Prevalence of distress, its associated factors and referral to support services in people with cancer

AIMS AND OBJECTIVES: To (i) characterise prevalence of distress amongst people diagnosed with cancer, (ii) determine factors associated with increasing distress, (iii) describe reported problems for those with clinically significant distress and (iv) investigate the factors associated with referral to support services. BACKGROUND: International studies report a high prevalence of clinically significant distress in people with cancer. Australian studies are notably lacking. Additionally, clinicians still do not fully understand the factors associated with cancer-related distress. DESIGN: Period prevalence study. METHODS: Distress screening data were analysed for 1,071 people accessing the Cancer Council Western Australia information and support line between 01/01/2016-31/12/2018. These data included people's demographics, cancer diagnoses, level of distress, reported problems and the service to which they were referred. Distress and reported problems were measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List. A partial proportional logistic regression model was constructed to determine which factors were associated with increasing levels of distress. Standard binary logistic regression models were used to investigate factors associated with referral to support services. The STROBE checklist was followed. RESULTS: Prevalence of clinically significant distress was high. Self-reported depression, sadness, worry and a lack of control over treatment decisions were significantly associated with increasing distress. Emotional problems were the most prevalent problems for people with clinically significant distress. Most people were referred to emotional health services, with depression, fatigue, living regionally and higher socioeconomic status associated with referral. CONCLUSIONS: Emotional problems such as depression, sadness and worry are associated with increasing levels of distress. RELEVANCE TO CLINICAL PRACTICE: Not all factors associated with referral to support services were those associated with increasing levels of distress. This suggests that other factors may be more influential to referral decisions.