Psycho-oncological care in rural and urban areas. Experiences and desires of cancer patients and caregivers

Background. The diagnosis of cancer is frequently accompanied by significant psychosocial distress not only for patients but also for their caregivers. Psycho-oncological services are nowadays implemented in routine oncological care to address such needs; however, little is known about utilization of psychosocial support by patients and caregivers outside of cancer centers. Objective. The aim of the study was to establish whether there is sufficient coverage and adequate use of psycho-oncological services in cancer survivors living in rural areas. Additionally, we were interested in the number of caregivers who received any form of psycho-oncological care. Methods. In a cross-sectional survey we estimated psychosocial stress and use of psycho-oncological services in mainly rural cancer patients, which we recruited in primary care practices. We used the distress thermometer (DT) and the short form of the Patient Health Questionnaire (PHQ-4) as well as a checklist on utilization of psychosocial and other support facilities. A total of 585 cancer patients and 488 caregivers provided data. Results. Approximately 2 years after diagnosis 48% of the patients experienced increased levels of distress and approximately 25% expressed signs of depression and/or anxiety disorders. Caregivers showed comparable levels of psychological burden. Large differences 22% versus 6%) were found between patients and caregivers with respect to utilization of psycho-oncological resources. Conclusion. Financial and work-related support was provided in more than half of the patients; however, the level of emotional support was poor, in particular with respect to caregivers needs. Public awareness on available resources should be strengthened.