How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling?

20-40% of cancer patients show emotional distress. Psychosocial support sho uld be offered to severely distressed patients. However. little is known ab out the selection of patients to whom such support should be offered. This study investigated oncologists' ability to identify such patients. In a con secutive series of 298 cancer patients undergoing radiotherapy, distress, p erceived social support and desire for supportive counselling were assessed using screening instruments. Simultaneously 8 oncologists estimated patien t distress and need for psychosocial support. A complete set of data was ob tained in 80.2% of cases. Concordance of the oncologists' estimation of pat ient distress and perceived social support with the results of the screenin g instruments was weak (kappa = 0.10 and kappa = 0.05). Oncologjsts recogni zed the presence of severe distress only in 11 of the 30 severely distresse d patients. Correct perception of distress was lower in patients with head and neck cancer and lung cancer and in lower class patients. Oncologists' r ecommendations for supportive counselling did not correlate with patient di stress or the amount of perceived support but rather with progressive disea se and less denial behaviour. Our results underline the need for educating oncologists in order to improve their ability to identify patient distress. (C) 2001 Cancer Research Campaign.