Structured multi-disciplinary psychosocial care for cancer patients and the perceived quality of care from the patient perspective: a cluster-randomized trial

  • Susanne SingerEmail author
  • Helge Danker
  • Jürgen Meixensberger
  • Susanne Briest
  • Andreas Dietz
  • Rolf-Dieter Kortmann
  • Jens-Uwe Stolzenburg
  • Anette Kersting
  • Julia Roick
Original Article – Clinical Oncology



We examined whether multi-disciplinary stepped psychosocial care for cancer patients improves quality of care from the patient perspective.


In a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for distress, consultation between doctor and patient, and the provision of psychosocial services. Quality of care was measured with the Quality of Care from the Patient Perspective questionnaire. The analysis employed mixed-effects multivariate regression, adjusting for age and gender.


Thirteen wards were randomized, and 1012 patients participated (n = 570 in stepped care and n = 442 in standard care). Patients who were highly distressed at baseline had 2.3 times the odds of saying they had had the possibility to converse in private with doctors and/or psychologists/social workers when they were in stepped care compared to standard care, 1.3 times the odds of reporting having experienced shared decision-making, 1.1 times the odds of experiencing their doctors as empathic and personal, and 0.6 times the odds of experiencing the care at the ward to be patient oriented. There was no evidence for an effect of stepped care on perceived quality of care in patients with moderate or low distress.


Stepped care can improve some aspects of perceived quality of care in highly distressed patients.

Trial registration NCT01859429.


Cancer Quality of care Distress Psychosocial care Randomized trial 



This study was funded by the German Federal Ministry of Health (#NKP-332-026).

Compliance with ethical standards

Conflict of interest

We declare that we have no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Susanne Singer
    • 1
    • 2
    Email author
  • Helge Danker
    • 3
  • Jürgen Meixensberger
    • 4
  • Susanne Briest
    • 5
  • Andreas Dietz
    • 6
  • Rolf-Dieter Kortmann
    • 7
  • Jens-Uwe Stolzenburg
    • 8
  • Anette Kersting
    • 9
  • Julia Roick
    • 10
  1. 1.Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI)University Medical Centre MainzMainzGermany
  2. 2.University Cancer CentreUniversity Medical Centre MainzMainzGermany
  3. 3.Department of Medical Psychology and Medical SociologyUniversity Medical Centre LeipzigLeipzigGermany
  4. 4.Department of NeurosurgeryUniversity Medical Centre LeipzigLeipzigGermany
  5. 5.Department of Obstetrics and GynecologyUniversity Medical Centre LeipzigLeipzigGermany
  6. 6.Department of OtolaryngologyUniversity Medical Centre LeipzigLeipzigGermany
  7. 7.Department of Radiation-OncologyUniversity Medical Centre LeipzigLeipzigGermany
  8. 8.Department of UrologyUniversity Medical Centre LeipzigLeipzigGermany
  9. 9.Department of Psychosomatic Medicine and PsychotherapyUniversity Medical Centre LeipzigLeipzigGermany
  10. 10.Institute of Medical SociologyUniversity of HalleHalleGermany

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