Comprehensive Cancer Center, Munich, Germany.
Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
Psychooncology. 2019 Oct;28(10):2049-2059. doi: 10.1002/pon.5191. Epub 2019 Aug 16.
Many distressed cancer patients do not want or, finally, do not use psychological support. This study aimed at identifying factors associated with the decline of psychological support during hospital stay.
This cross-sectional study included inpatients with different cancer diagnoses. Distress was assessed using the short form of the Questionnaire on Stress in Cancer Patients-Revised (QSC-R10) and the Distress Thermometer (DT). Multivariable logistic regression was used to identify factors associated with decline.
Of 925 patients, 71.6% (n = 662) declined psychological support. Male sex (OR = 2.54, 95% CI = 1.69-3.80), low psychosocial distress (OR = 3.76, CI = 2.50-5.67), not feeling depressed (OR = 1.93, CI = 1.24-2.99), perceived overload (OR = 3.37, CI = 2.19-5.20), no previous psychological treatment (OR = 1.88, CI = 1.25-2.83), and feeling well informed about psychological support (OR = 1.66, CI = 1.11-2.46) were associated with decline. Among the patients who indicated clinical distress (46.2%), 53.9% declined psychological support. Male sex (OR = 2.96, CI = 1.71-5.12), not feeling depressed (OR = 1.87, CI = 1.12-3.14), perceived overload (OR = 5.37, CI = 3.07-9.37), agreeableness (OR = 0.70, CI = 0.51-0.95), and feeling well informed about psychological support (OR = 1.81, CI = 1.07-3.07) were uniquely associated with decline in this subgroup.
Decline of psychological support is primarily due to psychological factors. Feeling well informed about support emerged as a relevant factor associated with decline. Thus, design of informational material and education about available psychological services seem crucial.
许多痛苦的癌症患者不想要或最终不使用心理支持。本研究旨在确定与住院期间心理支持下降相关的因素。
本横断面研究纳入了不同癌症诊断的住院患者。使用癌症患者应激修订版问卷（QSC-R10）短表和应激温度计（DT）评估痛苦。采用多变量逻辑回归确定与下降相关的因素。
在 925 名患者中，71.6%（n=662）拒绝心理支持。男性（OR=2.54，95%CI=1.69-3.80）、低心理社会困扰（OR=3.76，CI=2.50-5.67）、不感到抑郁（OR=1.93，CI=1.24-2.99）、感知负担过重（OR=3.37，CI=2.19-5.20）、无既往心理治疗（OR=1.88，CI=1.25-2.83）和对心理支持了解良好（OR=1.66，CI=1.11-2.46）与下降相关。在有临床痛苦的患者中（46.2%），53.9%拒绝心理支持。男性（OR=2.96，CI=1.71-5.12）、不感到抑郁（OR=1.87，CI=1.12-3.14）、感知负担过重（OR=5.37，CI=3.07-9.37）、宜人性（OR=0.70，CI=0.51-0.95）和对心理支持了解良好（OR=1.81，CI=1.07-3.07）与该亚组的下降相关。
心理支持的下降主要是由于心理因素。对支持的了解是与下降相关的一个相关因素。因此，设计信息材料和宣传可用的心理服务似乎至关重要。
