Computerized prospective screening for high levels of emotional distress in head and neck cancer patients and referral rate to psychosocial care

I.M. de Leeuw, R. de Bree, A.L. Keizer, T. Houffelaar, P. Cuijpers, M.H.M. van der Linden, C.R. Leemans

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To investigate prospectively the prevalence of high levels of emotional distress and referral rate to psychosocial
care in head and neck cancer (HNSCC) patients. Fifty-five consecutive newly diagnosed HNSCC
patients were asked to complete the hospital anxiety and depression scale (HADS) and the EORTC QLQC30
and H&N35 quality of life questionnaires on a touch screen computer-assisted data collection system
on their first visit and during follow-up visit. Sociodemographic, clinical, and quality of life parameters
were compared to a high level of distress (HADS score >15). Number of patients with a high level of distress
were compared to referral rates to psychosocial care as retrieved from patient hospital files. At time
of diagnosis, 18% (10/55) of the patients had a high level of distress (related to tumor stage and site, and
global quality of life and social eating) versus 25% (14/55) at follow-up (related to a variety of quality of
life parameters). Low levels of distress at baseline or follow-up was noted in 64%; 18% had normal scores
at baseline and developed distress at follow-up; 11% had high levels at baseline and returned to normal
scores at follow-up, and 7% had persistent distress from baseline to follow-up. No patients were referred
to psychosocial care at time of diagnosis. At follow-up visit 21% (3/14) were referred, all patients who
developed a high level of distress after initial diagnosis. High level of emotional distress is common
and few patients are referred to psychosocial care. Development of a stepped care model (including careful
monitoring by using a touch screen computer system) may meet the potentially unmet needs of HNC
patients and contribute improving cancer care.
Original languageUndefined/Unknown
Pages (from-to)129-133
Number of pages5
JournalOral Oncology
Issue number10
Publication statusPublished - 2009

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