Development of a screening tool for the identification of psychooncological treatment need in breast cancer patients.
OBJECTIVE
In breast cancer patients the diagnosis, treatment and aftercare of the physical disease cause a large amount of psychosocial distress, which can have a variety of negative consequences on patients' physical and mental well-being. Although about one-third of the patients show heightened psychosocial distress that may require psychooncological interventions its detection in daily clinical routine is poor and referral to mental health professionals is insufficient. The aim of the study was to develop a short screening tool for the detection of need for psychooncological treatment (POT) in breast cancer patients.


METHODS
Over a period of six months, 115 breast cancer outpatients attending the Department of Gynaecology at Innsbruck Medical University were consecutively included in the study. Logistic regression analysis and ROC analyses were used to identify the most predictive item set from a set of questionnaires (EORTC-QLQ-C30, HADS and Hornheide Screening Instrument) and other additional questions.


RESULTS
Data from 105 breast cancer patients (mean age 58.8, SD 12.3) were available for analysis. A logistic regression equation containing the EORTC-QLQ-C30 scales Emotional Functioning and Role Functioning as well as the yes-no question after psychiatric/psychological/psychotherapeutic treatment at any point in lifetime showed highest predictive power with regard to need of POT (AUC=0.88; CI 95% 0.82-0.95). A pilot study (n=20) investigating applicability of a computerized version of this screening tool in oncological routine showed high acceptance and feasibility.


CONCLUSIONS
The developed PO-screening tool showed high diagnostic accuracy regarding POT needs. The short assessment time and good usability of its computerized version allowed easy implementation in daily oncological routine.
Meraner
Verena
V
Department of Biological Psychiatry, Innsbruck Medical University, Innsbruck, Austria.
Giesinger
Johannes
J
Kemmler
Georg
G
Taucher
Susanne
S
Hubalek
Michael
M
Weber
Barbara
B
Rumpold
Gerhard
G
Sperner-Unterweger
Barbara
B
Holzner
Bernhard
B
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D020380:Needs Assessment; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010865:Pilot Projects; D011594:Psychometrics / Q000706:statistics & numerical data; D011613:Psychotherapy; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D012803:Sick Role; D012984:Software; D011795:Surveys and Questionnaires