Development of a screening tool for the identification of psychooncological treatment need in breast cancer patients

Abstract

Objective: In breast cancer patients the diagnosis, treatment and aftercare of the physical disease cause a large amount of psychosocial distress, which can have a variety of negative consequences on patients' physical and mental well-being. Although about one-third of the patients show heightened psychosocial distress that may require psychooncological interventions its detection in daily clinical routine is poor and referral to mental health professionals is insufficient. The aim of the study was to develop a short screening tool for the detection of need for psychooncological treatment (POT) in breast cancer patients.Methods: Over a period of six months, 115 breast cancer outpatients attending the Department of Gynaecology at Innsbruck Medical University were consecutively included in the study. Logistic regression analysis and ROC analyses were used to identify the most predictive item set from a set of questionnaires (EORTC-QLQ-C30, HADS and Hornheide Screening Instrument) and other additional questions.Results: Data from 105 breast cancer patients (mean age 58.8, SD 12.3) were available for analysis. A logistic regression equation containing the EORTC-QLQ-C30 scales Emotional Functioning and Role Functioning as well as the yes-no question after psychiatric/ psychological/psychotherapeutic treatment at any point in lifetime showed highest predictive power with regard to need of POT (AUC 5 0.88; CI 95% 0.82-0.95). A pilot study (n 5 20) investigating applicability of a computerized version of this screening tool in oncological routine showed high acceptance and feasibility.Conclusion: The developed PO-screening tool showed high diagnostic accuracy regarding POT needs. The short assessment time and good usability of its computerized version allowed easy implementation in daily oncological routine.

Patient-Reported Outcome Monitoring in Brain Tumour Patients: Benefits and Requirements

“…Effective screening for psychosocial distress can be performed by means of PRO-instruments like the Hospital Anxiety and Depression Scale (HADS) (Zigmond & Snaith, 1983) or the General Health Questionnaire (GHQ-12) (Goldberg, 1972). Approximately 20-40 percent of cancer patients suffer from psychosocial distress and are therefore in need for referral to psychooncological treatment (Meraner et al, 2009 these patients, PROs contribute in the detection of needs for psychooncological treatment and therefore prevent further ailments. As a screening tool is supposed to offer a quick possibility to check for impairments that require treatment, cut-off scores are of major importance.…”

“…Next to treatment-related symptoms, cancer patients have also to deal with psychosocial distress triggered by the disease itself and anti-cancer therapy. Since the inadequate or missing treatment of psychosocial distress may confront the patient with further impairments, as they might develop chronic mental disorders, early detection of psychosocial distress is necessary (Meraner et al, 2009). Effective screening for psychosocial distress can be performed by means of PRO-instruments like the Hospital Anxiety and Depression Scale (HADS) (Zigmond & Snaith, 1983) or the General Health Questionnaire (GHQ-12) (Goldberg, 1972).…”

Surveying patients with smart devices

“…We considered three alternative tools for administering the questionnaire. The first one is CHES (Computer-based Health Evaluation System) [8], a tablet-based application where the users, using a stylus instead of a pen, enter their replies by performing the same actions required by the paper-based form (see Figure 1).…”

Message-Based Patient Guidance in Day-Hospital

“…CHES (Computer-based Health Evaluation System) is an innovative application used to collect data about the psychological and physical status of patients [11]. CHES allows the clinicians to submit to their patients standardized questionnaires, as that on the "Quality of Life" [12] and to automatically elaborate their answers into consistent indicators on their health status.…”