The prevalence and implications of elderly inpatients' desire for a formal psychological help at the start of cancer treatment

Introduction: Little is known about elderly cancer inpatients' desire for psychological help.

Purpose: The aim of this study was to investigate whether elderly cancer inpatients well informed about their diagnosis expressed a desire to receive formal psychological help at the start of their cancer treatment. The characteristics of the patients that sought help were examined.

Methods: This cross-sectional study assessed 650 consecutive cancer inpatients that were 65 years of age and older when they started treatment for breast, colorectal, ovarian, lung, prostate or haematological cancers. Disease-related, medical and psychological characteristics of these patients were assessed using validated tools.

Results: Distress and cognitive impairment were experienced by 37% and 46% of elderly cancer inpatients, respectively. However, only 12% of patients reported a desire for formal psychological help (14% of women vs 9% of men). The patient characteristics examined were found to be weakly associated with this desire (this explained 16% of the variance for women and 14% for men). For the female subgroup, this desire was associated with age [<75 years vs ≥75 years; odds ratio (OR) = 2.57], marital status (without a partner vs with a partner; OR = 2.26) and distress (OR = 1.13). For the male subgroup, loss of functional autonomy (OR = 1.41) and pain (OR = 1.22) were relevant characteristics.

Conclusions: Although more than about four out of 10 elderly cancer inpatients in this study experience distress or cognitive impairment, only about one out of 10 expresses a desire for formal psychological help. Therefore, an appropriate sequence of interventions should be scheduled in order to offer them an optimal formal psychological help.