Factors associated with distress and the impact of distress on acute health-care service utilization among patients diagnosed with breast and gynecological cancers.

Autor:	Lim SY; Doctor of Medicine (MD) programme, Duke-NUS Medical School Singapore, Singapore, Singapore., Ke Y; Department of Pharmacy, National University of Singapore, Singapore, Singapore., Mok NK; Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore., Tan YY; Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore., Neo PSH; Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore., Chan A; Department of Pharmacy, National University of Singapore, Singapore, Singapore.; Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore.; Department of Clinical Pharmacy Practice, University of California Irvine, Irvine, USA., Yang GM; Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore.; Department of General Medicine, Sengkang General Hospital, Singapore, Singapore.; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.
Jazyk:	angličtina
Zdroj:	Palliative & supportive care [Palliat Support Care] 2024 Aug; Vol. 22 (4), pp. 726-733.
DOI:	10.1017/S1478951522001444
Abstrakt:	Objectives: Patients with cancer often have unmet needs (e.g., physical, psychosocial, and emotional) during their cancer journey, putting them at risk for distress. This study aimed to identify factors associated with distress and to investigate the association between distress and acute health-care services utilization in a cohort of breast and gynecological cancer patients across different survivorship stages. Methods: This was a retrospective cohort study of patients who visited National Cancer Centre Singapore between September 2019 and July 2020. Distress was evaluated using the self-reported Distress Thermometer and Problem List, with a distress thermometer score ≥4 signifying high distress. Data were extracted from electronic medical records. Multivariable logistic regression was used to identify demographic or clinical variables associated with distress and estimate the odds of emergency department (ED) visits and hospitalizations within 30 days of distress screening, adjusted for covariates. Results: Of the 1386 patients included in the analysis, 510 (36.8%) reported high distress on their first distress screening. Variables associated with high distress included younger age, presence of psychiatric diagnosis, poorer Eastern Cooperative Oncology Group performance status, and shorter duration from cancer diagnosis to distress screening. Patients with high distress were associated with higher odds of ED visits (adjusted odds ratio [OR] = 2.25, 95% confidence interval [CI]: 1.14-4.43) and hospitalizations (adjusted OR = 2.11, 95% CI: 1.27-3.50) within 30 days of distress screening. Significance of Results: Self-reported high distress was associated with higher odds of increased acute health-care services utilization (ED visits and hospitalizations) in patients with breast and gynecological cancer. Identifying the subgroups at risk of high distress could trigger early interventions that reduce unplanned health-care services utilization and possibly health-care costs.
Databáze:	MEDLINE
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