title: Referral patterns and psychosocial distress in cancer patients accessing a psycho-oncology counseling service.
abstract: OBJECTIVE
  One in three cancer patients will experience significant psychosocial distress, yet less than 10% will seek formal counseling. Who are the patients accessing counseling and what are their presenting needs? The purpose of this study was to identify referral patterns and psychosocial distress in cancer patients newly referred to a psycho-oncology counseling service.
  
  
  METHODS
  Consecutive new referrals were tracked over 1 year (n=361). On initial visit, 145 patients completed a demographic survey, Brief Symptom Inventory-18 (BSI-18), Cancer Coping Questionnaire and Medical Outcomes Study Social Support Survey.
  
  
  RESULTS
  Approximately one in five newly referred patients never attended counseling, with a significant representation of men (p=0.016) and lung cancer patients (p=0.010). Of 361 referrals, 295 patients attended initial counseling, 259 were approached, and 145/259 (56%) completed the survey. Most were women (79%), urban-dwelling (73%), diagnosed with non-advanced cancer (72%), well-educated (68%) and married (56%); average age of 52 years (SD=12.3). Two most common diagnoses were breast (36%) and genitourinary (14%) cancers. A total of 59% were significantly distressed (BSI-18 global severity index T-score⩾63) with less available social support than non-distressed patients (p=0.022). Coping strategy use did not differ significantly between distressed and non-distressed groups. Two of five patients were not significantly distressed.
  
  
  CONCLUSIONS
  Most cancer patients attending counseling are well-educated urban residing women, with significant psychosocial distress. Further research is needed to better understand barriers and appropriate screening methods for accessing counseling, as well as the needs of men, advanced Copyright © 2010 John Wiley & Sons, Ltd.
authors.affiliation: Department of Oncology, University of Alberta, Edmonton, Alta., Canada. cheryl.nekolaichuk@covenanthealth.ca
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Nekolaichuk
authors.forename: Ceinwen
authors.initials: C
authors.lastname: Cumming
authors.forename: Jill
authors.initials: J
authors.lastname: Turner
authors.forename: Audrey
authors.initials: A
authors.lastname: Yushchyshyn
authors.forename: Rami
authors.initials: R
authors.lastname: Sela
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling / Q000706:statistics & numerical data*; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011795:Surveys and Questionnaires