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Assessment of psychological distress in cancer patients: a pivotal role for clinical interview

Authors

  • A. Bonacchi,

    Corresponding author
    1. Service of Psychosomatic Medicine, U.O. Internal Medicine and Hepatology, Department of Internal Medicine, University of Florence, Florence, Italy
    • Service of Psychosomatic Medicine, U.O. Internal Medicine and Hepatology, Department of Internal Medicine, University of Florence, Florence, Italy
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  • A. Rossi,

    1. Service of Psychosomatic Medicine, U.O. Internal Medicine and Hepatology, Department of Internal Medicine, University of Florence, Florence, Italy
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  • L. Bellotti,

    1. Service of Psychosomatic Medicine, U.O. Internal Medicine and Hepatology, Department of Internal Medicine, University of Florence, Florence, Italy
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  • S. Franco,

    1. Service of Psychosomatic Medicine, U.O. Internal Medicine and Hepatology, Department of Internal Medicine, University of Florence, Florence, Italy
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  • A. Toccafondi,

    1. Service of Psychosomatic Medicine, U.O. Internal Medicine and Hepatology, Department of Internal Medicine, University of Florence, Florence, Italy
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  • G. Miccinesi,

    1. Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
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  • M. Rosselli

    1. Service of Psychosomatic Medicine, U.O. Internal Medicine and Hepatology, Department of Internal Medicine, University of Florence, Florence, Italy
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Abstract

Objective: The evaluation of psychological distress in cancer patients recently entered oncologic clinical practice. The objective of this study was to evaluate the role of clinical interview within psycho-oncologic assessment.

Methods: Questionnaires assessing distress (PDI), psychopathology (MHQ, HADS) and needs (NEQ) and a subsequent clinical interview were proposed to 320 consecutive inpatients from the Oncology Department of Careggi Hospital in Florence.

Results: The clinical interview made it possible to evaluate a significant percentage of patients (30%) who did not fill in questionnaires and to detect the presence of distress in 39 (13.7%) patients who would not have received a diagnosis in a protocol for the assessment of distress based only on questionnaires. It also provided the possibility to ask for help or to receive clinical support to a high percentage of patients (44.1%) who had not requested to speak to a psychologist through the questionnaires (NEQ). Moreover, 25% of patients who received prolonged clinical support had a low score in tests detecting distress, indicating that the opportunity for therapeutic support can emerge during a clinical interview, also in the absence of relevant symptoms detected by questionnaires.

Conclusions: The use of more than one questionnaire in the assessment of distress and psychopathology is associated with reduced compliance and redundant information. On the other hand, clinical interview has a pivotal role in clinical evaluation and access to psychological support. We conclude that optimal efficacy of programs assessing distress in cancer patients is reached when a single questionnaire evaluating distress is associated with a clinical interview. Copyright © 2010 John Wiley & Sons, Ltd.

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