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Barriers to psychosocial oncology service utilization in patients newly diagnosed with head and neck cancer
Author(s) -
Cohen Alexandra,
Ianovski Lola E.,
Frenkiel Saul,
Hier Michael,
Zeitouni Anthony,
Kost Karen,
Mlynarek Alex,
Richardson Keith,
Black Martin,
MacDonald Christina,
Chartier Gabrielle,
Rosberger Zeev,
Henry Melissa
Publication year - 2018
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.4889
Subject(s) - psychosocial , medicine , anxiety , psychological intervention , population , head and neck cancer , family medicine , distress , cancer , psychiatry , clinical psychology , oncology , environmental health
Objectives While patients with head and neck cancer (HNC) are known to experience higher levels of anxiety and depression, they do not always use psychosocial oncology (PSO) services when available. This study aimed to investigate barriers to PSO service utilization in this patient population, with the goal of appropriately targeting outreach interventions. Methods A conceptual model based on the Behavioral Model of Health Services Use was tested in 84 patients newly diagnosed with a first occurrence of HNC followed longitudinally over 1 year, including variables collected through self‐administered questionnaires, Structured Clinical Interviews for DSM (SCID‐I), and medical chart reviews. Results Within the first‐year post‐diagnosis, 42.9% of HNC patients experienced clinical levels of psychological distress, with only 50% of these consulting PSO services (29% total). A logistic regression indicated that PSO utilization was increased when patients presented with advanced cancer ( P = 0.04) and a SCID‐I diagnosis of major depressive disorder, anxiety disorder, or substance use disorder ( P = 0.02), while there was an inverse relationship with self‐stigma of seeking help ( P = 0.03); these variables together successfully predicted 76.3% of overall PSO utilization, including 90.6% of non‐users. Conclusions Future outreach interventions in patients with HNC could address stigma in an attempt to enhance PSO integration into routine clinical care.