Background
Objectives
Methods
Setting description
Study sample
Expert rating instrument
Statistical analysis
Ethics
Results
N | Statistics for the whole sample | Differences breast cancer/bowel cancer | Differences cancer centres/ referred if needed | |
---|---|---|---|---|
F(p) r. X2(p) | F(p) r. X2(p) | |||
Sociodemographic characteristics
| ||||
Gender: proportion women | 290 | 82% | ||
Age
| 273 | M = 65; SD = 13.4 |
6.56 (0.011)
| 0.02 (0.902) |
Steady relationships:
| 285 | 64%/ 36% | 0.62 (0.735) | 0.17 (0.916) |
Couple/ single | ||||
Having children
| 279 | 78% | 0.04 (0.982) | 0.90 (0.636) |
Working situation:
| 290 | 23%/ 59%/ 17% | 6.06 (0.300) | 1.38 (0.926) |
Employed/retired/unemployed | ||||
Medical characteristics
| ||||
Diagnosis: Breast /bowel/gynaecological/ digestive/other | 290 | 48%/ 25%/ 10%/ 7%/ 10% | ||
Metastases:
| 290 | 30%/ 19%/ 51% |
22.4 (<0.001)
|
21.86 (<0.001)
|
Yes/no/not known | ||||
First diagnosis/recidive/2nd cancer | 279 | 84%/ 9%/ 7% | 8.08 (0.089) | 3.86 (0.425) |
Surgery
| 290 | 75% |
18.2 (<0.001)
|
23.9 (<0.001)
|
Chemotherapy
| 290 | 10% |
14.3 (<0.001)
| 3.25 (0.071) |
Radiotherapy
| 290 | 8% |
12.5 (<0.001)
| 0.13 (0.720) |
Performance status (Levels 0–4)
| 290 | 24%/ 33%/ 18%/ 18%/ 7% |
63.8 (<0.001)
|
24.25 (<0.001)
|
M =1.48; SD = 1.22 | ||||
Duration of illness (days) | 290 | M = 101; SD = 327 |
5.1 (0.024)
| 0.34 (0.314) |
Psychiatric/psychological treatment in past
| 276 | 14% | 2.53 (0.283) | 0.96 (0.618) |
Current treatment with psychotropic drugs
| 266 | 20% | 5.2 (0.075) |
16.9 (<0.001)
|
Additional serious disease: No/yes/no known | 290 | 30%/ 36%/ 34% | 4.02 (0.134) | 2.43 (0.297) |
Psychological distress
| ||||
Sum score psychological distress
| 290 | M =7.5; SD = 5.65 |
14.1 (<0.001)
|
34.52 (0.017)
|
Physical distress
| ||||
Sum score physical distress
| 290 | M =3.7; SD = 3.01 |
5.26 (0.022)
| 2.70 (0.100) |
Other distress factors
| ||||
Problems in family/ significant others
| 290 | 17% | 0.48 (0.488) | 0.34 (0.581) |
Economic/work-related problems
| 290 | 4.5% | 0.63 (0.425) | 0.08 (0.770) |
Additional stressful factors
| 290 | 3.4% | 0.11 (0.733) | 0.04 (0.842) |
Stressors unrelated to the illness
| 290 | 13% | 1.24 (0.265) | 1.71 (0.190) |
Indication
| ||||
Professional psychosocial support is indicated
| 290 | 30% | 0.02 (0.879) |
31.9 (<0.001)
|
Compared groups
| Comparison full survey in centres/ selectively referral | Comparison breast/ bowel centres | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Distress items
| Group | Degrees of severity (%) | Mean(SD) | ANOVA:F (p) R2
| Group | Degrees of severity (%) | Mean(SD) | ANOVA:F (p) | ||||
Sleep disturbances | To | 30 | 59 | 11 | 1.12 (1.00) | Ce | 32 | 60 | 8 | 1.02 (0.93) | ||
Ce | 32 | 60 | 8 | 1.02 (0.93) |
7.46 (0.007)
| Br | 32 | 61 | 7 | 0.99 (0.89) | 0.44 (0.507) | |
Re | 25 | 56 | 19 | 1.38 (1.14) | 0.03 | Bo | 32 | 57 | 11 | 1.08 (0.99) | ||
Mood swings | To | 22 | 59 | 19 | 1.37 (1.11) | Ce | 25 | 62 | 13 | 1.15 (0.99) | ||
Ce | 25 | 62 | 13 | 1.15 (0.99) |
33.08 (<0.001)
| Br | 22 | 67 | 11 | 1.13 (0.92) | 0.11 (0.740) | |
Re | 14 | 52 | 34 | 1.95 (1.22) | 0.10 | Bo | 30 | 54 | 16 | 1.18 (1.12) | ||
Cognitive impairment | To | 66 | 28 | 6 | 0.56 (0.95) | Ce | 70 | 26 | 3 | 0.45 (0.85) | ||
Ce | 70 | 26 | 3 | 0.45 (0.85) |
9.78 (0.002)
| Br | 75 | 23 | 2 | 0.36 (0.74) |
4.26 (0.042)
| |
Re | 54 | 34 | 11 | 0.84 (1.11) | 0.03 | Bo | 62 | 33 | 5 | 0.62 (1.02) | ||
Helplessness/ vulnerability | To | 52 | 40 | 8 | 0.80 (1.01) | Ce | 59 | 36 | 5 | 0.62 (0.89) | ||
Ce | 59 | 36 | 5 | 0.62 (0.89) |
26.7 (<0.001)
| Br | 59 | 38 | 3 | 0.58 (0.84) | 0.66 (0.417) | |
Re | 33 | 49 | 18 | 1.28 (1.15) | 0.08 | Bo | 57 | 34 | 8 | 0.68 (0.98) | ||
Anxiety/worry/ tension | To | 21 | 58 | 21 | 1.53 (1.20) | Ce | 23 | 62 | 16 | 1.33 (1.11) | ||
Ce | 23 | 62 | 16 | 1.33 (1.11) |
22.9 (<0.001)
| Br | 21 | 64 | 15 | 1.30 (1.06) | 0.24 (0.624) | |
Re | 15 | 47 | 38 | 2.06 (1.27) | 0.03 | Bo | 26 | 57 | 17 | 0.69 (0.98) | ||
Shame/loss of esteem | To | 78 | 20 | 2 | 0.27 (0.59) | Ce | 82 | 17 | 0.5 | 0.20 (0.50) | ||
Ce | 82 | 17 | 0.5 | 0.20 (0.50) |
9.7 (0.002)
| Br | 82 | 18 | 0 | 0.20 (0.45) | 0.001 (0.971) | |
Re | 67 | 30 | 3 | 0.44 (0.76) | 0.03 | Bo | 84 | 15 | 1 | 0.21 (0.58) | ||
Depression/grief | To | 28 | 51 | 20 | 1.40 (1.22) | Ce | 33 | 54 | 13 | 1.15 (1.10) | ||
Ce | 33 | 54 | 13 | 1.15 (1.10) |
35.2 (<0.001)
| Br | 33 | 55 | 12 | 1.12 (1.06) | 0.54 (0.463) | |
Re | 15 | 55 | 39 | 2.06 (1.30) | 0.11 | Bo | 33 | 52 | 15 | 1.23 (1.17) | ||
Fatigue | To | 21 | 67 | 12 | 1.24 (0.95) | Ce | 25 | 66 | 9 | 1.09 (0.87) | ||
Ce | 25 | 66 | 9 | 1.09 (0.87) |
20.8 (<0.001)
| Br | 28 | 66 | 6 | 0.97 (0.81) |
7.59 (0.006)
| |
Re | 11 | 68 | 20 | 1.64 (1.04) | 0.07 | Bo | 19 | 66 | 15 | 1.32 (0.95) | ||
Pain | To | 40 | 54 | 6 | 0.82 (0.88) | Ce | 45 | 53 | 2 | 0.70 (0.77) | ||
Ce | 45 | 53 | 2 | 0.70 (0.77) |
17.3 (<0.001)
| Br | 46 | 53 | 1 | 0.65 (0.69) | 1.81 (0.180) | |
Re | 27 | 58 | 15 | 1.16 (1.04) | 0.06 | Bo | 42 | 53 | 4 | 0.79 (0.89) | ||
Functional limitations | To | 37 | 48 | 15 | 1.13 (1.15) | Ce | 46 | 46 | 9 | 0.86 (1.01) | ||
Ce | 46 | 46 | 9 | 0.86 (1.01) |
52.3 (<0.001)
| Br | 56 | 40 | 4 | 0.63 (0.87) |
22.3 (<0.001)
| |
Re | 15 | 54 | 31 | 1.87 (1.20) | 0.15 | Bo | 26 | 57 | 17 | 1.29 (1.11) |
Dependent variables
| Mood swings | Cognitive impairment | Anxiety | Grief | Sleep disorders | Helplessness | Shame | Sum score psychological distress | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Regressors
| BETA | p | BETA | p | BETA | p | BETA | p | BETA | p | BETA | p | BETA | p | BETA | p |
1. Referral mode |
0.146
|
0.017
| 0.032 | 0.651 | 0.099 | 0.105 | 0.107 | 0.056 | 0.044 | 0.499 | 0.109 | 0.098 | 0.085 | 0.317 | 0.107 | 0.062 |
2. Age | −0.121 | 0.107 | 0.450 | 0.533 | −0.098 | 0.227 | −0.099 | 0.166 | 0.005 | 0.951 |
−0.151
|
0.040
| −0.113 | 0.252 | −0.129 | 0.051 |
3. Gender | 0.106 | 0.075 | −0.024 | 0.666 | 0.093 | 0.125 | 0.049 | 0.331 | 0.091 | 0.108 | 0.058 | 0.285 | 0.025 | 0.640 | 0.073 | 0.166 |
4. Steady relationships | −0.035 | 0.541 |
0.138
|
0.023
| −0.041 | 0.475 | −0.036 | 0.511 | −0.023 | 0.705 | −0.019 | 0.760 | 0.041 | 0.661 | 0.024 | 0.635 |
5. Working situation | 0.035 | 0.653 | −0.131 | 0.068 | −0.047 | 0.554 | −0.026 | 0.715 | −0.017 | 0.832 | 0.079 | 0.285 | −0.014 | 0.859 | −0.041 | 0.565 |
6. Having children | −0.004 | 0.935 | 0.030 | 0.598 | −0.030 | 0.540 | −0.052 | 0.291 | −0.085 | 0.104 | −0.021 | 0.648 | −0.002 | 0.968 | −0.056 | 0.196 |
7. Problems in family | −0.004 | 0.938 | −0.021 | 0.711 | −0.079 | 0.117 |
0.124
|
0.011
| 0.070 | 0.226 | 0.007 | 0.909 | −0.063 | 0.344 | −0.069 | 0.110 |
8. Fatigue |
0.202
|
0.001
|
0.230
|
0.000
|
0.212
|
0.001
|
0.349
|
0.000
|
0.276
|
0.000
|
0.178
|
0.008
|
0.156
|
0.010
|
0.299
|
0.000
|
9. Pain |
0.145
|
0.022
| 0.041 | 0.578 |
0.066
|
0.003
| 0.060 | 0,290 | 0.099 | 0.191 | 0.061 | 0.350 | 0.079 | 0.398 | 0.081 | 0.162 |
10. No metastases |
−0.273
|
0.000
| −0.023 | 0.716 |
−0.187
|
0.002
|
−0.155
|
0.007
| 0.051 | 0.429 |
−0.135
|
0.048
| 0.086 | 0.216 |
−0.042
|
0.007
|
11. Metastases status unknown |
−0.165
|
0.021
| −0.011 | 0.878 | −0.223 | 0.338 |
−0.167
|
0.011
| −0.026 | 0.730 | −0.115 | 0.139 | 0.108 | 0.165 | −0.146 | 0.030 |
12. Duration of illness | −0.072 | 0.181 | 0.167 | 0.076 | −0.054 | 0.177 | −0.001 | 0.995 | 0.069 | 0.249 | −0.007 | 0.902 | −0.046 | 0.394 | 0.036 | 0.540 |
13. Previous psych. treatment | −0.009 | 0.864 | −0.002 | 0.980 | −0.070 | 0.658 | −0.065 | 0.203 | 0.020 | 0.751 | −0.042 | 0.482 | −0.001 | 0.984 | −0.053 | 0.273 |
14. Performance status | −0.036 | 0.642 | 0.449 | 0.493 | −0.031 | 0.658 | 0.061 | 0.295 | 0.015 | 0.861 | −0.001 | 0.992 | −0.007 | 0.934 | 0.018 | 0.765 |
15. Functional limitations | 0.122 | 0.146 |
0.191
|
0.041
| 0.163 | 0.053 | 0.146 | 0.056 | 0.040 | 0.692 |
0.265
|
0.001
| 0.195 | 0.066 |
0.273
|
0.005
|
Constant
| 1.63 | 0.000 | 0.04 | 0.914 | 2.24 | 0.000 | 1.87 | 0.001 | 0.26 | 0.522 | 0.95 | 0.007 | 0.27 | 0.255 | 9.23 | 0.000 |
F/Prob > F
| 11.66/ <0.001 | 4.01/ <0.001 | 10.41/ <0.001 | 20.39/ <0.001 | 3.23/ <0.001 | 7.30/ <0.001 | 2.70/ <0.001 | 19.02/ <0.001 | ||||||||
R2
| 0.34 | 0.27 | 0.32 | 0.46 | 0.16 | 0.31 | 0.14 | 0.45 | ||||||||
N
| 273 | 273 | 273 | 273 | 273 | 273 | 273 | 273 |
Dep.variable: Further psychosocial support is indicated
| |||
---|---|---|---|
Regressors
| OR | p | 95% CI |
1. Referral mode
|
3.13
|
0.010
|
1.32; 7.42
|
2. Age
|
0.96
|
0.037
|
0.93; 0.99
|
3. Gender
|
3.76
|
0.018
|
1.25; 11.27
|
4. Steady relationships
| 0.62 | 0.289 | 0.26; 1.48 |
5. Working situation
| 0.94 | 0.913 | 0.35; 2.58 |
6. Having children
| 1.13 | 0.779 | 0.46; 2.78 |
7. Problems in family
|
2.73
|
0.026
|
1.13; 6.63
|
8. Fatigue
|
1.80
|
0.038
|
1.03; 3.14
|
9. Pain
| 0.78 | 0.411 | 0.44; 1.39 |
10. Sum score physical distress
| 1.38 | 0.068 | 0.97; 1.92 |
11. No metastases
| 0.34 | 0.063 | 0.11; 1.06 |
12. Metastases status unknown
| 1.56 | 0.305 | 0.66; 3.65 |
13. Duration of illness
| 1.00 | 0,434 | 0.99; 1.00 |
14. Prev. psychiatric. treatment
|
2.85
|
0.026
|
1.13; 7.16
|
15. Performance status
| 0.64 | 0.062 | 0.40; 1.02 |
16. Functional limitations
| 1.28 | 0.463 | 0.66; 2.50 |
Constant
| 0.24 | 0.365 | 0.0; 5.24 |
LR/Prob > Chi
2
| 115.54/<0.001 | ||
Pseudo R2
| 0.37 | ||
N
| 250 |