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Identifying patients psychological needs in oncology consultations: an exploration of rates of discussion and patterns of referral
  1. L Warrington and
  2. G Velikova
  1. Psychosocial Oncology and Clinical Practice Research Group, St James' University Hospital, Leeds, UK

Abstract

Background High levels of emotional distress are common in cancer patients but oncologists often report feeling ill-equipped to discuss these issues. Little information exists on the discussion of depression and anxiety within consultations and how further support is offered.

Aims The current study aims to determine the frequency of discussion of depression and anxiety within consultations and how often referrals and prescriptions are offered and made.

Method 28 oncologists and 286 cancer patients were recruited to a randomized controlled trial examining the effects of the regular collection and use of health-related quality-of-life data in oncology practice on process of care and patient well-being. Each patient was recorded at four consecutive consultations, which were then analysed using content analysis. Descriptive data relating to the discussion of depression and anxiety and the offer and uptake of referrals and prescriptions was then extracted using SPSS version 16.0.

Results Depression and anxiety was discussed with 17.5% of patients in at least one of the four consultations. Referrals were offered to 6.6% and made for 1.4% of patients.1.7% mentioned ongoing psychosocial care. Prescriptions were offered to 3.5% and made for 1.4% of patients. 4.9% mentioned ongoing psychotropic medications. 42% of patients who discussed depression or anxiety with their doctors were not offered any further support.

Conclusion Depression and anxiety are not routinely discussed in oncology consultations and if discussed; patients are not always offered further support. Oncologists could benefit from a clear pathway of how to manage distress and make patients aware of support available.

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