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Observational Study
. 2022 Mar;30(3):2327-2339.
doi: 10.1007/s00520-021-06620-z. Epub 2021 Nov 4.

Predictors for the utilization of social service counseling by prostate cancer patients

Clara Breidenbach  1 , Lena Ansmann  2 , Nora Tabea Sibert  3 , Simone Wesselmann  3 , Sebastian Dieng  4 , Ernst-Günther Carl  5 , Günter Feick  5 , Cindy Stoklossa  6   7 , Anne Taubert  6   7 , Amanda Pomery  8 , Burkhard Beyer  9 , Andreas Blana  10 , Marko Brock  11 , Florian Distler  12 , Michael Enge  13 , Amr A Gaber  14 , Christian Gilfrich  15 , Andreas Hinkel  16 , Björn Kaftan  17 , Thomas Knoll  18 , Frank Kunath  19 , Simba-Joshua Oostdam  20 , Inga Peters  21 , Bülent Polat  22 , Valentin Schrodi  23 , Friedemann Zengerling  24 , Christoph Kowalski  3
Affiliations
Observational Study

Predictors for the utilization of social service counseling by prostate cancer patients

Clara Breidenbach et al. Support Care Cancer. 2022 Mar.

Abstract

Purpose: Social service counseling (SSC) is an important instrument to support cancer patients, for example, regarding legal support, or rehabilitation. Several countries have established on-site SSC in routine care. Previous analyses have shown that SSC utilization varies across cancer centers. This analysis investigates patient and center-level predictors that explain variations in SSC utilization between centers.

Methods: Logistic multilevel analysis was performed with data from 19,865 prostate cancer patients from 102 prostate cancer centers in Germany and Switzerland. Data was collected within an observational study between July 2016 and June 2020 using survey (online and paper) and tumor documentation.

Results: The intraclass correlation coefficient for the null model implies that 51% of variance in SSC utilization is attributable to the center a patient is treated in. Patients aged 80 years and older, with higher education, private insurance, without comorbidities, localized intermediate risk, and undergoing androgen deprivation therapy before study inclusion were less likely to utilize SSC. Undergoing primary radiotherapy, active surveillance, or watchful waiting as compared to prostatectomy was associated with a lower likelihood of SSC utilization. Significant negative predictors at the center level were university hospital, center's location in Switzerland, and a short period of certification.

Conclusion: The results show that patient and center characteristics contribute to explaining the variance in SSC utilization in prostate cancer centers to a large extent. The findings may indicate different organizational processes in the countries included and barriers in the sectoral structure of the healthcare system. In-depth analyses of processes within cancer centers may provide further insights into the reasons for variance in SSC utilization.

Keywords: Oncology; Prostate cancer; Psychosocial needs; Social work; Supportive care.

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Conflict of interest statement

CB, NTS, SW, SD, and CK are employees of the two institutions in charge of the certification system. SJO reports personal fees from EUSA Pharma Inc. and medac GmbH outside the submitted work. FZ reports personal fees from Janssen Cilag GmbH, Bayer Vital GmbH, and Sanofi Aventis GmbH outside the submitted work. CK is treasurer of the German Society for Medical Sociology (unpaid) and member of the governing board of the European Public Health Association (unpaid). AT is board member of the Deutsche Vereinigung für Soziale Arbeit im Gesundheitswesen e. V. (unpaid). LA, EGC, GF, CS, AP, BB, AB, MB, FD, ME, AAG, CG, AH, BK, TK, FK, BP, VS, and IP declare no potential conflicts of interest.

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