Health Psychology Section, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Psychooncology. 2011 Jun;20(6):655-63. doi: 10.1002/pon.1939. Epub 2011 Mar 6.
We evaluated screening for distress in terms of its ability to uncover unmet need for psychosocial services in cancer patients. Correlates of distress, need for services and met and unmet need for services were investigated.
Immediately after cancer treatment (T1) and 2 months later (T2), 302 patients completed the Hopkins Symptom Checklist-25 (HSCL-25) and a single question assessing the need for services. All distressed patients (HSCL-25≥39) and non-distressed patients endorsing a need for services were then called (n = 99) to assess their need.
Thirty-seven percent (T1) and 31% (T2) of patients were distressed and 31% (T1) and 18% (T2) expressed the need for services. Both time points showed higher distress in younger patients and females and lower distress in prostate cancer and patients treated by radiotherapy only. Less need for services was found in prostate cancer (T1), greater need was related to being single (T1) and younger (T2). Distress and need for services were positively related (p<0.001). The HSCL-25 showed modest sensitivity (T1: 0.59, T2: 0.65) and specificity (T1: 0.75, T2: 0.78) as an indicator of need for services. Interviews at T2 revealed that 51% of distressed patients needed no psychosocial services and 25% were already receiving services. At T2, regardless of distress level, 10% of all screened patients reported an unmet need for psychosocial services.
Depending on the clinical context, screening might be more efficient if it assessed the unmet need for services rather than distress. More attention should be concentrated on directing patients with meetable unmet needs to available services.
我们评估了在癌症患者中筛查痛苦的能力，以发现他们对心理社会服务的未满足需求。研究了痛苦、服务需求、已满足和未满足的服务需求的相关因素。
在癌症治疗后立即（T1）和 2 个月后（T2），302 名患者完成了霍普金斯症状清单-25（HSCL-25）和一个评估服务需求的单一问题。然后，所有痛苦的患者（HSCL-25≥39）和表示需要服务的非痛苦患者（n=99）都被打电话评估他们的需求。
37%（T1）和 31%（T2）的患者感到痛苦，31%（T1）和 18%（T2）的患者表示需要服务。两个时间点都显示年轻患者和女性患者的痛苦程度更高，前列腺癌和仅接受放疗的患者的痛苦程度更低。前列腺癌患者的服务需求较低（T1），单身（T1）和年轻（T2）的患者需求更大。痛苦和服务需求呈正相关（p<0.001）。HSCL-25 在指示服务需求方面显示出中等的敏感性（T1：0.59，T2：0.65）和特异性（T1：0.75，T2：0.78）。T2 时的访谈显示，51%的痛苦患者不需要心理社会服务，25%的患者已经在接受服务。在 T2，无论痛苦程度如何，10%的筛查患者报告有未满足的心理社会服务需求。
根据临床背景，如果筛查评估未满足的服务需求而不是痛苦，可能会更有效率。应更加关注将有可满足的未满足需求的患者引导到可用的服务中。
