Accessibility, Availability, and Potential Benefits of Psycho-Oncology Services: The Perspective of Community-Based Physicians Providing Cancer Survivorship Care
Open accessAbstract
Background: As persons of trust, community-based physicians providing survivorship care (e.g., general practitioners [GPs]) often serve as the primary contacts for cancer survivors disclosing distress. From the perspective of physicians providing survivorship care for cancer patients, this study explores (a) the accessibility, availability, and potential benefits of psycho-oncology services; (b) whether physicians themselves provide psychosocial support; and (c) predictors for impeded referrals of survivors to services. Methods: In a cross-sectional survey, all GPs and community-based specialists in a defined region were interviewed. In addition to descriptive analyses, categorical data were investigated by applying chi-square tests. Predictors for impeded referrals were explored through logistic regression. Results: Of 683 responding physicians, the vast majority stated that survivors benefit from psycho-oncology services (96.8%), but the physicians also articulated that insufficient coverage of psycho-oncology services (90.9%) was often accompanied by impeded referrals (77.7%). A substantial proportion (14.9%) of physicians did not offer any psychosocial support. The odds of physicians in rural areas reporting impeded referrals were 1.91 times greater than the odds of physicians in large urban areas making a similar report (95% confidence interval [1.07, 3.40]). Conclusion: Most community-based physicians providing survivorship care regard psycho-oncology services as highly beneficial. However, a large number of physicians report tremendous difficulty referring patients. Focusing on those physicians not providing any psychosocial support, health policy approaches should specifically (a) raise awareness of the role of physicians as persons of trust for survivors, (b) highlight the effectiveness of psycho-oncology services, and (c) encourage a proactive attitude toward the assessment of unmet needs and the initiation of comprehensive care.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Access to in-person supportive care is often limited by clinician shortages, financial constraints, and time available to attend therapy sessions.
“Access to in-person supportive care is often limited by clinician shortages, financial constraints, and time available to attend therapy sessions [9-13].”
From Co-Designing the MOSAIC mHealth App With Breast Cancer Survivors: User-Centered Design Approach (2024) · cites this paper as [11]
The Availability and Accessibility section reports insufficient local psycho-oncology coverage and difficult access to psychotherapists, supporting the clinician-shortage portion of the claim. The Discussion mentions long wait lists, but does not identify financial constraints or patients’ time to attend therapy sessions as barriers; it describes the German care setting as providing free healthcare. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBreast cancer survivors in this study recognized the current limitations of in-person psychosocial support, particularly a shortage of mental health clinicians trained to meet the unique needs of cancer survivors.
“Breast cancer survivors in this study recognized the current limitations of in-person psychosocial support [9,71], particularly a shortage of mental health clinicians trained to meet the unique needs of cancer survivors [11,72,73].”
From Co-Designing the MOSAIC mHealth App With Breast Cancer Survivors: User-Centered Design Approach (2024) · cites this paper as [11]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Initiative, F. T. S. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040296 · Cited by 23,020 · see citing works
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2008) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2007.11.008 · Cited by 17,893 · see citing works
Cohen, J. (1992) · Psychological Bulletin · doi:10.1037//0033-2909.112.1.155 · Cited by 8,771 · see citing works
An Introduction to Logistic Regression Analysis and Reporting
Peng, C.-Y. J., Lee, K. L., & Ingersoll, G. M. (2002) · The Journal of Educational Research · doi:10.1080/00220670209598786 · Cited by 2,671 · see citing works
Psychosomatic medicine in Germany: more timely than ever
Zipfel, S., Herzog, W., Kruse, J., & Henningsen, P. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000447701 · Cited by 2,323 · see citing works
Self-citationKrosnick, J. A. (1999) · Annual Review of Psychology · doi:10.1146/annurev.psych.50.1.537 · Cited by 1,852 · see citing works
Faller, H., Schuler, M., Richard, M., Heckl, U., Weis, J., & Küffner, R. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2011.40.8922 · Cited by 912 · see citing works
Peabody, J., Luck, J., Glassman, P., Jain, S., Hansen, J., Spell, M., & Lee, M. L. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-141-10-200411160-00008 · Cited by 773 · see citing works
Methodologies for Improving Response Rates in Surveys of Physicians
VanGeest, J. B., Johnson, T. P., & Welch, V. L. L. (2007) · Evaluation & the Health Professions · doi:10.1177/0163278707307899 · Cited by 697 · see citing works
Four-Week Prevalence of Mental Disorders in Patients With Cancer Across Major Tumor Entities
Mehnert, A., Brähler, E., Faller, H., Härter, M., Keller, M., Schulz, H., Wegscheider, K., Weis, J., Boehncke, A., Hund, B., et al. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2014.56.0086 · Cited by 649 · see citing works
American Society of Clinical Oncology Statement: Achieving High-Quality Cancer Survivorship Care
McCabe, M. S., Bhatia, R., Oeffinger, K. C., Reaman, G. H., Tyne, C. A., Wollins, D. S., & Hudson, M. M. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.46.6854 · Cited by 468 · see citing works
Holland, J. C., Andersen, B. L., BREITBART, W. S., Buchmann, L. O., Compas, B. E., Deshields, T. L., Shannon-Dudley, M., Fleishman, S. B., Fulcher, C. D., Greenberg, D. B., et al. (2013) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2013.0027 · Cited by 425 · see citing works
Defining Urban and Rural Areas in U.S. Epidemiologic Studies
Hall, S. A., Kaufman, J. S., & Ricketts, T. C. (2006) · Journal of Urban Health · doi:10.1007/s11524-005-9016-3 · Cited by 408 · see citing works
Interventions to improve outpatient referrals from primary care to secondary care
Akbari, A., Mayhew, A., Al-Alawi, M. A., Grimshaw, J., Winkens, R. A. G., Glidewell, L., Pritchard, C., Thomas, R. E., & Fraser, C. M. (2008) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005471.pub2 · Cited by 404 · see citing works
Logistic Regression Analysis and Reporting: A Primer
Peng, C. J., & So, T. H. (2002) · Understanding Statistics · doi:10.1207/s15328031us0101_04 · Cited by 313 · see citing works
Psychiatric disorders and mental health service use in patients with advanced cancer
Kadan‐Lottick, N. S., Vanderwerker, L. C., Block, S. D., Zhang, B., & Prigerson, H. G. (2005) · Cancer · doi:10.1002/cncr.21532 · Cited by 308 · see citing works
Dilworth, S., Higgins, I., Parker, V., Kelly, B., & Turner, J. (2014) · Psycho-Oncology · doi:10.1002/pon.3474 · Cited by 286 · see citing works
Potosky, A. L., Han, P. K. J., Rowland, J. H., Klabunde, C. N., Smith, T. G., Aziz, N. M., Earle, C. C., Ayanian, J. Z., Ganz, P. A., & Stefanek, M. E. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1808-4 · Cited by 274 · see citing works
Chronic Medical Illness, Depression, and Use of Acute Medical Services Among Medicare Beneficiaries
Himelhoch, S. S., Weller, W. E., Wu, A. W., Anderson, G. F., & Cooper, L. A. (2004) · Medical Care · doi:10.1097/01.mlr.0000127998.89246.ef · Cited by 266 · see citing works
Rural‐urban disparities in health status among US cancer survivors
Weaver, K. E., Geiger, A. M., Lu, L., & Case, L. D. (2012) · Cancer · doi:10.1002/cncr.27840 · Cited by 249 · see citing works
Butow, P. N., Phillips, F., Schweder, J., White, K., Underhill, C. R., & Goldstein, D. (2011) · Supportive Care in Cancer · doi:10.1007/s00520-011-1270-1 · Cited by 242 · see citing works
Eakin, E., & Strycker, L. A. (2001) · Psycho-Oncology · doi:10.1002/pon.500 · Cited by 223 · see citing works
Hewitt, M. E., & Rowland, J. H. (2002) · Journal of Clinical Oncology · doi:10.1200/jco.2002.03.077 · Cited by 203 · see citing works
A New Quality Standard: The Integration of Psychosocial Care Into Routine Cancer Care
Jacobsen, P. B., & Wagner, L. I. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.39.5046 · Cited by 180 · see citing works
Bober, S. L., Recklitis, C. J., Campbell, E. G., Park, E. R., Kutner, J. S., Najita, J., & Diller, L. (2009) · Cancer · doi:10.1002/cncr.24590 · Cited by 176 · see citing works
Li, M., Kennedy, E. B., Byrne, N., Gérin-Lajoie, C., Katz, M. R., Keshavarz, H., Sellick, S., & Green, E. (2017) · Psycho-Oncology · doi:10.1002/pon.4286 · Cited by 151 · see citing works
Mitchell, A. J., Vahabzadeh, A. B. N., & Magruder, K. M. (2011) · Psycho-Oncology · doi:10.1002/pon.1943 · Cited by 150 · see citing works
Zebrack, B., Kayser, K., Sundstrom, L., Savas, S. A., Henrickson, C., Acquati, C., & Tamas, R. L. (2015) · Journal of Clinical Oncology · doi:10.1200/jco.2014.57.4020 · Cited by 131 · see citing works
Greer, J. A., Traeger, L., Bemis, H., Solis, J., Hendriksen, E. S., Park, E. R., Pirl, W. F., Temel, J. S., Prigerson, H. G., & Safren, S. A. (2012) · The Oncologist · doi:10.1634/theoncologist.2012-0041 · Cited by 111 · see citing works
What is a psychological intervention? A metareview and practical proposal
Hodges, L. J., Walker, J., Kleiboer, A. M., Ramirez, A. J., Richardson, A., Velikova, G., & Sharpe, M. (2010) · Psycho-Oncology · doi:10.1002/pon.1780 · Cited by 103 · see citing works
Absolom, K. L., Holch, P., Pini, S. A., Hill, K. M., Liu, A., Sharpe, M., Richardson, A., & Velikova, G. (2011) · Psycho-Oncology · doi:10.1002/pon.1916 · Cited by 101 · see citing works
Forsythe, L. P., Alfano, C., Leach, C., Ganz, P., Stefanek, M., & Rowland, J. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.39.9832 · Cited by 83 · see citing works
Health care needs of cancer survivors in general practice: a systematic review
Hoekstra, R. A., Heins, M. J., & Korevaar, J. C. (2014) · BMC Family Practice · doi:10.1186/1471-2296-15-94 · Cited by 81 · see citing works
For which health problems do cancer survivors visit their General Practitioner?
Heins, M. J., Korevaar, J. C., Rijken, M., & Schellevis, F. (2012) · European Journal of Cancer · doi:10.1016/j.ejca.2012.07.011 · Cited by 81 · see citing works
Rankin, N. M., Butow, P. N., Thein, T., Robinson, T., Shaw, J., Price, M. A., Clover, K. A., Shaw, T. J., & Grimison, P. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0691-9 · Cited by 79 · see citing works
Management of psychosocial distress by oncologists
Muriel, A. C., Hwang, V. S., Kornblith, A., Greer, J., Greenberg, D. B., Temel, J., Schapira, L., & Pirl, W. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.8.1132 · Cited by 75 · see citing works
Mori, M., Shimizu, C., Ogawa, A., Okusaka, T., Yoshida, S., & Morita, T. (2015) · The Oncologist · doi:10.1634/theoncologist.2015-0147 · Cited by 72 · see citing works
Barriers Against Psychosocial Communication: Oncologists' Perceptions
Fagerlind, H., Kettis, Å., Glimelius, B. L. G., & Ring, L. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.45.1609 · Cited by 63 · see citing works
Depression, anxiety and disease-related distress in couples affected by advanced lung cancer
Haun, M. W., Sklenarova, H., Villalobos, M., Thomas, M., Brechtel, A., Löwe, B., Herzog, W., & Hartmann, M. (2014) · Lung Cancer · doi:10.1016/j.lungcan.2014.09.009 · Cited by 59 · see citing works
Self-citationHoward, A. F., Smillie, K., Turnbull, K., Zirul, C., Munroe, D., Ward, A., Tobin, P., Kazanjian, A., & Olson, R. A. (2014) · The Journal of Rural Health · doi:10.1111/jrh.12064 · Cited by 52 · see citing works
Neumann, M., Galushko, M., Karbach, U., Goldblatt, H., Visser, A. P., Wirtz, M. A., Ernstmann, N., Ommen, O., & Pfaff, H. (2009) · Supportive Care in Cancer · doi:10.1007/s00520-009-0731-2 · Cited by 49 · see citing works
Andrykowski, M. A., & Burris, J. L. (2009) · Psycho-Oncology · doi:10.1002/pon.1669 · Cited by 46 · see citing works
Kam, L. Y. K., Knott, V. E., Wilson, C. J., & Chambers, S. K. (2010) · Psycho-Oncology · doi:10.1002/pon.1897 · Cited by 42 · see citing works
Chrischilles, E. A., McDowell, B. D., Rubenstein, L. M., et al. (2014) · Journal of Cancer Survivorship · doi:10.1007/s11764-014-0406-y · Cited by 32 · see citing works
Psychiatry and Psychosomatic Medicine in Germany: Lessons to be Learned?
Diefenbacher, A. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01683.x · Cited by 30 · see citing works
Buchanan, N. D., King, J., Rodriguez, J. L., White, A. L., Trivers, K. F., Forsythe, L. P., Kent, E. E., Rowland, J. H., & Sabatino, S. A. (2013) · ISRN Oncology · doi:10.1155/2013/238017 · Cited by 26 · see citing works
Whitney, R. L., Bell, J. F., Bold, R. J., & Joseph, J. G. (2014) · Psycho-Oncology · doi:10.1002/pon.3569 · Cited by 25 · see citing works
The changing landscape of cancer care - the impact of psychosocial clinical practice guidelines
Turner, J. (2015) · Psycho-Oncology · doi:10.1002/pon.3803 · Cited by 21 · see citing works
Use of cancer-specific mental health resources—is there an urban-rural divide?
Beraldi, A., Kukk, E., Nest, A., Schubert-Fritschle, G., Engel, J., Heußner, P., & Herschbach, P. (2014) · Supportive Care in Cancer · doi:10.1007/s00520-014-2467-x · Cited by 13 · see citing works
Promoting the Implementation of Best-Practice Guidelines Using a Matrix Tool
Luxford, K., Hill, D., & Bell, R. (2006) · Disease Management & Health Outcomes · doi:10.2165/00115677-200614020-00003 · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Holland JC, Andersen B, Breitbart WS et al. Dis- tress management. J Natl Compr Canc Netw 2013; 11:190-209.
- Del Giudice ME, Leszcz M, Pritchard KI et al. Attitudes of Canadian oncology practitioners toward psychosocial interventions in clinical and research settings in women with breast cancer. Psychooncol- ogy 1997;6:178-189.
- Adler NE, Page AE, eds. Cancer care for the whole patient: Meeting psychosocial health needs. Washington, DC: National Academies Press, 2008.
Cited by
Sorted by citations
Holtdirk, F., Mehnert, A., Weiss, M., Mayer, J., Meyer, B., Bröde, P., Claus, M., & Watzl, C. (2021) · PLOS ONE · doi:10.1371/journal.pone.0251276 · Cited by 62 · see citing works
Vartolomei, L., Shariat, S. F., & Vartolomei, M. D. (2018) · European Urology Oncology · doi:10.1016/j.euo.2018.04.011 · Cited by 22 · see citing works
Tsiouris, A., Mayer, A., Nölke, C., Ruckes, C., Labitzke, N., Wiltink, J., Beutel, M. E., & Zwerenz, R. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100410 · Cited by 11 · see citing works
“…(Haun et al., 2018), e.g. by lack of transportation, living in a rural area, suffering from physical disabilities, or information deficits, which prevent cancer patients from taking advantage of face-to-face support (Zimmermann-Schlegel et al., 2017; Sakellariou et al., 2019; Neumann et al., 2010).”
BackgroundCo-Designing the MOSAIC mHealth App With Breast Cancer Survivors: User-Centered Design Approach
Nuseibeh, B. Z., Johns, S. A., Shih, P. C., Lewis, G. F., Gowan, T. M., & Jordan, E. J. (2024) · JMIR Formative Research · doi:10.2196/59426 · Cited by 5 · see citing works
- Authors
- Zimmermann-Schlegel, V., Hartmann, M., Sklenarova, H., Herzog, W., & Haun, M. W.
- Affiliations
- Department of General Internal Medicine and Psychosomatics Heidelberg University Hospital, Germany
- University Hospital Heidelberg (DE)
- University of Regensburg (DE)
- Corresponding author
- Haun, Markus W.
- Venue
- The Oncologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-04-24
- Volume
- 22
- Issue
- 6
- Pages
- 719-727
- ISSN
- 1083-7159 (ISSN-L)
- 1549-490X
- PMC
- PMC5469591
- OpenAlex
- W2609367840
- Cited by
- 35
- References
- 51
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1 · 2023: 6 · 2022: 8 · 2021: 6 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Oncologist (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Regensburg Publication Server (University of Regensburg) (submittedVersion)
- Funders
- Bundesministerium für Gesundheit
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- survivorship care, community-based physicians, general practitioners, referral barriers, psychosocial support, access to services, urban-rural differences, physician attitudes, health policy
- MeSH terms
- Psycho-Oncology, Survivorship, Female, Humans, Male, Neoplasms, Practice Patterns, Physicians', Physicians, Surveys and Questionnaires, Survivors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
