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Cancer patients' emotional distress, coping styles and perception of doctor-patient interaction in European cancer settings*

Published online by Cambridge University Press:  09 July 2015

Elena Meggiolaro ,
Maria Alejandra Berardi ,
Elisabeth Andritsch ,
Maria Giulia Nanni ,
Agustina Sirgo ,
Elena Samorì ,
Clemens Farkas ,
Federica Ruffilli ,
Rosangela Caruso  and
Marta Bellé
...Show all authors
Elena Meggiolaro
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Maria Alejandra Berardi
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Elisabeth Andritsch
Affiliation:
Psycho-Oncology Service, Clinical Department of Oncology, University Medical Center of Internal Medicine, Medical University of Graz, Graz, Austria
Maria Giulia Nanni
Affiliation:
Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Italy and University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Integrated Department of Mental Health, S. Anna University Hospital and Health Authorities, Ferrara, Italy
Agustina Sirgo
Affiliation:
Psycho-oncology Unit Oncology Department University Hospital Sant Joan de Reus, Reus, Spain
Elena Samorì
Affiliation:
Istituto Oncologico Romagnolo (IOR), Forlì, Italy
Clemens Farkas
Affiliation:
Psycho-Oncology Service, Clinical Department of Oncology, University Medical Center of Internal Medicine, Medical University of Graz, Graz, Austria
Federica Ruffilli
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Rosangela Caruso
Affiliation:
Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Italy and University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Integrated Department of Mental Health, S. Anna University Hospital and Health Authorities, Ferrara, Italy
Marta Bellé
Affiliation:
Department of Oncology, Cà Foncello Hospital of Treviso, Treviso, Italy
Eva Juan Linares
Affiliation:
Psycho-Oncology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Silvia de Padova
Affiliation:
Istituto Scientifico Romagnolo per lo studio e la Cura dei Tumori (IRST) S.r.l, Meldola (FC), Italy
Luigi Grassi*
Affiliation:
Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Italy and University Hospital Psychiatry Unit, Psycho-Oncology and Psychiatry in Palliative Care Program, Integrated Department of Mental Health, S. Anna University Hospital and Health Authorities, Ferrara, Italy
*
Address correspondence and reprint requests to: Luigi Grassi, Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Corso Giovecca 203, 44121 Ferrara, Italy. E-mail [email protected]
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Abstract

Objective:

As a part of a European study, we cross-culturally examined the rate of emotional distress and maladaptive coping and their association with cancer patients' satisfaction with their interactions with the physician responsible for their care.

Methods:

Cancer patients (n = 302) from one Middle European (Austria) and two Southern European (Italy, Spain) countries completed the NCCN Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation (AP) and Hopelessness (H) sub-scales, and the Physician Patient Satisfaction with Doctors Questionnaire (PSQ).

Results:

The prevalence of emotional distress (DT caseness) was 60% (26.1% mild, 18.8% moderate, and 14.9% severe distress). Maladaptive coping (Mini-MAC cases) was found in 22.8% (hopeless cases), and 22.5% (anxious preoccupation cases). PSQ-MD was significantly correlated with Mini-MAC/H and Mini-Mac/AP, while PSQ-PS was negatively correlated with Mini-MAC/H. DT cases and those with higher levels of hopelessness reported higher scores on PSQ-MD and lower on PSQ-PS than non-cases. Some differences were found between countries both as far as patients' coping and perception of the interaction with doctors. In hierarchical multiple regression analysis, after adjusting for socio-demographic and medical variables, Mini-MAC/H significantly predicted the scores on PSQ-MD (positive direction) and PSQ-PS (negative direction).

Significance of results:

The study confirms that about one out of three cancer patients have moderate to high level of emotional distress and about one out of four, clinically significant maladaptive coping. Also, patients showing hopelessness and distress tended to perceive their doctors as both disengaged and less supportive. These results highlights the need for physicians to monitor their patient's level of distress and coping mechanisms and to adjust their own relational and communication style according to patients' psychological condition. Also, cross-cultural issues should be taken into account when exploring psychosocial variables and cancer patients' perception of and satisfaction with the interaction with their doctors.

Keywords

Emotional distressCopingDoctor-patient relationCancer
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 3 , June 2016 , pp. 204 - 211
Copyright
Copyright © Cambridge University Press 2015 

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Footnotes

*

The paper is co-authored by the The IOR-IRST Psycho-Oncology Working Group and the UNIFE Psychiatry Working Group: Giorgia Bellini, Tatiana Bertelli, Laura Cavana, Maria Cristina Colistro, Alessandra Montesi, Maura Muccini, Elisa Ruggeri, Ilaria Strada, Antonella Carbonara, Sara Massarenti, Silvana Sabato

References

REFERENCES

Arora, N.K., Street, R.L. Jr., Epstein, R.M. & Butow, P.N. (2009). Facilitating patient-centered cancer communication: a road map. Patient Education and Counseling, 77, 319–321.Google Scholar
Barth, J. & Lannen, P. (2011). Efficacy of communication skills training courses in oncology: A systematic review and meta-analysis. Annals of Oncology, 22, 1030–1040.Google Scholar
Brédart, A., Bouleuc, C. & Dolbeault, S. (2005). Doctor-patient communication and satisfaction with care in oncology. Current Opinion in Oncology, 17, 351–354.Google Scholar
Bultz, B.D. & Carlson, L.E. (2006). Emotional distress: The sixth vital sign—Future directions in cancer care. Psycho-Oncology, 15, 93–95.Google Scholar
De Vries, A.M., de Roten, Y., Meystre, C., Passchier, J., Despland, J.-N. & Stiefel, F. (2014). Clinician characteristics, communication, and patient outcome in oncology: A systematic review. Psychooncology, 23, 375–381 CrossRefGoogle ScholarPubMed
Donovan, K.A., Grassi, L., McGinty, H.L., Jacobsen, P.B. (2014). Validation of the distress thermometer worldwide: State of the science. Psycho-Oncology, 23, 241–250 CrossRefGoogle ScholarPubMed
Gilbar, O. & Zusman, A. (2007). The correlation between coping strategies, doctor-patient/spouse relationships and psychological distress among women cancer patients and their spouses. Psychooncology, 16, 1010–1018.Google Scholar
Grassi, L., Ruffilli, F., Berardi, A., et al. (in press). Role of psychosocial variables on chemotherapy-induced nausea and vomiting and health-related quality of life among cancer patients: a European study. Psychotherapy & Psychosomatics.Google Scholar
Grassi, L., Caruso, R., Sabato, S., Massarenti, S., Nanni, M.G. & The UniFe Psychiatry Working Group Coauthors. (2015). Psychosocial screening and assessment in oncology and palliative care settings. Frontiers in Psychology, 5, 1485.CrossRefGoogle ScholarPubMed
Grassi, L., Malacarne, P., Maestri, A. & Ramelli, E. (1997). Depression, psychosocial variables and occurrence of life events among patients with cancer. Journal of Affective Disorders, 44, 21–30 Google Scholar
Grassi, L., Rossi, E., Sabato, S., Cruciani, G. & Zambelli, M. (2004a). Diagnostic Criteria for Psychosomatic Research (DCPR) and psychosocial variables in breast cancer. Psychosomatics, 45, 483–491.Google Scholar
Grassi, L., Travado, L., Moncayo, F.L., Sabato, S. & Rossi, E. (2004b). Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: findings from the Southern European Psycho-Oncology Study. Journal of Affective Disorders, 83, 243–248.CrossRefGoogle ScholarPubMed
Gysels, M., Richardson, A. & Higginson, IJ. (2005). Communication training for health professionals who care for patients with cancer: A systematic review of training methods. Support Care Cancer, 13, 356–366.CrossRefGoogle Scholar
Inoue, S., Saeki, T., Mantani, T., Okamura, H. & Yamawaki, S. (2003). Factors related to patient's mental adjustment to breast cancer: patient characteristics and family functioning. Support Care Cancer, 11, 178–184.CrossRefGoogle ScholarPubMed
Jacobsen, P.B. & Wagner, L.I. (2012). A new quality standard: The integration of psychosocial care into routine cancer care. Journal of Clinical Oncology, 30, 1154–1159.CrossRefGoogle ScholarPubMed
Kissane, D.W., Bylund, C.L., Banerjee, S.C., Bialer, P.A., Levin, T.T., Maloney, E.K. & D'Agostino, T.A. (2012). Communication skills training for oncology professionals. Journal of Clinical Oncology, 30, 1242–1247.Google Scholar
Lam, W.W., Au, A.H., Wong, J.H.F., Lehmann, C., Koch, Uwe, Fielding, R. & Mehnert, A. (2011). Unmet supportive care needs: A cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Research and Treatment, 130, 531–541.Google Scholar
Landen, C.N. Jr., Younger, N.O., Collins Sharp, B.A. & Underwood, P.B. (2003). Cancer patients' satisfaction with physicians: Princess Margaret Hospital Satisfaction with Doctor Questionnaire results. American Journal of Obstetrics and Gynecology, 188, 1177–1179.CrossRefGoogle ScholarPubMed
Libert, Y., Merckaert, I., Reynaert, C., Delvaux, N., Marchal, S., Etienne, A.-M., Boniver, J., Klastersky, J., Scalliet, P., Slachmuylder, J.-L. & Razavi, D. (2006). Does psychological characteristic influence physicians' communication styles? Impact of physicians' locus of control on interviews with a cancer patient and a relative. Support Care Cancer, 14, 230–242.CrossRefGoogle ScholarPubMed
Loblaw, D.A., Bezjak, A. & Bunston, T. (1999). Development and testing of a visit-specific patient satisfaction questionnaire: The Princess Margaret Hospital satisfaction with doctor questionnaire. Journal of Clinical Oncology, 17, 1931–1938.Google Scholar
Loblaw, D.A., Bezjak, A., Mony Singh, Golowiec, A., Joubert, D., Mah, K. & Devins, G.M. (2004). Psychometric refinement of an outpatient, visit–Specific satisfaction with doctor questionnaire. Psycho-Oncology, 13, 223–234.Google Scholar
Mitchell, A.J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C. & Meader, N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncology, 12, 160–174.Google Scholar
Mitchell, A.J., Hussain, N., Grainger, L. & Symonds, P. (2011). Identification of patient-reported distress by clinical nurse specialists in routine oncology practice: A multicentre UK study. Psychooncology, 20, 1076–1083.Google Scholar
National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. Guidelines for Supportive Care/Distress Management. Version 2.2013. Jenkintown, PA: NCCN. www.nccn.org (Accessed January 13, 2013).Google Scholar
Neumann, M., Wirtz, M., Bollschweiler, E., Mercer, S.W., Warm, M., Wolf, J. & Pfaff, H. (2007). Determinants and patient-reported long-term outcomes of physician empathy in oncology: A structural equation modelling approach. Patient Education and Counseling, 69, 63–75.Google Scholar
Ong, L.M., Visser, M.R., van Zuuren, F.J., Rietbroek, R.C., Lammes, F.B. & de Haes, J.C.J.M. (1999). Cancer patients' coping styles and doctor-patient communication. Psychooncology, 8, 155–166.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
Pollak, K.I., Arnold, R., Alexander, S.C., Jeffreys, A.S., Olsen, M.K., Abemethy, A.P., Rodriguez, K.L. & Tulsky, J.A. (2010). Do patient attributes predict oncologist empathic responses and patient perceptions of empathy? Support Care Cancer, 18, 1405–1411.Google Scholar
Ross, L., Petersen, M.A., Johnsen, A.T., Lundstrom, L.H. & Groenvold, M. (2013). Cancer patients’ evaluation of communication: a report from the population-based study “The Cancer Patient's World.” Support Care Cancer, 21, 235–244.Google Scholar
Seetharamu, N., Iqbal, U. & Weiner, J.S. (2007). Determinants of trust in the patient-oncologist relationship. Palliative and Support Care, 5, 405–409.CrossRefGoogle ScholarPubMed
Shim, E.-J., Mehnert, A., Koyama, A., Cho, S.J., Inui, H., Paik, N.-S. & Koch, U. (2006). Health-related quality of life in breast cancer: A cross-cultural survey of German, Japanese, and South Korean patients. Breast Cancer Research and Treatment, 99, 341–350.Google Scholar
Street, R.L. Jr, Gordon, H. & Haidet, P. (2007). Physicians' communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor? Social Science Medicine, 65, 586–598.Google Scholar
Surbone, A. (2008). Cultural aspects of communication in cancer care. Support Care Cancer, 16, 235–240.CrossRefGoogle ScholarPubMed
Takayama, T., Yamazaki, Y. & Katsumata, N. (2001). Relationship between outpatients' perceptions of physicians' communication styles and patients' anxiety levels in a Japanese oncology setting. Social Science and Medicine, 53, 1335–13350.Google Scholar
Thorne, S., Hislop, T.G., Kim-Sing, C., Oglov, V., Oliffe, J.L. & Stajduhar, K.I. (2014). Changing communication needs and preferences across the cancer care trajectory: Insights from the patient perspective. Support Care Cancer, 22, 1009–1015.Google Scholar
Travado, L., Grassi, L., Gil, F., Martins, C., Ventura, C., Bairradas, J. & The Southern European Psycho-Oncology Study Group. (2010). Do spirituality and faith make a difference? Report from the Southern European Psycho-Oncology Study Group. Palliative and Supportive Care, 8, 405–413.Google Scholar
Travado, L., Grassi, L., Gil, F., Ventura, C. & Martins, C. (2005). Physician-patient communication among Southern European cancer physicians: The influence of psychosocial orientation and burnout. Psychooncology, 14, 661–670.Google Scholar
Wang, J.H., Adams, I.F., Pasick, R.J., Gomez, S.L., Allen, L., Ma, G.X., Lee, M.X. & Huang, E. (2013). Perceptions, expectations, and attitudes about communication with physicians among Chinese American and non-Hispanic white women with early stage breast cancer. Support Care Cancer, 21, 3315–3325.Google Scholar
Watson, M., Law, M., dos Santos, M., Greer, S., Baruch, J. & Bliss, J. (1994). The Mini-MAC: further development of the mental adjustment to cancer scale. Journal of Psychosocial Oncology, 12, 33–44.Google Scholar
Zachariae, R., Pedersen, C.G., Jensen, A.B., Ehrnrooth, E., Rossen, P.B. & von der Maase, H. (2003). Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. British Journal of Cancer, 88, 658–665.CrossRefGoogle ScholarPubMed
Zandbelt, L.C., Smets, E.M., Oort, F.J., Godfried, M.H., de Haes, H.C.J.M. (2007). Patient participation in the medical specialist encounter: does physicians' patient-centred communication matter? Patient Education and Counseling, 65, 396–406.Google Scholar