ORIGINAL ARTICLE Barriers to using psycho-oncology services: a qualitative research into the perspectives of users, their relatives, non-users, physicians, and nurses Melanie Neumann & Maren Galushko & Ute Karbach & Hadass Goldblatt & Adriaan Visser & Markus Wirtz & Nicole Ernstmann & Oliver Ommen & Holger Pfaff Received: 29 May 2009 / Accepted: 13 August 2009 # Springer-Verlag 2009 Abstract Purpose The present explorative study was designed as a qualitative evaluation of the psycho-oncology services (POS) available at a psycho-oncology institution (POI) in Germany. The study focused on barriers to using these services. Methods Seven focus groups and five complementary individual interviews were conducted with POS users, their relatives, and POS non-users from a German POI, as well as with oncology physicians and nurses from an affiliated hospital. The focus groups and individual interviews were audiotaped and fully transcribed. Data were analyzed using the documentary method. Results Four utilization barriers were identified: (1) patients’ and physicians’ information deficits about POI and POS, (2) patients’ and physicians’ subjective norms regarding POS, (3) lack of organizational and therapeutic integration of POI and POS into routine oncology care on the ward, and (4) specific characteristics of cancer patients. The most important finding was that lack of organizational and therapeutic integration of POS in routine oncology care on the ward might have a lasting, negative effect on patients’ and physicians’ information deficits and subjective norms. Furthermore, the identified utilization barriers seem to be a multi-causal problem with complex interdependencies. Conclusion Based on these results, the organizational and therapeutic integration of POS in routine oncology care on the POI ward appears to be a useful tool in offering widely accessible therapies and providing patients with concise, Electronic supplementary material The online version of this article (doi:10.1007/s00520-009-0731-2) contains supplementary material, which is available to authorized users. M. Neumann (*) : U. Karbach : N. Ernstmann : O. Ommen : H. Pfaff Center for Health Services Research Cologne (ZVFK), Medical Department of the University of Cologne, Eupener Strasse 129, 50933 Cologne, Germany e-mail: mella.neumann@web.de M. Neumann : U. Karbach : N. Ernstmann : O. Ommen : H. Pfaff Center for Integrated Oncology (CIO), Medical Department of the University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany M. Galushko Department for Palliative Medicine, University Hospital Cologne, Kerpener Strasse 62, 50937 Cologne, Germany H. Goldblatt Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Mt. Carmel 31905, Israel A. Visser Helen Dowling Institute, Center for Psycho-oncology, Rubenslaan 190, Utrecht, The Netherlands M. Wirtz Institute for Psychology, University of Education Freiburg, Kartäuserstr. 61b, 79117 Freiburg, Germany H. Pfaff Division of Medical Sociology of the Institute and Policlinic for Occupational and Social Medicine, University of Cologne, Eupener Strasse 129, 50933 Cologne, Germany Support Care Cancer DOI 10.1007/s00520-009-0731-2