Physicians' attitudes towards psycho-oncology, perceived barriers, and psychosocial competencies: Indicators of successful implementation of adjunctive psycho-oncological care?

OBJECTIVE: Clinical experience reveals a gap between recommended psychosocial care and actual support for psycho-oncology. Physicians are essential for managing psychosocial distress and for the successful implementation of psycho-oncology. The aim was to explore physician's attitudes towards psycho-oncology, their self-perceived barriers towards referral to psycho-oncology, and their personal psychosocial competencies in a maximum-care hospital.

METHOD: Semistructured interviews informed the development of a questionnaire administered to a monocentric sample of 120 physicians at the University Hospital Frankfurt. The data were exploratively analysed.

RESULTS: One hundred two physicians completed the questionnaire. Physicians provided high ratings concerning the value of psycho-oncology, beliefs about its efficacy, and their personal commitment to psycho-oncology. Physicians noticed especially barriers that originated from patients themselves. They estimated their own psychosocial education and knowledge as moderate but rated their psychosocial skills and abilities as higher. Frequency of integration of psychosocial care was most strongly influenced by physicians' psychosocial competencies and their personal commitment to psycho-oncology. Integration of psycho-oncological issues occurs in 43% of patients.

CONCLUSION: Physicians are an important indicator of successful implementation. The discrepancy between the positive evaluation and actual support for psycho-oncology may be explained by several factors, eg, the lack of support from clinic leaders. Patient-related barriers, most often identified by physicians, seem to be an indication of actual lack of psychosocial competencies. Physicians' psychosocial competencies positively affect the implementation of psycho-oncology. Sound knowledge of psychosocial topics may result in increased integration of psychosocial aspects into treatment. Therefore, medical training should focus more on psychosocial issues.