Utilization of professional psychological care in a large German sample of cancer patients

Faller, Hermann; Weis, Joachim; Koch, Uwe; Brähler, Elmar; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Boehncke, Anna; Hund, Bianca; Reuter, Katrin; Richard, Matthias; Sehner, Susanne; Wittchen, Hans‐Ulrich; Mehnert, Anja

doi:10.1002/pon.4197

Cited by 91 publications

(123 citation statements)

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“…There is emerging evidence that the mental burden of cancer patients might be associated with increased health care utilization. Faller et al studied mental health care utilization in a sample of 4020 German cancer patients. Psychiatric disorder appeared to be a correlate of mental health care utilization (OR = 1.68) independently of symptoms of depression (OR = 1.04) and anxiety (OR = 1.08) .…”

Section: Introductionmentioning

confidence: 99%

“…Faller et al studied mental health care utilization in a sample of 4020 German cancer patients. Psychiatric disorder appeared to be a correlate of mental health care utilization (OR = 1.68) independently of symptoms of depression (OR = 1.04) and anxiety (OR = 1.08) . In addition, administrative data of 5055 heterogeneous‐cancer patients indicated that depression was associated with nonmental health care visits (OR = 1.76), emergency department visits (OR = 2.45), overnight hospitalization (OR = 1.81), and hospital readmission rates (OR = 2.03) .…”

Section: Introductionmentioning

confidence: 99%

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Exploring associations between psychiatric disorder, psychological distress, and health care utilization in cancer patients

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring associations between psychiatric disorder, psychological distress, and health care utilization in cancer patients

et al. 2018

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“…Similarly, positive attitudinal aspects, knowledge, and coping concepts were important for patients with an intention (yes). Attitudinal aspects and knowledge are relevant to support‐seeking behavior . Many of these patients had precise ideas of what they wanted and would get when asking for psychooncological support, which indicates that mental health literacy, knowledge, and patient empowerment is an important aspect for service use …”

Section: Discussionmentioning

confidence: 99%

Focusing on cancer patients' intentions to use psychooncological support: A longitudinal, mixed‐methods study

et al. 2018

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ObjectiveDistress screening programs aim to ensure appropriate psychooncological 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 psychooncological support and its association with distress and uptake of the psychooncology service.MethodsWe conducted a prospective, observational study in an Oncology Outpatient Clinic and assessed distress, intention to use psychooncological support, and uptake of the psychooncology service by using the Distress Thermometer, a semistructured interview, and hospital records. We analyzed data with a mixed‐methods approach.ResultsOf 333 patients (mean age 61 years; 55% male; 54% Distress Thermometer ≥ 5), 25% intended to use the psychooncology service (yes), 33% were ambivalent (maybe), and 42% reported no intention (no). Overall, 23% had attended the psychooncology service 4 months later. Ambivalent patients reported higher distress than patients with no intention (odds ratio = 1.18, 95% confidence interval [1.06‐1.32]) but showed significantly lower uptake behavior than patients with an intention (odds ratio = 14.04, 95% confidence interval [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.ConclusionsWe 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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“…The need for measures that address attitudes towards help‐seeking has been highlighted as attitudes appear to be central barriers to psychological care utilisation in the context of cancer (Faller et al, ; Tondorf et al, ). To investigate the role of attitudes towards help‐seeking of German cancer patients, we translated the ASHCa into German and tested its psychometric properties in a sample of patients with cancer.…”

Section: Discussionmentioning

confidence: 99%

“…On a socio‐demographic level, there may be a tendency for lower age and being female (Ellis et al, ; Faller et al, ; McDowell, Occhipinti, Ferguson, & Chambers, ; Zeissig et al, ) to be related with higher psychological care utilisation, but the current evidence on this is equivocal (Clover, Mitchell, Britton, & Carter, ; Tondorf et al, ). From patient self‐assessments, we know that low perceived social support (Ellis et al, ; Faller et al, ), high perceived need for help (Faller et al, ) and high distress (Clover, Kelly, Rogers, Britton, & Carter, ; Compen, Adang, Bisseling, van der Lee, & Speckens, ) are likely to be associated with higher care utilisation. When it comes to modifiable patient‐related variables, emotionally distressed individuals most frequently name attitudinal barriers as the reasons for not seeking psychosocial help (Andrade et al, ; Sareen et al, ).…”

Section: Introductionmentioning

confidence: 99%

Cancer patient utilisation of psychological care in Germany: The role of attitudes towards seeking help

et al. 2019

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Objective Even if significantly distressed, many patients with cancer do not seek psychological help. There is growing evidence that attitudes are central barriers for help‐seeking, and instruments to assess cancer patients’ attitudes towards help‐seeking are urgently needed. This study aimed to evaluate the German Attitudes towards Seeking Help after Cancer Scale (ASHCa‐G) and investigated the relationship between patients’ attitudes and psychological care utilisation. Methods The ASHCa‐G was presented to 270 patients with cancer (age 63.0 ± 12.7 years, 44.8% women). Item analyses, principal component analysis and associations with age, social support, help‐seeking intention and psychological care utilisation were calculated. A hierarchical logistic regression was performed to ascertain the leading role of attitudes in explaining psychological care utilisation. Results Principal component analysis supported a two‐component solution, which showed good internal consistency for the positive attitudes (α = 0.80) and negative attitudes (α = 0.75) subscales. The associations with age, distress and help‐seeking intention confirmed the validity of the ASHCa‐G. Positive attitudes explained most variance of cancer patients’ current psychological care utilisation. Conclusion The ASHCa‐G seems to be a reliable and valid questionnaire for assessing attitudes towards seeking psychological help among patients with cancer. Clinical practice might profit from identifying attitudinal barriers that hinder patients with cancer from seeking psychological help.

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Utilization of professional psychological care in a large German sample of cancer patients

Abstract: Special efforts should be made to reach populations that report low utilization of psychological care in spite of having a need for support.

Cited by 91 publications

References 40 publications

Exploring associations between psychiatric disorder, psychological distress, and health care utilization in cancer patients

Exploring associations between psychiatric disorder, psychological distress, and health care utilization in cancer patients

Focusing on cancer patients' intentions to use psychooncological support: A longitudinal, mixed‐methods study

Cancer patient utilisation of psychological care in Germany: The role of attitudes towards seeking help

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