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Determinants of psychology service utilization in a palliative care outpatient population
Author(s) -
Azuero Casey,
Allen Rebecca Sue,
Kvale Elizabeth,
Azuero Andres,
Parmelee Patricia
Publication year - 2014
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.3454
Subject(s) - palliative care , anxiety , population , service (business) , medicine , health care , family medicine , health psychology , psychology , clinical psychology , psychiatry , nursing , public health , environmental health , economy , economics , economic growth
Objective Research has demonstrated that treating cancer patients' psychological and physical health leads to improved overall health. This may be especially true for palliative care patients facing serious illness. This study examines the proportion and determinants of psychology service utilization in an outpatient palliative care population. Methods Data from an existing clinical database in an outpatient palliative clinic utilizing a collaborative care model to deliver psychology services were explored. This study was framed by Andersen's Behavioral Model of Health Service Use, which incorporates three main components: predisposing, enabling, and need factors to model health service utilization. The sample ( N = 149) was majority middle aged, female, and White with a primary diagnosis of cancer. Cross‐tabulations were conducted to determine how many patients who met screening criteria for depression or anxiety sought psychology services. Logistic regression analyses were conducted to assess for predisposing, enabling, and need factor determinants of psychology service utilization. Results Among patients who met criteria for moderate depression or anxiety, 50% did not access readily available psychology services. Enabling factors were the strongest determinant of psychology utilization. Factors associated with need for psychology services (i.e., emotional distress and psychological symptom burden) did not reach significance in determining psychology service use. Conclusions This study extends current knowledge about psychology utilization to palliative care outpatients receiving care within a collaborative care model. Directions for future research include further investigation of care models that optimize enabling strategies to enhance access to these services, and examination of patient‐reported barriers to receiving this care. Copyright © 2013 John Wiley & Sons, Ltd.