Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
Support Care Cancer. 2022 Aug;30(8):6963-6972. doi: 10.1007/s00520-022-07105-3. Epub 2022 May 12.
Health psychology (HP) plays a critical role within a multidisciplinary, integrative oncology team. HP in integrative oncology is not well established and criteria for referral have not been examined. This study examined characteristics of referral to HP.
A chart review of 1827 patients in the Integrative Medicine Center (IMC) between 2019 and 2020 was conducted. Patient assessments included the Edmonton Symptom Assessment Scale, Measure Yourself Concerns and Well-being, and PROMIS10. Chi-square tests were used to compare categorical variables, Mann-Whitney test for non-normally distributed continuous variables, and t-tests for normally distributed continuous variables comparing those referred and not referred to HP.
Patients referred (n = 316) were mostly female (85.4%), White (67.1%), married/partnered (67.7%), obese (42.1%), and with breast cancer (52.2%). When comparing the two groups, patients referred to HP and patients not referred to HP, patients referred had a higher proportion of female and Black patients than expected (p ≤ .01); patients referred were also younger and had higher BMIs (p ≤ .01). Referred patients reported worse fatigue, sleep, depression, anxiety, well-being, spiritual pain, financial distress, memory, overall mental health, physical health, and global health (p ≤ .01). Most common concerns of referrals were diet/nutrition, overall health, and stress/anxiety. Compared to non-referred, HP referrals were more likely to prioritize depression, spirituality, and stress/anxiety (p ≤ .01).
Patient characteristics are well-suited treatment targets for HP, including addressing emotional distress, healthy lifestyle, and quality of life. Our findings can help programs develop strategies to facilitate engagement with psychological counseling.
健康心理学（HP）在多学科、综合肿瘤团队中发挥着关键作用。综合肿瘤学中的 HP 尚未得到充分确立，也尚未检验转诊标准。本研究旨在探讨向 HP 转诊的特征。
对 2019 年至 2020 年期间综合医学中心（IMC）的 1827 名患者进行了图表审查。患者评估包括埃德蒙顿症状评估量表、自我评估关切和幸福感量表以及 PROMIS10。卡方检验用于比较分类变量，非正态分布连续变量采用 Mann-Whitney 检验，正态分布连续变量采用 t 检验，比较向 HP 转诊和未转诊的患者。
转诊患者（n = 316）主要为女性（85.4%）、白人（67.1%）、已婚/伴侣（67.7%）、肥胖（42.1%）和乳腺癌（52.2%）。比较两组患者，即向 HP 转诊和未向 HP 转诊的患者，向 HP 转诊的患者中女性和黑人患者的比例高于预期（p ≤.01）；转诊患者也更年轻，BMI 更高（p ≤.01）。转诊患者报告疲劳、睡眠、抑郁、焦虑、幸福感、精神痛苦、财务困境、记忆力、整体心理健康、身体健康和整体健康状况更差（p ≤.01）。转诊的最常见关注点是饮食/营养、整体健康和压力/焦虑。与未转诊者相比，HP 转诊者更有可能优先考虑抑郁、精神健康和压力/焦虑（p ≤.01）。
患者特征非常适合 HP 治疗，包括解决情绪困扰、健康生活方式和生活质量。我们的发现可以帮助项目制定策略，促进与心理咨询的接触。
