Why do oncology outpatients who report emotional distress decline help?
Abstract
OBJECTIVE: Many patients who experience distress do not seek help, and little is known about the reasons for this. We explored the reasons for declining help among patients who had significant emotional distress. METHODS: Data were collected through QUICATOUCH screening at an Australian hospital. Oncology outpatients scoring 4 or more on the Distress Thermometer were asked if they would 'like help' with their distress. Those who declined help were asked their reasons. Demographic variables and a clinical measure of anxiety and depression (PSYCH-6) were used to identify factors associated with reasons for declining help. RESULTS: Of 311 patients with significant distress, 221 (71%) declined help. The most common reasons were 'I prefer to manage myself' (n = 99, 46%); 'already receiving help' (n = 52, 24%) and 'my distress is not severe enough' (n = 50, 23%). Younger patients and women were more likely to decline help and were more likely to already be receiving help. Distress score and PSYCH-6 scores were significantly lower among patients who rated their distress as not severe enough to require help. Nevertheless, there were patients who had maximal scores on distress and PSYCH in each group. CONCLUSIONS: Two common patient barriers to help with distress are a preference for self-help and a belief that distress is not sufficiently severe to warrant intervention. These beliefs were held by a sizeable proportion of individuals who reported very high levels of distress. Qualitative research and subsequent interventions for overcoming these barriers are required to obtain the most benefit from distress screening programs.
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Perceived stigma, preference for self-help, and perception that distress is not severe enough are potential reasons for not seeking psychological support.
“Potential reasons for not seeking psychological support previously identified are perceived stigma, but also a preference for self-help or the perception the experienced distress is not severe enough in spite of reporting high distress (4, 8).”
Women cancer patients are more inclined to express their problems and seek help, while men may abstain from expressing fear or worry because of shame.
“Second, women cancer patients are more inclined to express their problems and seek for help, while men patients may abstain from expressing fear or worry when suffering a negative condition because of feelings of shame (Clover et al., 2015; Anuk et al., 2019).”
From The relationship between fears of cancer recurrence and patient gender: a systematic review and meta‐analysis (2021) · cites this paper as Clover et al., 2015
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“Potential reasons for not seeking psychological support previously identified are perceived stigma, but also a preference for self-help or the perception the experienced distress is not severe enough in spite of reporting high distress (4, 8).”
Background
- Authors
- Clover, K. A., Mitchell, A. J., Britton, B., & Carter, G.
- Affiliations
- Calvary Mater Newcastle Hospital (AU)
- University of Leicester (GB)
- Corresponding author
- Clover, Kerrie Ann
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2014-12-11
- Volume
- 24
- Issue
- 7
- Pages
- 812-818
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- OpenAlex
- W1950968949
- Cited by
- 180
- References
- 29
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 10 · 2023: 29 · 2022: 15 · 2021: 24 · 2020: 18 · 2019: 17 · 2018: 20 · 2017: 12 · 2016: 7 · 2015: 5 · 2013: 1
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Funders
- Australian Government
- Cancer Institute NSW
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- emotional distress, help-seeking, help-seeking barriers, cancer outpatients, cancer patients, self-management, anxiety, depression, distress screening
- MeSH terms
- Help-Seeking Behavior, Age Factors, Aged, Anxiety, Attitude to Health, Australia, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Neoplasms, Outpatients, Severity of Illness Index, Sex Factors, Stress, Psychological, Treatment Refusal
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