Psychosocial distress among oncology patients in the safety net

Objective Psychosocial distress among cancer patients leads to poor health outcomes and lower satisfaction. However, little is known about psychosocial distress among disadvantaged populations. We examined the prevalence, predictors, and follow‐up experience of psychosocial distress among cancer pat...

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Bibliographic Details
Published in:Psycho-oncology (Chichester, England) England), 2020-11, Vol.29 (11), p.1927-1935
Main Authors: Cimino, Theora, Said, Kiana, Safier, Leslie, Harris, Heather, Kinderman, Anne
Format: Article
Language:English
Subjects:
Adult
Anxiety - etiology
Anxiety - psychology
Cancer
Cohort analysis
commission on cancer
Disadvantaged
Economic problems
Emotional disturbances
Female
Health status
Homeless people
Housing
Humans
Male
Mass Screening
Medical Oncology
Medical referrals
Medical screening
Medicine
Mental disorders
Middle Aged
Money
NCCN distress thermometer
Neoplasms - complications
Neoplasms - psychology
Neoplasms - rehabilitation
Oncology
Patients
Psychological distress
psychosocial distress
Psychosocial factors
Psychosocial well being
psycho‐oncology
Race
Referrals
Retrospective Studies
Safety
safety net
Severity
Sleep
Stress, Psychological - etiology
Stress, Psychological - psychology
Tests
Visual Analog Scale
vulnerable patient populations
Worry
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Summary:Objective Psychosocial distress among cancer patients leads to poor health outcomes and lower satisfaction. However, little is known about psychosocial distress among disadvantaged populations. We examined the prevalence, predictors, and follow‐up experience of psychosocial distress among cancer patients within a diverse, urban, and multi‐lingual safety‐net setting. Methods We conducted a retrospective cohort study of cancer patients undergoing psychosocial distress screening at initial medical oncology visits from 2014‐2016. The primary outcome was self‐reported moderate to severe psychosocial distress, defined by the NCCN as a Distress Thermometer score ≥ 4. Predictors of distress were assessed using logistic regression. Patients reporting distress were contacted by telephone 1‐12 months later to reassess distress and assess completion of supportive service referrals. Results Among 200 screened patients, 61% had moderate to severe psychosocial distress. African‐American race, psychiatric illness, greater number of emotional problems, and reported problems with housing, money, worry, sleep, memory or homelessness were associated with psychosocial distress. Among 39 patients with moderate to severe psychosocial distress who completed follow‐up (42% of eligible patients), mean distress scores decreased from 6.5 at screening to 4.5 at follow‐up (P
ISSN:1057-9249
1099-1611
DOI:10.1002/pon.5525