Why do oncology outpatients who report emotional distress decline help?
Why do oncology outpatients who report emotional distress decline help?
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DOI：
10.1002/pon.3729
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发表时间：
2015-07-01
期刊：
影响因子：
3.6
通讯作者：
Carter, Gregory
中科院分区：
文献类型：
--
作者：
Clover, Kerrie Ann;Mitchell, Alex J.;Carter, Gregory
目的许多经历痛苦的患者不会寻求帮助，而对其原因知之甚少。我们探讨了有严重情绪困扰的患者拒绝帮助的原因。方法通过澳大利亚一家医院的 QUICATOUCH 筛查收集数据。肿瘤科门诊患者在痛苦温度计上得分为 4 分或以上时，会被询问是否需要帮助来缓解痛苦。那些拒绝帮助的人被问及原因。使用人口统计学变量和焦虑和抑郁的临床测量 (PSYCH-6) 来确定与拒绝帮助的原因相关的因素。结果 在 311 名患有严重痛苦的患者中，221 名 (71%) 拒绝了帮助。最常见的原因是我更喜欢自我管理”（n=99, 46%）；已经接受帮助”（n=52, 24%）并且我的痛苦还不够严重”（n=50, 23%）。年轻的患者和女性更有可能拒绝帮助，并且更有可能已经在接受帮助。那些认为自己的痛苦没有严重到需要帮助的患者的痛苦评分和 PSYCH-6 评分显着较低。尽管如此，每组中都有患者在痛苦和心理方面得分最高。 结论 帮助缓解痛苦的两个常见患者障碍是偏好自助和相信痛苦还没有严重到需要干预的程度。相当大比例的人都持有这些信念，他们报告了非常严重的痛苦。需要进行定性研究和随后的干预措施来克服这些障碍，才能从痛苦筛查计划中获得最大利益。版权所有 (c) 2014 约翰·威利父子有限公司
ObjectiveMany patients who experience distress do not seek help, and little is known about the reasons for this. We explored the reasons for declining help among patients who had significant emotional distress.MethodsData were collected through QUICATOUCH screening at an Australian hospital. Oncology outpatients scoring 4 or more on the Distress Thermometer were asked if they would like help' with their distress. Those who declined help were asked their reasons. Demographic variables and a clinical measure of anxiety and depression (PSYCH-6) were used to identify factors associated with reasons for declining help.ResultsOf 311 patients with significant distress, 221 (71%) declined help. The most common reasons were I prefer to manage myself' (n=99, 46%); already receiving help' (n=52, 24%) and my distress is not severe enough' (n=50, 23%). Younger patients and women were more likely to decline help and were more likely to already be receiving help. Distress score and PSYCH-6 scores were significantly lower among patients who rated their distress as not severe enough to require help. Nevertheless, there were patients who had maximal scores on distress and PSYCH in each group.ConclusionsTwo common patient barriers to help with distress are a preference for self-help and a belief that distress is not sufficiently severe to warrant intervention. These beliefs were held by a sizeable proportion of individuals who reported very high levels of distress. Qualitative research and subsequent interventions for overcoming these barriers are required to obtain the most benefit from distress screening programs. Copyright (c) 2014 John Wiley & Sons, Ltd.