Single-institution cross-sectional study to evaluate need for information and need for referral to psychooncology care in association with depression in brain tumor patients and their family caregivers

Abstract

Background: The prognosis of patients with brain tumors is widely varying. Psychooncologic need and depression are high among these patients and their family caregivers. However, the need for counselling and need for referral to psychooncology care is often underestimated.

Methods: We performed a single-institution cross-sectional study to evaluate psychooncologic need, depression and information need in both patients and their family caregivers. The Hornheider Screening Instrument (HSI) and the Patient Health Questionnaire (PHQ-9) were used to evaluate psychooncologic need and depression, and a study-specific questionnaire was developed to evaluate information need. Multivariable analyses were performed to detect correlations.

Results: A total of 444 patients and their family caregivers were approached to participate, with a survey completion rate of 35.4%. More than half of the patients and family caregivers were in need for referral to psychooncology care and 31.9% of patients suffered from clinically relevant depression. In multivariable analysis, psychooncologic need were positively associated with mild (odds ratio, OR, 7.077; 95% confidence interval, CI, 2.263-22.137; p = 0.001) or moderate to severe (OR 149.27, 95% CI 26.690-737.20; p < 0.001) depression. Patient information need was associated with depression (OR 3.007, 95% CI 1.175-7.695; p = 0.022).

Conclusions: Unmet counselling need in brain tumor patients and their family caregivers associate to high psychooncologic need and depression. Adequate information may decrease the need for referral to psychooncology care and treatment of depression in these patients. Future studies should further explore these relations to promote development of supportive structures.

Keywords: Brain tumor; Depression; Family caregiver; Information need; Need for referral to psychooncology care; Patient; Psychooncologic need.

Fig. 1

Impact of patient characteristics on depression, psychooncologic need, and information need. a: Multivariable binary logistic regression analysis of depression, showing the odds ratios of mild to severe vs no to minimal depression in relation to psychooncologic need, low information status, high WHO grade, high education level, higher age and female sex. A mild to severe depression relates significantly to a higher psychooncologic need. b: Multivariable binary logistic regression analysis of psychooncologic need, showing the odds ratios of psychooncologic need in relation to mild to severe depression, low information status, high WHO grade, high education level, higher age and female sex . A higher psychooncologic need relates significantly to a mild to sever depression. c: Multivariable binary logistic regression analysis of information need, showing the odds ratios of information need in relation to mild to severe depression, low information status, high WHO grade, high education level, higher age and female sex. Higher information need relates significantly to a mild to severe depression