title: [Utilisation of Psycho-oncological Services in Hospitals and Outpatient Counselling Centres by Survivors of Breast, Colon and Prostate Cancer].
abstract: BACKGROUND
  We investigated how many cancer survivors receive psycho-oncological care in hospitals and outpatient cancer counselling centres and which factors influence usage.
  
  
  METHODS
  Long-term survivors of breast, colon or prostate cancer completed a questionnaire assessing the use of psycho-oncological services in the "Cancer Survivorship--a multiregional population-based study (CAESAR)". Gender, age, community size, education, income and stage of disease were investigated as potential predictors of use.
  
  
  RESULTS
  Out of 6,143 participants, 547 (9%) reported having received psycho-oncological support in the hospital, 183 (3%) had visited a counselling centre. Inpatient services were more frequently used by higher educated persons (OR 1.5), women (OR 1.3), and patients with advanced disease (OR 1.3); less frequently by older survivors (OR 0.6). Community size and income were not related to inpatient use. Counselling centres were visited more frequently by women (OR 2.2), higher educated survivors (OR 2.1), patients with advanced disease (OR 1.6), and participants from communities with >100,000 inhabitants (OR 2.4); less frequently from elderly OR 0.4).
  
  
  CONCLUSIONS
  Especially the use of outpatient cancer counselling centres was associated with contextual and individual factors whereas this was not so much the case with the use of inpatient services. This implies that care models where psycho-oncologists actively approach patients are better able to access all patient groups in contrast to care models where patients have to actively seek help. It also implies that non-use not necessarily means that patients do not need help but that there are barriers to health care access.
authors.affiliation: Vertrauensstelle, Krebsregister Rheinland-Pfalz, Mainz.
authors.forename: Sylke Ruth
authors.initials: SR
authors.lastname: Zeissig
authors.affiliation: Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin Mainz.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.affiliation: Klinische Epidemiologie und Alternsforschung, Deutsches Krebsforschungszentrum, Heidelberg.
authors.forename: Lena
authors.initials: L
authors.lastname: Koch
authors.affiliation: Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universitätsmedizin Mainz.
authors.forename: Maria
authors.initials: M
authors.lastname: Blettner
authors.affiliation: Klinische Epidemiologie und Alternsforschung, Deutsches Krebsforschungszentrum, Heidelberg.
authors.forename: Volker
authors.initials: V
authors.lastname: Arndt
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D004522:Educational Status; D005260:Female; D005858:Germany; D006801:Humans; D007414:Intestinal Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D011613:Psychotherapy / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data