Frequencies and Predictors of Health Psychology Referrals after Integrative Oncology Consultation

Abstract

Objective: Health psychology (HP) plays a critical role within a multidisciplinary, integrative oncology team. HP provides coping tools, helping patients engage in healthy lifestyle. HP in integrative oncology is not well established and criteria for referral has not been examined. This study examined characteristics of referral to HP. Methods: A retrospective chart review of 1827 patients seen for consultation in the IMC between January 1st, 2019 and January 13th, 2020 was conducted. Patient assessments included the Edmonton Symptom Assessment Scale, Measure Yourself Concerns and Well-being, and PROMIS-10. 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. Results: Referred patients were mostly female (85.4%), White (67.1%), married/partnered (67.7%), obese (42.1%), with breast cancer (52.2%). Compared to those not referred, patients referred to HP were significantly more likely to be female, younger, Black, and had a higher BMI (p ≤ .01). Referred patients reported worse fatigue, sleep, depression, anxiety, well-being, spiritual pain, financial distress, memory, and 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 as their concerns (p ≤ .01). Conclusions: Patient characteristics are well-suited treatment targets for HP, including addressing emotional distress, healthy lifestyle, and quality of life. Our findings can help cancer programs develop strategies to facilitate engagement with psychological counseling.