{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T03:06:38Z","timestamp":1774580798745,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008719","name":"Movember Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008719","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cancer patients often suffer from psychological distress. Psycho\u2010oncological services (POS) have been established in some health care systems in order to address such issues. This study aims to identify patient and center characteristics that elucidate the use of POS by patients in prostate cancer centers (PCCs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Center\u2010reported certification and patient survey data from 3094 patients in 44 certified PCCs in Germany were gathered in the observational study (Prostate Cancer Outcomes). A multilevel analysis was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Model 1 showed that utilization of POS in PCCs is associated with patients\u2019 age (OR\u00a0=\u00a00.98; 95%\u2010CI\u00a0=\u00a00.96\u20100.99; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), number of comorbidities (1\u20102 vs 0, OR\u00a0=\u00a01.27; 95%\u2010CI\u00a0=\u00a01.00\u20101.60; <jats:italic>P<\/jats:italic>=.048), disease staging (localized high\u2010risk vs localized intermediate risk, OR\u00a0=\u00a01.41; 95%\u2010CI\u00a0=\u00a01.14\u20101.74; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), receiving androgen deprivation therapy before study inclusion (OR\u00a0=\u00a00.19; 95%\u2010CI\u00a0=\u00a00.10\u20100.34; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), and hospital teaching status (university vs academic, OR\u00a0=\u00a00.09; 95%\u2010CI\u00a0=\u00a00.02\u20100.55; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.009). Model 2 additionally includes information on treatment after study inclusion and shows that after inclusion, patients who receive primary radiotherapy (OR\u00a0=\u00a00.05; 95%\u2010CI\u00a0=\u00a00.03\u20100.10; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) or undergo active surveillance\/watchful waiting (OR\u00a0=\u00a00.06; 95%\u2010CI\u00a0=\u00a00.02\u20100.15; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) are less likely to utilize POS than patients who undergo radical prostatectomy. Disease staging (localized high\u2010risk vs localized intermediate risk, OR\u00a0=\u00a01.31; 95%\u2010CI\u00a0=\u00a01.05\u20101.62; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02) and teaching status (university vs academic, OR\u00a0=\u00a00.08; 95%\u2010CI\u00a0=\u00a00.01\u20100.65; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02) are also significant predictors for POS use. The second model did not identify any other significant patient characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Future research should explore the role of institutional teaching status and whether associations with therapy after study inclusion are due to treatment effects \u2013 for example, less need following radiotherapy \u2013 or because access to POS is more difficult for those receiving radiotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.2999","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T12:50:11Z","timestamp":1585659011000},"page":"3680-3690","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Use of psycho\u2010oncological services by prostate cancer patients: A multilevel analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1357-472X","authenticated-orcid":false,"given":"Clara","family":"Breidenbach","sequence":"first","affiliation":[{"name":"German Cancer Society Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Roth","sequence":"additional","affiliation":[{"name":"Institute of Medical Statistics and Computational Biology (IMSB) Faculty of Medicine University of Cologne Koln Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Ansmann","sequence":"additional","affiliation":[{"name":"Organizational Health Services Research Department for Health Services Research Carl von Ossietzky University of Oldenburg Oldenburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Wesselmann","sequence":"additional","affiliation":[{"name":"German Cancer Society Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Dieng","sequence":"additional","affiliation":[{"name":"OnkoZert GmbH Neu\u2010Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernst\u2010G\u00fcnther","family":"Carl","sequence":"additional","affiliation":[{"name":"Federal Association of German Prostate Cancer Patient Support Groups Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fcnter","family":"Feick","sequence":"additional","affiliation":[{"name":"Federal Association of German Prostate Cancer Patient Support Groups Bonn Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisa","family":"Oesterle","sequence":"additional","affiliation":[{"name":"OnkoZert GmbH Neu\u2010Ulm Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Bach","sequence":"additional","affiliation":[{"name":"Kliniken Rhein\u2010Ruhr Herne 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