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OBJECTIVE: Although patient education may enhance knowledge, coping with illness, and quality of life among cancer patients, it is uncertain which didactic method is most effective. We compared the impact of an interactive, patient-oriented group program to a lecture-based, information-only program in gastric cancer patients. METHODS: In this prospective, controlled trial, 121 gastric cancer patients attending inpatient rehabilitation after surgical treatment received either the interactive intervention or lectures providing information. The outcomes were patients' disease-related knowledge, active coping with illness, and quality of life (QoL) at the end of their stay and 6 and 12 months thereafter. RESULTS: Both groups improved their knowledge and QoL during rehabilitation; however, knowledge was significantly higher in the interactive group compared to the lecture group. This difference was maintained at the 6- and 12-months follow-ups. In addition, the interactive group proved superior to the lecture group regarding active coping with illness and QoL at the end of rehabilitation, but not during follow-up. CONCLUSIONS: A structured, interactive patient education program proved superior to lecture-based provision of information in regards to short-term and long-term knowledge as well as short-term coping and QoL. PRACTICE IMPLICATIONS: In gastric cancer patients, interactive patient education seems preferable over lectures. [ABSTRACT FROM AUTHOR]

BACKGROUND: To examine whether depression and heart failure severity are independent predictors of both the physical and psychologic domains of health-related quality of life (HRQoL) in patients with chronic heart failure. METHODS AND RESULTS: A sample of 206 outpatients with chronic heart failure (mean age 64 years, 69% male) was evaluated. Depression was measured with the Patient Health Questionnaire and disease-specific HRQoL with the Kansas City Cardiomyopathy Questionnaire. Heart failure severity was assessed with physician ratings of the New York Heart Association (NYHA) functional class. The simultaneous effects of predictor variables on outcomes were estimated using structural equation modeling. Both depression and NYHA functional class independently predicted the physical domain of HRQoL. By contrast, the psychologic domain was only predicted by depression, but not by NYHA functional class. CONCLUSIONS: Our results suggest that comorbid depression has an independent impact on both physical and psychologic HRQoL in patients with chronic heart failure after controlling for the severity of heart failure symptoms, while heart failure severity only impacts physical HRQoL. Thus, assessment of comorbid depression may help interpreting reduced HRQoL in heart failure patients. Research seems warranted evaluating whether the amelioration of depression may enhance patients' HRQoL in chronic heart failure. [ABSTRACT FROM AUTHOR]

At the University of Würzburg the ‘Würzburg Model’ of integrative therapy for obesity was developed 9 years ago in cooperation of the Center of Operative Medicine, the Department of Internal Medicine and the Institute of Psychotherapy and Medical Psychology. Its distinctive feature is the involvement of an interdisciplinary team consisting of surgeons, internists and psychologists in the evaluation of patients. This kind of interdisciplinary approach is still unusual in Germany although it has proven to performwell and allowed to achieve good and even above-average results. Yet, surgical measures turn out to be unsuccessful in some cases. About 20-30% of the patients take no or only small profit from bariatric surgical treatment. The reasons for these failures are supposed to be, among others, failing compliance, often correlated with psychosocial and psychological problems, a behavioral addiction component, and insufficient follow-up support. In consideration of previous research as well as our data gathered in the 5-year follow-up, an aftercare program has been developed in our group. Problems related to eating and movement behavior, time and stress management, regulation of emotions as well as gastric band adjustment are discussed. The program aims at improving the compliance and the selfmanagement of patients and at reducing postoperative complications. [ABSTRACT FROM AUTHOR]

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