Resumen de Differences in distress severity among oncology patients treated by a consultation–liaison service. A five-year survey in Germany
Juan Valdés Stauber, S. Bachthaler
Background and objectives Cancer diagnosis commonly causes distress. There are associations between distress levels and clinical and psychosocial variables, but they are not necessarily dependent on cancer type. We assessed whether distress in hospitalised oncology patients treated by a consultation–liaison service (CLS) varied with oncological diagnosis or sociodemographic, clinical and care variables.
Methods A naturalistic, retrospective survey of all cancer patients (N = 2864) treated by a CLS over a five-year period (2012–2016). Data were collected using standardised documents. Differences were analysed using bivariate regression. Multivariate linear regression and logistic regression respectively were used to assess associations between distress as a continuous (0–10) or dichotomous variable (0–4 vs. 5–10) and clinical and care variables.
Results Bivariate tests showed that the following characteristics were associated with higher distress levels: female (68.5%); foreign (7.9%); psychiatric comorbidity (18.9%); electively referral (23.6%); two or more interventions (20.7%); psychotherapeutic (35.3%) or psychopharmacological (5.4%) interventions; post-discharge treatment recommendation (23.3%). Level of functioning (Eastern Cooperative Oncology Group Scale-ECOG), number of contacts and cumulative treatment time were positively associated with distress, unlike age. Patients with gynaecological, lung, otorhinolaryngological and brain cancers had higher distress levels. Multivariate linear regression largely confirmed the bivariate results. Logistic regression demonstrated that a dichotomous distress variable did not differentiate between cancer types.
Conclusions Distress is less strongly related to cancer type than other clinical factors, e.g. psychiatric comorbidity, autonomy. Highly distressed patients should receive more intensive CLS care, irrespective of specific diagnosis. The positive association between elective referral and distress indicates that the CLS referral process works well.
