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Multicenter Study
. 2018 Oct 4;13(10):e0205160.
doi: 10.1371/journal.pone.0205160. eCollection 2018.

Doctor's recommendations for psychosocial care: Frequency and predictors of recommendations and referrals

Jochen Ernst  1 , Hermann Faller  2 , Uwe Koch  3 , Elmar Brähler  1   4 , Martin Härter  3 , Holger Schulz  3 , Joachim Weis  5 , Norbert Köhler  6 , Andreas Hinz  1 , Anja Mehnert  1
Affiliations
Multicenter Study

Doctor's recommendations for psychosocial care: Frequency and predictors of recommendations and referrals

Jochen Ernst et al. PLoS One. .

Abstract

Background: A significant number of oncological patients are heavily burdened by psychosocial stress. Doctors recommending or referring their patients to psycho-oncologists in the course of routine consultations can positively influence psycho-oncological care. The aim of this study was to analyze the frequency and predictors of such recommendations and to examine the use of these services by patients.

Methods: 4,020 cancer patients (mean age 58 years; 51% women) were evaluated in a multicenter, cross-sectional study in Germany. Data was gathered about doctors' referral practices, patients' utilization of psycho-oncological care services, and disease-related symptoms. The PHQ-9 depression scale and the GAD-7 anxiety scale were used to measure psychological burden. Descriptive data analysis was conducted on the basis of subgroup comparisons and multivariable analysis was done using binary logistical regression.

Results: 21.9% of the respondents reported having been given a recommendation or referral for psycho-oncological care by a doctor within the course of their cancer diagnosis and treatment. This comprises 29.5% of the patients identified by screening as being psychologically burdened. Nearly half of the patients who received a recommendation or referral (49.8%) acted on it. Predictors for seeking out psycho-oncological care included: patient desire (OR = 2.0), previous experience with psycho-oncological care (OR = 1.59), and female gender (OR = 1.57). Multivariable analysis indicated that patients' level of psychological burden (depression, anxiety) had no effect on whether doctors gave them a recommendation or referral.

Conclusions: Along with examining the degree to which patients are burdened (e.g. using screening instruments), determining whether or not patients would like to receive psycho-oncological care is an important aspect of improving referral practices and, by extension, will allow important progress in the field of psycho-oncological care to be made.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Recommendations or referrals given for psychosocial support services, and utilization of those services (n = 3,725).
See this image and copyright information in PMC

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