Depression predicts lower use of services in gynaecological cancer survivors (#448)
To assess the psychological wellbeing, unmet supportive care needs, quality of life and service needs of gynaecological cancer survivors with depression and/or anxiety and determine factors associated with their use of services.
In 2010, a population-based cross-sectional mail survey (49% response rate) was completed by 160 gynaecological cancer survivors, who were 5 to 30 month post diagnosis. Descriptive statistics summarized prevalence of outcomes. Chi-Square tests were used to ascertain factors associated with depression and anxiety and assess whether patients with psychological distress had higher supportive care needs and used services to alleviate those ailments.
The prevalence of depression/anxiety was 21% and 24% respectively. Factors associated with higher levels of depression included living alone, and being unemployed or retired.
Women with high levels of depression/anxiety had higher unmet supportive care needs in all domains including psychological (p=<0.01), physical and daily living (p=<0.01), health system and information needs (p= <0.01), patient care and support needs (p=<0.01) and sexuality needs (p=<0.01), and also reported significantly lower quality of life. Women with depression/anxiety were less likely to use services. Services needed but not used by women with high levels of depression or anxiety were psychiatrists, psychologists and pain specialists.
Still not enough women with physical and psychological sequela after treatment for gynaecological cancers are using services. Inadequate use of services may lead to lower quality of life and more unmet supportive care needs in a number of domains. To improve utilization of services and supportive care, well-defined survivorship care plans, and targeted survivorship interventions need to be developed, tested in randomised trials, and those successful need to be integrated into standard care.