Cited by 139Cancer survivorship and carePatient-Provider Communication in HealthcarePalliative and Oncologic Care

Psychological intervention targeting distress for cancer patients: a meta-analytic study investigating uptake and adherence.

Open access
Brebach, Rachel, Sharpe, Louise, Costa, Daniel S. J., Rhodes, Paul, Butow, Phyllis·2016·Psycho-Oncology

Abstract

Objective: Although cancer care guidelines recommend screening for distress among cancer patients and offering psychological support when indicated, many patients decline offers of such support. This study aimed to quantify uptake and adherence to psychological support and to identify predictors of each.Methods: Searches were conducted in Embase, Medline, PsychInfo and Scopus to identify studies reporting uptake or adherence rates for individual psychological interventions targeting distress, anxiety or depression for cancer patients or survivors.Results: Across the 53 included studies reporting uptake and/or adherence rates for 12 323 cancer patients, the uptake and adherence rates were 60.1% and 90.4%, respectively. Patients screened and identified as distressed were less likely to accept intervention than unselected patients (50.3% compared with 66.3%, Q(1) = 4.66, P = 0.031). Uptake of therapy was higher for interventions delivered by telephone rather than face-to-face (71.2% compared with 53.8%, Q(1) = 4.91, P = 0.027) and when therapy was offered prior to medical treatment compared with later (72.9% compared with 56.8%, Q(1) = 5.60, P = 0.018). Patients were more likely to accept intervention from nurses than other allied health professionals (68.3% compared with 50.5%, Q(1) = 5.76, P = 0.016).Conclusions: Patients appeared more receptive to interventions offered near diagnosis, over the telephone and by nurses. Although this suggests higher acceptability of such interventions, evidence of their greater efficacy is lacking, and this merits further investigation. Research is needed to understand barriers to acceptance of psychological support, particularly because uptake rates were lower for distressed patients. Copyright © 2016 John Wiley & Sons, Ltd.

Integrity signals

Registry

Crossref · 10.1002/pon.4099

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

8 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

11 of 33 cited sources checked · 7 supported · 0 flagged · accuracy not yet measured

  • Interpretationcitation

    The low rate of uptake may help to explain the lack of evidence that screening protocols result in better outcomes.

    “The low rate of uptake may help to explain the lack of evidence that screening protocols result in better outcomes [11].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [11] 11. Bidstrup PE, Johansen C, Mitchell AJ. Screening for cancer-related distress: sum- mary of evidence from tools to programmes. Acta Oncol 2011;50(2):194-204. DOI:10.3109/ 0284186X.2010.533192. source
    • The authors state this as an assumption: Efforts to incorporate routine distress screening into cancer care are based on the assumption that if a patient with clinically significant distress is identified and offered an effective intervention, outcomes will be improved.
  • Premisecitation

    Higher distress has predicted desire for help or uptake of interventions in some but not all reports.

    “Because higher distress has predicted desire for help or uptake of interventions in some [19,20,22,31] although not all [21,[32][33][34] reports, it was anticipated that those who were distressed may be more likely to uptake the offer of help.”
    Quote in the paperSubstantial claim2 of 5 sources checked
    • cites [19] 19. Baker-Glenn EA, Park B, Granger L, et al. Desire for psychological support in cancer pa- tients with depression or distress: validation of a simple help question. Psycho-Oncology 2011;20(5):525-531. DOI:10.1002/pon.1759. source
    • cites [20] 20. Watson M, White C, Davolls S, et al. Problem-fo- cussed interactive telephone therapy for cancer pa- tients: a phase II feasibility trial. Psychooncology 2013;22(7):1485-91. DOI:10.1002/pon.3194. source
    • cites [22] 22. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic re- views and meta-analyses of studies that evalu- ate health care interventions: explanation and elaboration PRISMA: explanation and elabora- tion. Ann Intern Med 2009;151(4):W-65. DOI: 10.7326/0003-4819-151-4-200908180-00136 source

      The passages in our copy concern reporting standards for systematic reviews, including selective reporting bias (p. 19). Searches for distress predicting desire for help and uptake of interventions found no passage addressing that relationship. (LLM, conf=0.75)

      Experimental — accuracy not yet measured
    • cites [31] 31. Shapiro PJ, Coyne JC, Kruus LK, et al. Inter- est in services among prostate cancer patients receiving androgen deprivation therapy. Psycho-Oncology 2004;13(8):512-525. source
    • cites [21,[32][33][34]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Premisecitation

    Survey studies suggest that desire for help is low.

    “Survey studies suggest that desire for help is low [19,20], but there is little research into whether or not patients accept interventions that are actually offered and if so, whether the course of treatment is completed.”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [19] 19. Baker-Glenn EA, Park B, Granger L, et al. Desire for psychological support in cancer pa- tients with depression or distress: validation of a simple help question. Psycho-Oncology 2011;20(5):525-531. DOI:10.1002/pon.1759. source
    • cites [20] 20. Watson M, White C, Davolls S, et al. Problem-fo- cussed interactive telephone therapy for cancer pa- tients: a phase II feasibility trial. Psychooncology 2013;22(7):1485-91. DOI:10.1002/pon.3194. source
  • Premisecitation

    Routine screening for distress is not carried out in most cancer care settings.

    “Routine screening for distress is not carried out in most cancer care settings [8].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [8] 8. Jacobsen PB, Ransom S. Implementation of NCCN distress management guidelines by member institutions. J Natl Compr Canc Netw 2007;5(1):99-103. source

      The Results report that 8 of 15 responding NCCN institutions (53%) routinely screened at least some patients, so the paper does not show that most surveyed institutions carried out no routine screening. The Discussion reports that only 20% screened all patients; the claim would be supported if it specified universal screening, but it also generalizes beyond the NCCN institutions surveyed. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    Evidence that implementation of screening in cancer settings improves outcomes for cancer patients is inconclusive.

    “However, the evidence that implementation of screening in cancer settings improves outcomes for cancer patients is inconclusive.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [11] 11. Bidstrup PE, Johansen C, Mitchell AJ. Screening for cancer-related distress: sum- mary of evidence from tools to programmes. Acta Oncol 2011;50(2):194-204. DOI:10.3109/ 0284186X.2010.533192. source
  • Classified as probably not a substantial claim. 18
  • May combine two claims. 8
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The higher uptake rates in the present study compared with survey-reported interest of 14-41% may be inflated by an altruistic desire to participate in research.

    “Even this weighted uptake rate is higher than seen in surveys, which report that between 14 and 41% of cancer patients show a definite interest in psychological support [19,20,30] possibly suggesting that the higher uptake rates in the present study are inflated by an altruistic desire to participate in the research.”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [19] 19. Baker-Glenn EA, Park B, Granger L, et al. Desire for psychological support in cancer pa- tients with depression or distress: validation of a simple help question. Psycho-Oncology 2011;20(5):525-531. DOI:10.1002/pon.1759. source
    • cites [20] 20. Watson M, White C, Davolls S, et al. Problem-fo- cussed interactive telephone therapy for cancer pa- tients: a phase II feasibility trial. Psychooncology 2013;22(7):1485-91. DOI:10.1002/pon.3194. source
    • cites [30] 30. Semple CJ, Dunwoody L, Kernohan WG, McCaughan E. Development and evaluation of a problem-focused psychosocial interven- tion for patients with head and neck cancer. [Controlled Clinical Trial Research Support, Non-U.S. Gov't]. Support Care Cancer 2009;174:379-88. source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Research has indicated that stigma is a barrier to acceptance of mental health care.

    “Research has indicated that stigma is a barrier to acceptance of mental health care [37], and it is possible that there is more stigma associated with seeing a psychologist than a nurse [38].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [37] 37. Turner J, Kelly B, Clarke D, et al. A randomised trial of a psychosocial interven- tion for cancer patients integrated into routine care: the PROMPT study (promoting optimal outcomes in mood through tailored psychoso- cial therapies). BMC Cancer 2011;1148. DOI: 10.1186/1471-2407-11-48 source
  • May combine two claims.

    Study design and conductcitation

    Risk of bias assessment was conducted on the 30 RCTs among the included studies, 21 of which were rated as having low risk of bias in at least three of the five domains assessed.

    “conducted on the 30 RCTs among the included studies, 21 of which were rated as having low risk of bias in at least three of the five domains assessed (Table S2).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [29] 29. Tuinman MA, Gazendam-Donofrio SM, Hoekstra-Weebers JE. Screening and referral for psychosocial distress in oncologic practice -use of the distress thermometer. Cancer 2008;1134:870-878. DOI: 10.1002/Cncr.23622 source

      The Procedure section describes questionnaires given to cancer patients, and the Results discuss Distress Thermometer scores; neither reports a risk-of-bias assessment of included RCTs. Searches for “30 RCTs,” “21 low risk,” and randomized-trial bias assessment found no passage supporting the claim. Page numbers were not available in our copy. (LLM, conf=0.78)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The potential for publication bias was assessed using the trim and fill method.

    “The potential for publication bias (small studies with positive effects influencing results) was assessed using the trim and fill method [28].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [28] 28. Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343:. DOI:10.1136/bmj.d5928. source

      The 'Assessments of risk of bias and synthesis of results' section mentions publication bias as a factor to consider when interpreting reviews, but does not describe assessing it with the trim-and-fill method. A search for 'trim and fill method' found no passage addressing that method, so our copy does not verify the cited claim. (LLM, conf=0.77)

      Experimental — accuracy not yet measured
  • May combine two claims.

    Premisecitation

    In a systematic review, distress screening was associated with improved psychological outcomes in only four of seven randomised controlled trials, one of which found benefit only for those who were depressed at baseline.

    “Heterogeneous designs hinder attempts to synthesise data across studies, but in a systematic review, distress screening was associated with improved psychological outcomes in only four of seven randomised controlled trials [11], one of which found benefit only for those who were depressed at baseline.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [11] 11. Bidstrup PE, Johansen C, Mitchell AJ. Screening for cancer-related distress: sum- mary of evidence from tools to programmes. Acta Oncol 2011;50(2):194-204. DOI:10.3109/ 0284186X.2010.533192. source
  • May combine two claims.

    Study design and conductown data

    No studies were imputed using the trim and fill method, suggesting publication bias was not of concern in these analyses.

    “No studies were imputed using the trim and fill method, suggesting publication bias was not of concern in these analyses.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationcitation

    Distress is only one factor influencing uptake of intervention; another is unmet need.

    “Distress is only one factor influencing uptake of intervention; another is unmet need.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Some people who report a need for psychological support are not clinically distressed, and some who are clinically distressed do not report unmet needs.

    “Some of those who report a need for psychological support are not clinically distressed, and others who are clinically distressed do not report unmet needs [20,30].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [20] 20. Watson M, White C, Davolls S, et al. Problem-fo- cussed interactive telephone therapy for cancer pa- tients: a phase II feasibility trial. Psychooncology 2013;22(7):1485-91. DOI:10.1002/pon.3194. source
    • cites [30] 30. Semple CJ, Dunwoody L, Kernohan WG, McCaughan E. Development and evaluation of a problem-focused psychosocial interven- tion for patients with head and neck cancer. [Controlled Clinical Trial Research Support, Non-U.S. Gov't]. Support Care Cancer 2009;174:379-88. source
  • May combine two claims.

    Study design and conductown data

    Across each significant meta-regression, the fail-safe N was greater than 372, indicating stability of the effect size.

    “Across each significant meta-regression, the fail-safe N was greater than 372, indicating stability of the effect size.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    The type of therapy did not influence uptake rates, suggesting no systematic effect of preference for one type of therapy over another.

    “Our findings demonstrate that the type of therapy did not influence uptake rates, however, suggesting that there was no systematic effect of preference for one type of therapy over another.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Discrepancies between raters were resolved by discussion.

    “Discrepancies were resolved by discussion.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two raters assessed the eligibility of a subset of titles and a subset of studies selected for full-text review.

    “Two raters assessed the eligibility of a subset of titles and a subset of studies selected for full-text review.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Seven potential study-level sources of heterogeneity in uptake and adherence rates were pre-specified.

    “Seven potential study-level sources of heterogeneity (or moderators) in uptake and adherence rates were investigated.These were pre-specified [24].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [24] 24. Cochran WG. The comparison of percentages in matched samples. Biometrics 1950;6(2):178-178.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The stability of the overall effect reported in each significant meta-regression was examined by calculating a fail-safe N.

    “The stability of the overall effect reported in each significant meta-regression was examined by calculating a fail-safe N, which determines the number of studies with a null effect size that would be needed to render the overall effect non-significant.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    If patients do not accept the offer of treatment or drop out before a therapeutic dose is given, then these interventions will not be effective in clinical settings.

    “However, if patients do not accept the offer of treatment or drop-out before a therapeutic dose is given, then these interventions will not be effective in clinical settings.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    For the subset of 66 references evaluated by two raters at full-text evaluation, agreement was present in 61 of 66 references (92.42% agreement, Kappa = 0.84).

    “For the subset of 66 references that were evaluated by two raters at the full-text evaluation stage, agreement was present in 61 of 66 references (92.42% agreement, Kappa = 0.84).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Much research has focused on whether or not psychological interventions for cancer patients are effective.

    “Much research has focused on whether or not psychological interventions for cancer patients are effective [15][16][17]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [15][16][17]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    In this study, we did not attempt a qualitative synthesis of reasons for declining intervention.

    “In this study, we did not attempt a qualitative synthesis of reasons for declining intervention.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A range of screening tools has an acceptable level of sensitivity and specificity in identifying clinically significant distress levels.

    “A range of screening tools has an acceptable level of sensitivity and specificity in identifying clinically significant distress levels [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] 12. Mitchell AJ, Meader N, Davies E, et al. Meta- analysis of screening and case finding tools for depression in cancer: evidence based rec- ommendations for clinical practice on behalf of the depression in cancer care consensus group. [meta-analysis]. J Affect Disord 2012;140(2):149-60. source
  • May combine two claims.

    Study design and conductown data

    It was not possible to test for an effect of gender because three quarters of intervention offers were made to women and most offers made to men were in a mixed gender sample.

    “Three quarters of intervention offers reported in the included studies were made to women, and most offers made to men were in a mixed gender sample, meaning it was not possible to test for an effect of gender.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    We limited our analyses to investigation of individual face-to-face and telephone interventions.

    “Finally, we limited our analyses to investigation of individual face-to-face and telephone interventions.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    For the subset of 207 references rated by two raters at title evaluation, agreement was present in 204 cases (98.55% agreement, Kappa = 0.83).

    “For the subset of 207 references that were rated by two raters at the stage of evaluation by title, there was an agreement in 204 cases (98.55% agreement, Kappa = 0.83).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The 53 studies included in this review are only a subset of all intervention studies.

    “The 53 studies included in this review are only a subset of all intervention studies.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The recommendations of the PRISMA statement for transparent reporting of meta-analyses were followed.

    “The recommendations of the PRISMA statement for the transparent reporting of meta-analyses were followed [23].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] 23. Thompson SG, Higgins JPT. How should meta-regression analyses be undertaken and interpreted? Stat Med 2002;21(11):1559-1573. DOI:10.1002/sim.1187. source
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    This study fills an important gap in the literature.

    “Hence, this study fills an important gap in the literature.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Little research has investigated whether patients actually engage in psychological interventions when offered.
  • Classified as probably not a substantial claim.

    Premisecitation

    Clinical practice guidelines for cancer care recommend routine screening for distress to identify patients who may benefit from psychological intervention.

    “Clinical practice guidelines for cancer care recommend that strategies such as routine screening for distress are used to identify patients who may benefit from psychological intervention [4][5][6][7].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [4][5][6][7]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

26 of 26
  • The paper relies on this without support.

    There is little research into whether patients accept interventions that are actually offered and whether the course of treatment is completed.

    “Survey studies suggest that desire for help is low [19,20], but there is little research into whether or not patients accept interventions that are actually offered and if so, whether the course of treatment is completed.”
  • The paper relies on this without support.

    Very little is known about whether uptake or adherence differs according to characteristics of patients or characteristics of the interventions being offered.

    “Furthermore, very little is known about whether uptake or adherence differs according to characteristics of patients or characteristics of the interventions being offered.”
  • The authors state this as an assumption.

    The model for distress screening assumes that identification of distress will result in identification of an unmet need for emotional support.

    “The model for distress screening assumes that the identification of distress will result in the identification of an unmet need for emotional support.”
  • The authors state this as an assumption.

    It is assumed that if effective screening measures can be developed, distress can be identified.

    “It is assumed therefore that if effective screening measures can be developed, distress can be identified.”
  • The authors state this as an assumption.

    Once distress is identified, patients' distress can be reduced by the provision of effective psychosocial interventions.

    “Once distress is identified, the assumption is that patients' distress can be reduced by the provision of effective psychosocial interventions.”
  • The authors state this as an assumption.

    Efforts to incorporate routine distress screening into cancer care are based on the assumption that if a patient with clinically significant distress is identified and offered an effective intervention, outcomes will be improved.

    “This is an important finding, because efforts to incorporate routine distress screening into cancer care are based on the assumption that if a patient with clinically significant distress is identified, and offered an effective intervention, outcomes will be improved.”
  • The paper relies on this without support.

    Little research has investigated whether patients actually engage in psychological interventions when offered.

    “yet, little research has investigated whether patients actually engage in such interventions when offered.”
7 of 7

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: Q(1) = 7.11, p = .007

    Minor

    The paper reports p = .007 here; recomputing from the test statistic and its degrees of freedom gives p = .008. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .007 · recomputed p = .008

1 of 1

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upQ(1) = 7.11reported p = .007 · recomputed p = .008

    “Q(1) = 7.11, p = .007”

  • ConsistentQ(1) = 4.66reported p = .031 · recomputed p = .031

    “Q(1) = 4.66, p = .031”

  • ConsistentQ(1) = 4.91reported p = .027 · recomputed p = .027

    “Q(1) = 4.91, p = .027”

  • ConsistentQ(1) = 5.6reported p = .018 · recomputed p = .018

    “Q (1) = 5.60, p = .018”

  • ConsistentQ(1) = 5.76reported p = .016 · recomputed p = .016

    “Q(1) = 5.76, p = .016”

  • ConsistentQ(1) = 7.21reported p = .007 · recomputed p = .007

    “Q(1) = 7.21, p = .007”

  • ConsistentQ(1) = 5.6reported p = .018 · recomputed p = .018

    “Q(1) = 5.60, p = .018”

  • ConsistentQ(1) = 11.84reported p = .0006 · recomputed p < .001

    “Q (1) = 11.84,p = .0006”

8 of 8

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. 10.1038/sj.bjc.66018876601887 · DOI
  2. Adler N, 2008, Institute of Medicine: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
  3. NICE, 2004, Improving Supportive and Palliative Care for Adults with Cancer: The Manual

Cited by

Sorted by citations

Authors
Brebach, R., Sharpe, L., Costa, D. S. J., Rhodes, P., & Butow, P.
Affiliations
The University of Sydney (AU)
Corresponding author
Sharpe, Louise
Venue
Psycho-Oncology
Publisher
Wiley
Published
2016-02-18
Volume
25
Issue
8
Pages
882-890
ISSN
  • 1057-9249 (ISSN-L)
  • 1099-1611
OpenAlex
W2275634305
Cited by
139
References
49
Citations by year
2026: 6 · 2025: 15 · 2024: 10 · 2023: 18 · 2022: 13 · 2021: 21 · 2020: 9 · 2019: 17 · 2018: 17 · 2017: 11 · 2016: 1 · 2012: 1
FWCI
1.54
Type
journal article
Language
en
Open access
Locations
  • Psycho-Oncology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
psychological intervention, cancer patients, distress screening, intervention uptake, medication adherence, anxiety, depression, telephone-delivered therapy, nurse-led intervention, cancer survivors
MeSH terms
Anxiety, Depression, Humans, Neoplasms, Psychotherapy, Quality of Life, Cognitive Behavioral Therapy

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