Need for Supportive Counselling – the Professionals’ versus the Patients’ Perspective

Abstract

Background: The aim of the study was to identify melanoma patients who suffered significant distress and were judged to be in need of supportive counselling, on the one hand, and, on the other, to investigate patient interest in such support. Methods: Out of 236 melanoma patients, who constitute a representative sample of melanoma patients in Western Austria, 215 patients participated in the study and were assessed with regard to psychosocial distress, coping strategies, social networks and interest in receiving psychosocial support. Multiple logistic regression analyses were performed with regard to patient interest in receiving psychosocial support either from the attending oncologist or from a mental health professional. Results: 65 patients (30.2%) experienced moderate and 30 patients (14.0%) severe distress, which was predominantly caused by tumour-related fears, tension and disturbance of emotional well-being. 83% of the severely distressed patients wanted psychosocial support from their oncologists, whereas only half of them were interested in additional support from a psychotherapist. In particular, patients who showed fear of tumour progression and felt that they were insufficiently informed about their disease preferred to consult their dermatologist for psychosocial support. On the other hand, patients with poor prognosis, receiving only low levels of support from their social network, and exhibiting a depressive coping style, showed interest in getting supplementary support from a psychotherapist. Conclusions: These findings underline the importance of educating oncologists with a view both to improve their communication skills and to help them identify patients making poor adjustment to illness in order to offer them appropriate emotional support.

Psychosocial Care Needs of Melanoma Survivors: Are They Being Met?

“…As the multivariate approach shows, compared to those without a need, patients who were identified as in need for psychosocial support are characterised by younger age (< 50), higher general fatigue (MFI), higher symptom burden (EORTC), lower general health (EORTC), suffering from detrimental interactions (ISSS), a denial/self-blaming coping style (Brief COPE) and a lack of illness related information; the coping style variable had the highest odds ratio. These findings are in concordance with other psychooncological studies [ 10 , 13 , 14 , 17 , 18 , 19 , 20 ]. The above mentioned variables might be used as indicators for offering and referring to psychooncologic support and a trigger for referrals.…”

“…Insufficient physician support [ 15 ], low social support [ 15 ] and detrimental interactions with others [ 14 ] were also determinants of care needs. High symptom burden, low quality of life [ 14 ], fatigue [ 17 ], an avoidant [ 17 ] or depressive coping style [ 19 , 20 ] were additionally associated with a need for care. The same was true for fear of progression [ 15 , 19 , 20 ], higher psychosocial burden, comorbid depression or anxiety and the feeling of being insufficiently informed about the illness and supportive institutions [ 19 , 20 ].…”

Depression but Not Anxiety Is a Significant Predictor of Physicians’ Assessments of Medical Status in Physically Ill Patients

“…Second, medical comorbidity might complicate the accurate assessment of depression. Even experienced internists occasionally have diagnostic difficulties in assigning the patient’s symptoms to an underlying psychosomatic etiology [1, 3, 4, 25, 27, 28, 29, 30, 31, 32, 33, 34, 35, 43, 44]. The internists participating in our study were not trained to interpret the psychological meanings of each somatic complaint and to inquire accurately into such symptoms.…”

Nonmelanoma Skin Cancer: Disease-Specific Quality-of-Life Concerns and Distress

“…Such research is important because treatment of NMSC often results in scars or physical disfigurement, which are experienced as particularly disturbing when occurring in the head and neck region. Patients with tumors on conspicuous areas of the body have reported higher levels of distress (Söllner, Zingg-Schir, Rumpold, Mairinger, & Fritsch, 1998) and, depending on the degree of physical disfigurement, treatment can result in psychosocial, sexual, and marital difficulties (Chren et al, 2007;Rhee, Matthews, Neuburg, Burzynski, & Nattinger, 2005).…”