Cancer treatment and services: Psycho-oncology

Psycho‑oncology in cancer care

Having cancer can affect people in many ways. The psychological impact of cancer can affect a person’s overall ability to function, quality of life, and capacity to cope. The field of psycho‑oncology considers the psychological, social and behavioural aspects of cancer.

Assessing psychological symptoms can help to identify patients’ concerns, their levels of distress, and the severity of their symptoms. This identification can allow health professionals to provide support at an early stage.

People who attended outpatient cancer clinics and who were in an active phase of treatment across NSW public hospitals in November 2018 were surveyed, and asked for feedback about their experiences and outcomes of care. People having treatment for cancer were asked to rate:

  • their levels of anxiety or depression
  • how confident they felt about their ability (self‑efficacy) to keep a positive attitude or control negative feelings.

Overall, there were 2,664 survey respondents in an active phase of treatment.

Identifying differences in the experiences of patients across NSW may help to target efforts to address the psychological problems associated with cancer.

Overall key findings:

In November 2018, patients in an active phase of treatment who attended outpatient cancer clinics in NSW public hospital reported the following experiences:

  • 31% of people reported moderate or high severity for anxiety.
  • 35% of people reported no symptoms of anxiety.
  • 28% of people reported moderate or high severity for depression.
  • 40% of people reported no symptoms of depression.
  • The majority of people felt they had some degree of confidence in their ability to control negative feelings.
  • The majority of people felt confident in their ability to keep a positive attitude.

Self‑assessed rating for anxiety* for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

Key findings:

  • In November 2018, 31% of people attending an outpatient cancer clinic in an active phase of treatment in NSW public hospitals reported moderate or high levels of anxiety.
  • 35% of people reported no symptoms of anxiety in NSW, with percentages ranging from 26% to 44% across LHDs, in November 2018.

Self‑assessed rating for anxiety* for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

N= Number of eligible responses to question.

* Edmonton Symptom Assessment System (ESAS). The respondents' response to the anxiety item, rated on a 10-point numerical scale of severity, was collapsed into four categories for this chart.

** Sydney LHD excludes Chris O'Brien Lifehouse.

Notes:

1. Data source: Outpatient Cancer Clinic Survey, November 2018 (pre-release data supplied by the Bureau of Health Information).

2. Patients who reported that they were currently in a course of treatment (Q61, responses 2 and 5) were classed as being in an active phase of treatment. For information regarding Q61, please refer to the appendices.

3. Hospital and LHD results were suppressed when there were fewer than 30 survey respondents. Refer to the appendix for the full list of participating hospitals.

4. Survey details (NSW): Number mailed = 24,097; Response rate = 47%.

Self‑assessed rating for depression* for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

Key findings:

  • In November 2018, 28% of people attending an outpatient cancer clinic in an active phase of treatment in NSW public hospitals reported moderate or high levels of depression.
  • 40% of people reported no symptoms of depression in NSW, with percentages ranging from 31% to 48% across LHDs, in November 2018.

Self‑assessed rating for depression* for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

N= Number of eligible responses to question.

* Edmonton Symptom Assessment System (ESAS). The respondents' response to the depression item, rated on a 10-point numerical scale of severity, was collapsed into four categories for this chart.

** Sydney LHD excludes Chris O'Brien Lifehouse.

Notes:

1. Data source: Outpatient Cancer Clinic Survey, November 2018 (pre-release data supplied by the Bureau of Health Information).

2. Patients who reported that they were currently in a course of treatment (Q61, responses 2 and 5) were classed as being in an active phase of treatment. For information regarding Q61, please refer to the appendices.

3. Hospital and LHD results were suppressed when there were fewer than 30 survey respondents. Refer to the appendix for the full list of participating hospitals.

4. Survey details (NSW): Number mailed = 24,097; Response rate = 47%.

Self‑efficacy rating on keeping a positive attitude*, for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

Key findings:

  • In November 2018, the majority of people attending outpatient cancer clinics who were in an active phase of treatment in NSW public hospitals had some degree of confidence in their ability to keep a positive attitude.
  • 81% to 90% of people in an active phase of treatment reported they strongly agree or slightly agree to ‘keeping a positive attitude’ across LHDs, in November 2018.

Self‑efficacy rating on keeping a positive attitude*, for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

N= Number of eligible responses to question.

* Individual item from Communication and Attitudinal Self-Efficacy scale (CASE-cancer): 'It is easy for me to keep a positive attitude', answered on a four-category response scale.

** Sydney LHD excludes Chris O'Brien Lifehouse.

Notes:

1. Data source: Outpatient Cancer Clinic Survey, November 2018 (pre-release data supplied by the Bureau of Health Information).

2. Patients who reported that they were currently in a course of treatment (Q61, responses 2 and 5) were classed as being in an active phase of treatment. For information regarding Q61, please refer to the appendices.

3. Hospital and LHD results were suppressed when there were fewer than 30 survey respondents. Refer to the appendix for the full list of participating hospitals.

4. Survey details (NSW): Number mailed = 24,097; Response rate = 47%.

Self‑efficacy rating on controlling negative feelings*, for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

Key findings:

  • In November 2018, the majority of people attending outpatient cancer clinics who were in an active phase of treatment in NSW public hospitals had some degree of confidence in their ability to control negative feelings.
  • 82% to 90% of people in an active phase of treatment reported they strongly agree or slightly agree to ‘controlling negative feelings’ across LHDs, in November 2018.

Self‑efficacy rating on controlling negative feelings*, for patients in an active phase of treatment attending an outpatient cancer clinic in NSW public hospitals, by local health district (LHD) and specialty health network (ranked), November 2018

N= Number of eligible responses to question.

* Individual item from Communication and Attitudinal Self-Efficacy scale (CASE-cancer): 'I am confident that I can control my negative feelings about cancer', answered on a four-category response scale.

** Sydney LHD excludes Chris O'Brien Lifehouse.

Notes:

1. Data source: Outpatient Cancer Clinic Survey, November 2018 (pre-release data supplied by the Bureau of Health Information).

2. Patients who reported that they were currently in a course of treatment (Q61, responses 2 and 5) were classed as being in an active phase of treatment. For information regarding Q61, please refer to the appendices.

3. Hospital and LHD results were suppressed when there were fewer than 30 survey respondents. Refer to the appendix for the full list of participating hospitals.

4. Survey details (NSW): Number mailed = 24,097; Response rate = 47%.


Why are different time periods and dates reported?

Cancer information is collected from many different sources, so it takes time to review and analyse the data. Different pieces of information may be collected over different time periods, or reported at different times. This means not all the measures reported here have the same dates.

The information presented is the most recent available for each measure at the time this report was written.

Why are confidence intervals reported here?

Confidence intervals are included when a small sample is used to represent the overall population, because there is a chance of an error due to this scaling.

In this report, a 95% confidence interval is presented only on charts where a sample of the population is used. This interval can be thought of as a margin of error.

The larger the sample size, the smaller the confidence interval range. The smaller the sample size, the larger the confidence interval range.