title: Cancer patients' referral wish: effects of distress, problems, socio-demographic and illness-related variables and social support sufficiency.
abstract: The present study's aim was to examine effects of cancer patients' perceived distress and problems, socio-demographic and illness-related variables and social support sufficiency on referral wish.
  
  
  
  A cross-sectional group of 1340 patients (response = 51%) completed a questionnaire consisting of the Dutch version of the Distress Thermometer and Problem List, including the referral wish question, and questions on socio-demographic and illness-related variables and perceived social support sufficiency. Univariate and multivariate analyses were performed to investigate the effects of these variables on patients' referral wish.
  
  
  
  Of the patients who completed the referral wish question (N = 1297), 13% wished and 21% considered a referral, while 66% did not want a referral. Univariate analyses showed that, in comparison with patients not having a referral wish, those having a (maybe) wish were more distressed, reporting more problems in all Problem List domains, younger, more likely not to have children or children living at home, higher educated, more likely to be employed, under active treatment or recently diagnosed, receiving more intensive treatment and more likely to perceive support received to be insufficient. A final ordinal logistic regression analysis showed independent effects of distress, practical and emotional problems, age and treatment phase on referral wish (χ2(6) = 205.9; p < 0.001; Nagelkerke's R2= 0.24).
  
  
  
  A third of the patients (maybe) wished a referral. Knowledge of risk variables (particularly increased distress, experience of more practical and emotional problems, younger age and receiving active treatment or recently diagnosed) may support the identification of patients at increased need of additional healthcare services. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Admiraal
authors.affiliation: Wenckebach Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.|Netherlands Comprehensive Cancer Organisation, Groningen, The Netherlands.
authors.forename: F M
authors.initials: FM
authors.lastname: van Nuenen
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: J G M
authors.initials: JG
authors.lastname: Burgerhof
authors.affiliation: Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: A K L
authors.initials: AK
authors.lastname: Reyners
authors.affiliation: Wenckebach Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. j.hoekstra-weebers@umcg.nl.|Netherlands Comprehensive Cancer Organisation, Groningen, The Netherlands. j.hoekstra-weebers@umcg.nl.
authors.forename: J E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D009426:Netherlands; D011788:Quality of Life / Q000523:psychology*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires