Standardized psychological assessment in cancer patients who are candidates for transplantation: Care needs and inter-rater consistency

Abstract

Oncology treatment may compromise mental health; therefore, a psychological evaluation is recommended to contribute to patients´ integral health. Objective: To evaluate the inter-rate reliability (psychologists and psychiatrists) of standardized vs non-structured psychological evaluation in patients who are candidates for a hematopoietic stem cell transplantation (hsct) and to describe the principal mental health problems and care needs of these patients. Method: Comparative study which included adult patients who were candidates for an autologous or allogeneic hsct. Participants were separated in two groups:(a) an unstandardized evaluation group (use) with 93 participants who were evaluated using an unstructured interview as was usual practice in this hospital and b) a structured evaluation group (sse) with 108 patients who were evaluated using a semi-structured interview and a test battery. Psychologist and psychiatric diagnoses of each group were analyzed by descriptive statistics. The Kappa index was calculated in order to determine agreement between health professionals. Finally, prevalence of mental health conditions was obtained based on each instrument's cutoff for possible pathology. Results: In both groups, principal mental health problems were anxious and depressive symptomatology. Agreement was higher in the sse group (K= .508) in contrast with the use group (K = .182). In the sse group, 7.53% of participants were considered a case of anxiety, 21.51% depression and 27.96% distress. Conclusion and discussion: Implementation of a standardized psychological evaluation could improve detection and treatment of psychological symptomatology in these patients and increase compliance with national and international mental health attention standards.