Experiences with a specific screening instrument to identify psychosocial support needs in breast cancer patients

Siedentopf, Friederike; Marten-Mittag, Birgitt; Utz-Billing, Isabell; Schoenegg, Winfried; Kentenich, Heribert; Dinkel, Andreas

doi:10.1016/j.ejogrb.2009.10.014

« Previous Next »European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 148, Issue 2 , Pages 166-171, February 2010

Experiences with a specific screening instrument to identify psychosocial support needs in breast cancer patients

Friederike Siedentopf
- DRK Kliniken Berlin-Westend, Womens’ Hospital, Spandauer Damm 130, D-14050 Berlin, Germany
- Corresponding author at: Women's Hospital, DRK-Kliniken Westend, Breast Unit, Spandauer Damm 130, D-14050 Berlin, Germany. Tel.: +49 3035 4924; fax: +49 3035 5929.
Birgitt Marten-Mittag
- Division of Psychosocial Oncology, Department for Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Langerstr. 3, D-81675 München, Germany
Isabell Utz-Billing
- DRK Kliniken Berlin-Westend, Womens’ Hospital, Spandauer Damm 130, D-14050 Berlin, Germany
Winfried Schoenegg
- DRK Kliniken Berlin-Westend, Womens’ Hospital, Spandauer Damm 130, D-14050 Berlin, Germany
Heribert Kentenich
- DRK Kliniken Berlin-Westend, Womens’ Hospital, Spandauer Damm 130, D-14050 Berlin, Germany
Andreas Dinkel
- Division of Psychosocial Oncology, Department for Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Langerstr. 3, D-81675 München, Germany

Received 31 July 2008; received in revised form 31 August 2009; accepted 14 October 2009. published online 05 November 2009.

Abstract

Objective

In order to determine the need for professional psychosocial support in breast cancer patients, we used the physician-administered Basic Documentation for Psycho-Oncology (PO-Bado), which is an expert rating scale containing 12 items belonging to somatic and psychological problems. Furthermore, we investigated sociodemographic and medical predictors of somatic and psychological distress and need for psychosocial support.

Study design

From 2/2005 to 09/2007, n=333 consecutive patients with breast cancer were included in the study. The majority of the patients suffered from early-stage breast cancer. The mean age of the participants was 59.9 years (SD=12.6, range 24–92). Two physicians rated patients’ psychosocial distress and evaluated their need for psychosocial support according to the PO-Bado guidelines.

Results

Exhaustion/tiredness was the item rated highest in the physical distress dimension. In the psychological distress dimension, the items anxiety/worries/tension and grief/despondency/depression obtained the highest mean. Younger age and a history of psychiatric/psychotherapeutic treatment in the past were associated with higher current distress. Women who planned to undergo mastectomy were rated as showing more somatic distress than women for whom breast conserving therapy was planned, but the two groups did not differ with regard to psychological distress. Objective cancer-related variables (tumour size and grading) were not associated with distress. Need for professional psychosocial support was seen in 23% of the patients. Previous psychiatric/psychotherapeutic treatment was the only variable associated with current need for psychosocial support. Forty-six percent of the patients with need for psychosocial support accepted the counselling offered.

Conclusions

The structured assessment of breast cancer patients’ psychosocial distress with the interviewer-administered PO-Bado assists the physician to arrive at a detailed expert evaluation. This might help to improve the psychosocial care of breast cancer patients.

Keywords: Physician-administered interview, Psychosocial distress, Distress screening, Need for psychosocial support, Breast cancer