Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Klinikstrasse 3, Würzburg, Germany.
PLoS One. 2018 Oct 4;13(10):e0205160. doi: 10.1371/journal.pone.0205160. eCollection 2018.
A significant number of oncological patients are heavily burdened by psychosocial stress. Doctors recommending or referring their patients to psycho-oncologists in the course of routine consultations can positively influence psycho-oncological care. The aim of this study was to analyze the frequency and predictors of such recommendations and to examine the use of these services by patients.
4,020 cancer patients (mean age 58 years; 51% women) were evaluated in a multicenter, cross-sectional study in Germany. Data was gathered about doctors' referral practices, patients' utilization of psycho-oncological care services, and disease-related symptoms. The PHQ-9 depression scale and the GAD-7 anxiety scale were used to measure psychological burden. Descriptive data analysis was conducted on the basis of subgroup comparisons and multivariable analysis was done using binary logistical regression.
21.9% of the respondents reported having been given a recommendation or referral for psycho-oncological care by a doctor within the course of their cancer diagnosis and treatment. This comprises 29.5% of the patients identified by screening as being psychologically burdened. Nearly half of the patients who received a recommendation or referral (49.8%) acted on it. Predictors for seeking out psycho-oncological care included: patient desire (OR = 2.0), previous experience with psycho-oncological care (OR = 1.59), and female gender (OR = 1.57). Multivariable analysis indicated that patients' level of psychological burden (depression, anxiety) had no effect on whether doctors gave them a recommendation or referral.
Along with examining the degree to which patients are burdened (e.g. using screening instruments), determining whether or not patients would like to receive psycho-oncological care is an important aspect of improving referral practices and, by extension, will allow important progress in the field of psycho-oncological care to be made.
相当数量的肿瘤患者承受着沉重的心理社会压力。在常规会诊中，医生向肿瘤患者推荐或转介心理肿瘤医生，可以积极影响心理肿瘤学的护理。本研究旨在分析此类建议的频率和预测因素，并检查患者对这些服务的使用情况。
在德国的一项多中心、横断面研究中，对 4020 名癌症患者（平均年龄 58 岁；51%为女性）进行了评估。收集了医生转诊实践、患者利用心理肿瘤学护理服务以及与疾病相关的症状的数据。使用 PHQ-9 抑郁量表和 GAD-7 焦虑量表测量心理负担。基于亚组比较进行描述性数据分析，并使用二元逻辑回归进行多变量分析。
21.9%的受访者报告在癌症诊断和治疗过程中曾被医生推荐或转介接受心理肿瘤学护理。这包括通过筛查确定的心理负担患者的 29.5%。近一半（49.8%）收到推荐或转介的患者接受了治疗。寻求心理肿瘤学护理的预测因素包括：患者的意愿（OR=2.0）、以前接受过心理肿瘤学护理的经历（OR=1.59）和女性（OR=1.57）。多变量分析表明，患者的心理负担程度（抑郁、焦虑）对医生是否给予他们推荐或转介没有影响。
除了评估患者的负担程度（例如使用筛查工具）外，确定患者是否愿意接受心理肿瘤学护理也是改善转诊实践的一个重要方面，从而在心理肿瘤学护理领域取得重要进展。
