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Focusing on cancer patients’ intentions to use psycho-oncological support: a longitudinal, mixed-methods study.

Focusing on cancer patients’ intentions to use psycho-oncological support: a longitudinal, mixed-methods study.
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Tondorf T, Grossert A, Rothschild SI, Koller MT, Rochlitz C, Kiss A, Schaefert R, Meinlschmidt G, Hunziker S, Zwahlen D,


Tondorf T, Grossert A, Rothschild SI, Koller MT, Rochlitz C, Kiss A, Schaefert R, Meinlschmidt G, Hunziker S, Zwahlen D, (click to view)

Tondorf T, Grossert A, Rothschild SI, Koller MT, Rochlitz C, Kiss A, Schaefert R, Meinlschmidt G, Hunziker S, Zwahlen D,

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Psycho-oncology 2018 04 15() doi 10.1002/pon.4735
Abstract
OBJECTIVE
Distress screening programs aim to ensure appropriate psycho-oncological support for cancer patients, but many eligible patients do not use these services. To improve distress management, we need to better understand patients’ supportive care needs. In this paper, we report the first key finding from a longitudinal study that focused on patients’ intentions to use psycho-oncological support, and its association with distress and uptake of the psycho-oncology service.

METHODS
We conducted a prospective, observational study in an Oncology Outpatient Clinic and assessed distress, intention to use psycho-oncological support, and uptake of the psycho-oncology service using the Distress Thermometer (DT), a semi-structured interview, and hospital records. We analyzed data with a mixed-methods approach.

RESULTS
Of 333 patients (mean age 61 years; 55% male; 54% DT≥5), 25% intended to use the psycho-oncology service (yes), 33% were ambivalent (maybe), and 42% reported no intention (no). Overall, 23% had attended the psycho-oncology service four months later. Ambivalent patients reported higher distress than patients with no intention (odds ratio (OR)=1.18, 95% confidence interval (CI)[1.06-1.32]) but showed significantly lower uptake behavior than patients with an intention (OR=14.04, 95%CI [6.74-29.24]). Qualitative analyses revealed that ambivalent patients (maybe) emphasized fears and uncertainties, while patients with clear intentions (yes/no) emphasized knowledge, attitudes, and coping concepts.

CONCLUSIONS
We identified a vulnerable group of ambivalent patients with high distress levels and low uptake behavior. To optimize distress screening programs, we suggest addressing and discussing patients’ supportive care needs in routine clinical practice.

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