Japanese Journal of Clinical Oncology Advance Access published online on August 29, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn088
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© The Author (2008). Published by Oxford University Press. All rights reserved
Patient-Perceived Barriers to the Psychological Care of Japanese Patients with Lung Cancer
1 Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
2 Course of Specialized Clinical Care, Psychiatry, Tokai University School of Medicine, Isehara, Kanagawa
3 Course of Internal Medicine, Medical Oncology, Tokai University School of Medicine, Isehara, Kanagawa
4 Oncology Center, Tokai University School of Medicine, Isehara, Kanagawa, Japan
For reprints and all correspondence: Tatsuo Akechi, Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. E-mail: takechi{at}med.nagoya-cu.ac.jp
Received March 11, 2008; accepted July 30, 2008
Objective: Although cancer patients frequently experience psychological distress, few cancer patients with psychological distress receive appropriate psychological care. The purpose of this study was to investigate the type and frequency of barriers to receive psychological care in patients with lung cancer.
Methods: Randomly selected ambulatory patients with lung cancer participated in the study. A self-administered questionnaire developed for this study was used to assess patient-perceived barriers toward psychological care provided in a medical context. Factor analysis indicated that this scale mapped four domains; emotional communication with their physicians, psychiatric consultation, psychotropic medication and counseling. The patients' demographic factors and levels of past and current psychological distress were also assessed to reveal potential factors associated with patient-perceived barriers to psychological care.
Results: Complete data were available from 100 patients. The mean (SD) age of the patients was 65.4 (9.8) years; more than 80% were male, and 77% suffered from advanced stage lung cancer. Lack of correct information and/or misunderstanding of treatments was found to be a major barrier for all four treatment options in common. Negative opinions toward the use of psychotropics were more frequent than those toward counseling. Patients with severe psychological distress were significantly more likely to report a reluctance to undergo psychiatric consultation than those without psychological distress.
Conclusions: Lung cancer patients commonly experienced concerns to utilize psychological care. Encouragement from physicians to discuss emotional aspects and the provision of sufficient information regarding psychological care may be useful to alleviate such concerns. Medical staffs should also be aware that severe psychological distress may itself be related to a reluctance to undergo psychiatric consultation.
Key Words: cancer • barrier • psychosocial treatment • communication • quality-of-life
A portion of this study's results has been published in the following article: Okuyama T, Endo C, Seto T, Kato M, Seki N, Akechi T, Furukawa TA, Eguchi K, Hosaka T. Cancer patients' reluctance to disclose their emotional distress to their physicians: a study of Japanese patients with lung cancer. Psychooncology 2008;17:460–5.