title: Psychosocial difficulties, deprivation and cancer: three questionnaire studies involving 609 cancer patients.
abstract: The aim of the study is to investigate associations between deprivation and self-reported social difficulties and psychological distress in cancer patients. A total of 304 men and 305 women (age range 18-88 years) with a range of cancer diagnoses and living in a socially diverse region (Carstairs and Morris index) completed the Hospital Anxiety and Depression Scale and the Social Difficulties Inventory. Univariate analyses of variance revealed statistically significant differences in reported social difficulties between groups (F (67, 576)=2.4, P<0.0001) with stage of disease (F (5, 576)=7.6, P<0.0001), age (F (2, 576)=4.8, P=0.009) and to a lesser extent deprivation (F (1, 576)=4.0, P=0.048) making significant contributions. Significantly more social difficulties were reported by less affluent patients with locally recurrent disease or 'survivors'. No other interactions were found. Significant differences in levels of reported psychological distress were found between groups (F (67, 575)=1.723, P=0.001) for stage of disease, sex and deprivation but no interactions observed. In conclusion, deprivation is associated with reported psychological distress and, to a lesser extent, social difficulties. Patients at particular risk cannot be identified with confidence by socio-demographic and clinical means supporting the recommendation from National Institute for Clinical Excellence for provision of psychosocial assessment for individual cancer patients.
authors.affiliation: Psychosocial and Clinical Practice Research Group, Cancer Research UK Clinical Centre in Leeds, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK. medepw@cancermed.leeds.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Wright
authors.forename: A
authors.initials: A
authors.lastname: Smith
authors.forename: L
authors.initials: L
authors.lastname: Booth
authors.forename: A
authors.initials: A
authors.lastname: Winterbottom
authors.forename: M
authors.initials: M
authors.lastname: Kiely
authors.forename: G
authors.initials: G
authors.lastname: Velikova
authors.forename: P
authors.initials: P
authors.lastname: Selby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D011610:Psychosocial Deprivation; D012931:Social Environment; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires