title: Comparison of patient-reported need of psycho-oncologic support and the doctor's perspective: how do they relate to disease severity in melanoma patients?
abstract: Psycho-neuro-immune research suggests an association between cancer outcomes and psychosocial distress. Objective criteria to determine patients' levels of distress are important to establish potential links to disease outcomes.
  
  
  
  We compared three patient-reported with one doctor-reported measures of psycho-oncologic distress frequently used in routine cancer care and investigated associations with standard disease severity parameters in melanoma patients. We enrolled n = 361 patients, successively seen at two outpatient university clinics in Germany. In the naturalistic study, n = 222 patients had been diagnosed <180 days and were seen for the first time (Group I); n = 139 had been diagnosed >180 days and were in after-care (Group II).
  
  
  
  Across groups, only moderate associations were seen between patient- reported and doctor-reported measures. Regarding clinical variables, disease severity and perceived need of psycho-oncologic support reported by patients or doctors showed hardly any association. After subgroup stratification, in patients of Group II, patient-reported and doctor-reported instruments showed some small associations with disease parameters commonly linked to more rapid cancer progression in patients who are in cancer after-care.
  
  
  
  Overall, the few and low associations suggest that need of psycho-oncologic support and clinical variables were largely independent of each other and doctors' perception may not reflect the patient's view. Therefore, the assessment of the patient perspective is indispensable to ensure that melanoma patients receive appropriate support, as such need cannot be derived from other disease parameters or proxy report. More research is needed applying psychometrically robust instruments that are ideally combined with sensitive biomarkers to disentangle psycho-neuro-immune implications in melanoma patients. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.|Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia.
authors.forename: Sandra
authors.identifier: 0000-0001-6185-9423
authors.initials: S
authors.lastname: Nolte
authors.affiliation: Department of Psychosomatic Medicine, Justus Liebig University (JLU), Giessen, Germany.
authors.forename: Sicco H
authors.initials: SH
authors.lastname: van der Mei
authors.affiliation: Department of Psychosomatic Medicine, Philipps University Marburg, Marburg, Germany.|Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine, Justus Liebig University (JLU), Giessen, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Strehl-Schwarz
authors.affiliation: Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine, Justus Liebig University (JLU), Giessen, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Köster
authors.affiliation: Department of Dermatology, Philipps University Marburg, Marburg, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Bender
authors.affiliation: Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.|Quantitative Health Sciences, Outcomes Measurement Science, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Matthias
authors.initials: M
authors.lastname: Rose
authors.affiliation: Department of Psychosomatic Medicine, Justus Liebig University (JLU), Giessen, Germany.|Department of Psychosomatic Medicine, Philipps University Marburg, Marburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kruse
authors.affiliation: Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany. eva.peters@eva-peters.com.|Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine, Justus Liebig University (JLU), Giessen, Germany. eva.peters@eva-peters.com.
authors.forename: Eva M J
authors.initials: EM
authors.lastname: Peters
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008545:Melanoma / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011594:Psychometrics; D012878:Skin Neoplasms / Q000523:psychology* / Q000628:therapy; D013315:Stress, Psychological / Q000523:psychology
keywords: patient-reported outcomes; proxy report; psycho-oncology; screening; self-report; skin cancer