reference Spielberger CD, Gorsuch R, Lushene R (1970) Manual for the State-Trait Anxiety Inventory (self-evaluation questionnaire). Consulting Psychologists Press, Palo Alto, CA Spielberger CD, Gorsuch R, Lushene R (1970) Manual for the State-Trait Anxiety Inventory (self-evaluation questionnaire). Consulting Psychologists Press, Palo Alto, CA
49.
go back to reference Stevens A, Gillam S (1998) Needs assessment: from theory to practice. BMJ 316:1448–1452PubMed Stevens A, Gillam S (1998) Needs assessment: from theory to practice. BMJ 316:1448–1452PubMed
53.
55.
go back to reference Wright J, Williams R, Wilkinson R (1998) Development and importance of health needs assessment. BMJ 316:1310–1313PubMed Wright J, Williams R, Wilkinson R (1998) Development and importance of health needs assessment. BMJ 316:1310–1313PubMed
Metadata
Title
Determinants and implications of cancer patients’ psychosocial needs
Authors
N. Ernstmann
M. Neumann
O. Ommen
M. Galushko
M. Wirtz
R. Voltz
M. Hallek
H. Pfaff
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 11/2009
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0605-7

Other articles of this Issue 11/2009

Supportive Care in Cancer 11/2009 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine