Predictors of psychological distress among cancer patients receiving care at a safety-net institution: the role of younger age and psychosocial problems

The present study examined prevalence and predictors of psychological distress among cancer patients receiving care at a safety-net institution during the first year of implementation of a distress screening protocol. Differences between screened and unscreened patients were also analyzed. Data on 182 breast and lung cancer patients who were treated at a NCI-designated Academic Comprehensive Cancer Center (ACAD) were abstracted from the patients' medical charts for a period of 1 year. Among the patients screened for distress, 66.2% reported a score higher than 4 (the established cut-off for distress) on the Distress Thermometer. Results from multiple regression analysis indicated that younger age, practical, and emotional problems were significant predictors of higher self-reported scores of psychological distress. There were no significant differences on socio-demographic and clinical variables between patients screened and those who were not screened. However, patients who were receiving more than one treatment modality were more likely to be screened. The occurrence of psychological distress in this setting was higher than the percentages reported in other similar studies. Furthermore, younger cancer patients and those presenting psychosocial problems were at risk for higher distress, which requires referral to psychosocial providers and the implementation of services able to meet these areas of need.