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Cited by 128Cancer survivorship and carePalliative and Oncologic CareMental Health Treatment and Access

Predictors of Referral for Specialized Psychosocial Oncology Care in Patients With Metastatic Cancer: The Contributions of Age, Distress, and Marital Status

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Ellis, Janet, Lin, Judy, Walsh, Andrew, Lo, Christopher, Shepherd, Frances A., Moore, Malcolm, Li, Madeline, Gagliese, Lucia +2 more·2009·Journal of Clinical Oncology
DOI 10.1200/jco.2007.15.4864
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Abstract

Purpose: This study examines the rate and prediction of referral for specialized psychosocial oncology care in 326 patients with metastatic GI or lung cancer. Patients and Methods: Referral information was abstracted from medical records and hospital databases. Patients completed measures of psychosocial and physical distress and functioning. Results: Routine referral occurred in 33% of patients, and in 42% and 44%, respectively, of those scoring high on measures of depression (Beck Depression Inventory [BDI]-II ≥ 15) and hopelessness (Beck Hopelessness Scale ≥ 8). Univariate analyses indicated that referral was associated with younger age, unmarried status, living alone, presence of more depressive symptoms, hopelessness, and attachment anxiety, and with less social support, self-esteem, and spiritual well-being (all P < .05). Among the significantly depressed (BDI-II ≥ 15), 100% of those less than 40 years of age, but only 22% of those age 70 years or older were referred. Multivariate analyses indicated that referral was associated with younger age, unmarried status, and presence of more depressive symptoms. Moreover, increasing age was associated with a progressively lower likelihood of referral independent of the level of distress. Conclusion: Routine referral of patients with metastatic cancer for psychosocial oncology care was predicted by presence of more severe depressive symptoms, younger age, and unmarried status. The rate of referral progressively declined with each decade of age, even among those with significant distress. These findings are consistent with some aspects of Andersen's model of health care utilization. The extent to which referred patients represent those who are most likely to benefit deserves further investigation.

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  • Referral at the centre occurs in approximately 33% of advanced cancer patients, of whom 66% are seen by a social worker and 33% are seen by a psychiatrist or psychologist.

    “Referral at our centre occurs in approximately 33% of advanced cancer patients, of whom 66% are seen by a social worker and 33% are seen by a psychiatrist or psychologist. 25”

    From Managing cancer and living meaningfully (CALM): Randomised feasibility trial in patients with advanced cancer (2019) · cites this paper as [25]

    The Results report that 109 patients (33.4%) were referred, supporting the approximately 33% referral rate. The provider percentages do not match: 59.6% were referred to social work only, 21.1% to psychiatry/psychology only, and 19.3% to both—not 66% and 33%. (LLM, conf=0.91)

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Authors
Ellis, J., Lin, J., Walsh, A., Lo, C., Shepherd, F. A., Moore, M., Li, M., Gagliese, L., Zimmermann, C., & Rodin, G.
Affiliations
University Health Network (CA)
Corresponding author
Rodin, Gary
ORCID
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2009-02-10
Volume
27
Issue
5
Pages
699-705
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.2007.15.4864
OpenAlex
W2043769110
Cited by
128
References
43
Citations by year
2026: 3 · 2025: 4 · 2024: 2 · 2023: 6 · 2022: 9 · 2021: 8 · 2020: 5 · 2019: 10 · 2018: 10 · 2017: 11 · 2016: 7 · 2015: 6 · 2014: 5 · 2013: 10 · 2012: 8
FWCI
4.22
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • ResearchOnline at James Cook University (James Cook University) (submittedVersion)
Funders
  • York University
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
metastatic cancer, depression, hopelessness, age, marital status, social support, attachment anxiety, self-esteem, spiritual well-being, health care utilization, gastrointestinal cancer, lung cancer
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Depression, Female, Gastrointestinal Neoplasms, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasm Metastasis, Referral and Consultation, Social Support, Marital Status

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