Detection and evaluation of preoperative psychological care needs in cancer and noncancer patients referred to thoracic surgery

Abstract

Objectives: (a) to evaluate and compare the psychological treatment needs of patients with cancer and non-cancer, who are going to undergo scheduled thoracic surgery, and (b) evaluate and compare the diagnostic accuracy of the screening tests of psychological treatment needs for cancer and non-cancer patients. Method: The need for psychological treatment was evaluated in a total of 169 patients prior to thoracic surgery, through a clinical interview. The screening tests used were: the physician’s judgment (yes/no), the Hospital Anxiety and Depression Scale (HADS) and, the single-item interview to assess depression ‘‘Do you feel depressed?’’ (DEPQ). Results: The number of patients who needed psychological treatment in the total sample was 47 (27.81%), in non-cancer-patients: 22 (30.99%) and in cancer patients: 25 (25.51%). The participants with treatment needs were more often young women with primary education levels, with more fears and concerns regarding their disease. With respect to the screening tests, the HADS-T (cut-off point =13) obtained a sensitivity (SE) of 0.75 and Specificity (SP) of 0.81 in the total sample. In patients with cancer, the HADS total score (cut-off point 10) obtained an SE = 0.84 and SP = 0.80, and, in non-cancer patients, the HADS total score (cut-off point=13) showed an SE = 0.59 and SP = 0.84. The DEPQ and the physician’s judgment did not achieve adequate levels of precision. Conclusions: A high percentage of patients have psychological treatment needs before performing thoracic surgery, which are similar for cancer and non-cancer patients. Preoperative detection of patients who need psychological intervention is feasible with a simple screening test: HADS, which achieves greater precision in cancer patients.