Psychological distress in patients attending an oncology clinic after definitive treatment for maxillofacial malignant neoplasia

Abstract

Although management of malignant tumours of the mouth and salivary glands generally involves joint consultation with radiotherapists in dedicated oncology clinics, patients' preferences or psychological needs in this environment have not been investigated prospectively, particularly for those on long-term review after treatment. In this prospective study, therefore, psychometric data were collected from a series of 40 consecutive review patients by questionnaires completed on the day of consultation. The following established psychometric tests were used: the Hospital Anxiety and Depression Scale and the General Health Questionnaire. Patients' reactions to duration of consultation, advice given, opportunity to ask questions, and number of staff present were also investigated by a standard structured questionnaire. Forty-seven per cent of patients exhibited symptoms of psychiatric disturbance; 33% were anxious, and 15% were depressed, preoccupation with physical symptoms being the most frequent problem. Explanations of continuing physical symptoms were particularly highly valued because these were often wrongly interpreted by the patients as evidence of recurrence. No patient objected to the presence of students and only one to the presence of more than 10 members of staff. However, 18% requested one-to-one discussion in addition.