Introduction: About 30 to 50 % of all cancer patients are so severely distressed that they need professional psycho-oncological support. However, if such support is offered to these patients, about 60-80u2009% refuse help.Objectives: The aim of this study conducted by the Comprehensive Cancer Center is to identify sociodemographic, medical and psychological conditions of the desire for psycho-oncological support among patients with high psychosocial distress. Methods: In a multicenter study in Germany a total of n = 972 inpatients with various cancer diagnoses were examined. Measuring instruments for psychological distress were the Distress Thermometer [1] and the QSC-R10 [2]. Further, we examined potential aspects regarding the refusal of / desire for psycho-oncological support services including sociodemographic, medical and psychological conditions (e.g. depression [3]), personality [4], social support, self-efficacy [5], previous experiences with psychological support offers and status of information.Results: Overall more than half of highly distressed cancer patients refuse psycho-oncological support. Women wish for psycho-oncological support nearly twice as often as men. Distressed patients who have a desire for psycho-oncological support are more depressed and have a worse physical condition than patients who refuse help. Personality factors (neuroticism and agreeableness) and current medical treatment (chemo- and radiotherapy) do play a role for the desire for psycho-oncological support. Conclusions: The fact that still a very large number of highly distressed cancer patients refuse psycho-oncological support forces us to reconsider if the established support offers match the needs of distressed cancer patients. Moreover we need to rethink how we communicate psycho-oncological support offers, especially for distressed men. We have to look more closely at how previous psycho-oncological treatment and personality factors may determine the desire for psychological support. Further multivariat analysis are neccessary to examine which variables are causative for this individual and health economic problem of refusal of psycho-oncological support services.

Introduction: Patient reported outcome measures (PROMs) are used for assessment and monitoring of psychosocial distress in cancer patients. However, studies on the implementation and use of electronic PROMs in everyday clinical practice are still limited [1] . Objectives: The aim of this study conducted by the Comprehensive Cancer Center Munich is to prove feasibility of Screen2Care - an electronic distress screening for cancer patients which is connected to the clinic's internal documentation system (SAP-system).Methods: A digital version of the distress screening for cancer patients (QSC-R10) [2] with connection to the clinic's internal documentation system has been investigated. Target group were patients with an assured tumor diagnosis and who have already been briefed about their diagnosis. Patients completed the questionnaire on a tablet-PC. The central performers of the screening procedure was the nursing staff. Following a three-month pilot study, feasibility of Screen2Care was assessed through study specific usability questionnaires evaluating patientu2019s and nursing staffu2019s satisfaction with the system.Results: N = 69 patients completed the distress screening on a tablet-PC, n = 39 patients and n = 13 nurses answered usability questionnaires. Overall patients judged the electronic screening overall very positive. Operating with the tablet was judged as uncomplicated by patients and nursing staff. 76,9 % of nurses preferred electronic screening over paper Screening. 92,3 % of nurses rated the functions within the documentation system as clearly arranged. Time required for the screening procedure and integration into the daily work routine is still critically assessed.Conclusions: In the course of the pilot study the feasibility of Screen2Care has been confirmed. The biggest advance of the system is the connection to the documentation system and thus the automatic monitoring of consultations.

Abstract: Objective Many distressed cancer patients do not want or, finally, do not use psychological support. This study aimed at identifying factors associated with the decline of psychological support during hospital stay. Methods This cross-sectional study included inpatients with different cancer diagnoses. Distress was assessed using the short form of the Questionnaire on Stress in Cancer Patients-Revised (QSC-R10) and the Distress Thermometer (DT). Multivariable logistic regression was used to identify factors associated with decline. Results Of 925 patients, 71.6% (n = 662) declined psychological support. Male sex (OR = 2.54, 95% CI = 1.69-3.80), low psychosocial distress (OR = 3.76, CI = 2.50-5.67), not feeling depressed (OR = 1.93, CI = 1.24-2.99), perceived overload (OR = 3.37, CI = 2.19-5.20), no previous psychological treatment (OR = 1.88, CI = 1.25-2.83), and feeling well informed about psychological support (OR = 1.66, CI = 1.11-2.46) were associated with decline. Among the patients who indicated clinical distress (46.2%), 53.9% declined psychological support. Male sex (OR = 2.96, CI = 1.71-5.12), not feeling depressed (OR = 1.87, CI = 1.12-3.14), perceived overload (OR = 5.37, CI = 3.07-9.37), agreeableness (OR = 0.70, CI = 0.51-0.95), and feeling well informed about psychological support (OR = 1.81, CI = 1.07-3.07) were uniquely associated with decline in this subgroup. Conclusions Decline of psychological support is primarily due to psychological factors. Feeling well informed about support emerged as a relevant factor associated with decline. Thus, design of informational material and education about available psychological services seem crucial