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Purpose To investigate the trade-off between survival outcome and quality of life (QoL) in Multiple Myeloma (MM). Methods We developed a questionnaire that asked patients amongst others, whether they would choose a shortened time of progression-free survival (PFS) in favor of an increased QoL Results Of 194 MM patients who answered this question, 81 (42%) subjects were willing to accept a shorter PFS for better QoL. On the other hand, 92 (47%) preferred a longer PFS at the cost of reduced QoL. Twenty-one patients (11%) indicated to be undecided. Specific features were associated with the two main groups (“in favor QoL” vs “in favor PFS”). Patients who belonged to the “in favor QoL”-group tended to be in more advanced treatment lines when compared to the “in favor PFS-group” (P = 0.0001). Patients who preferred PFS were found to generally be more likely to hand over responsibility to their physicians (P = 0.01). No associations were found for other disease specific conditions including pain, gastrointestinal symptoms, fatigue or infection. Conclusion The results of our study highlight significant differences in patients’ preferences, thus underlining the importance of assessing individual patient needs in determining the endpoints of further research.

Purpose Growing evidence implies that transition to parenthood triggers symptoms of mental burden not only in women but likewise in men, especially in high-risk pregnancies. This is the first study that examined and compared the prevalence rates of depression, anxiety, and somatic symptom burden of expectant fathers who face different risk situations during pregnancy. Methods Prevalence rates of paternal depression (Edinburgh postnatal depression scale), anxiety (generalized anxiety disorder seven), and somatic symptom burden (somatic symptom scale eight) were examined in two risk samples and one control group in the third trimester of their partners’ pregnancy: risk sample I (n = 41) consist of expectant fathers whose partners were prenatally hospitalized due to medical complications; risk sample II (n = 52) are fathers whose partners were prenatally mentally distressed; and control group (n = 70) are those non-risk pregnancies. Results On a purely descriptive level, the data display a trend of higher symptom burden of depression, anxiety, and somatic symptoms in the two risk samples, indicating that expectant fathers, whose pregnant partners were hospitalized or suffered prenatal depression, were more prenatally distressed. Exploratory testing of group differences revealed an almost three times higher prevalence rate of anxiety in fathers whose partner was hospitalized (12.2%) compared to those non-risks (4.3%). Conclusion Results underline the need for screening implementations for paternal prenatal psychological distress, as well as specific prevention and treatment programs, especially for fathers in risk situations, such as their pregnant partners’ prenatal hospitalization. The study was registered with the German clinical trials register (DRKS00020131) on 2019/12/09.

Background Patients with prostate cancer (PC) and their spouses are confronted with several treatment-related and psychosocial challenges that can reduce their health-related quality of life (HRQoL). Patients with advanced PC (aPC) and their spouses are at highest risk for psychological distress and show lower HRQoL compared with couples in other phases. The aim of this study was to investigate the psychological interdependencies between HRQoL and anxiety, fear of progression (FoP), and depression in patients with aPC and their spouses. Methods Ninety-six heterosexual couples with aPC participated in this cross-sectional study. Patients and spouses provided information about anxiety and depression (Patient Health Questionnaire-4), fear of progression (short form of the Fear of Progression Questionnaire), and HRQoL (EORTC QoL-C30, version 3). Psychological interdependencies were analyzed with various actor-partner interdependence models using structural equation modeling. Results Anxiety, FoP, and depression were significant predictors of HRQoL for patients with aPC and their spouses (actor effects). Spouses’ anxiety and FoP were negatively associated with patients’ HRQoL (partner effects), showing that patients’ HRQoL is associated with their own and their spouses’ anxiety and FoP. No partner effect was revealed between depression and HRQoL in the patients or spouses. Conclusions The resulted partner effects between spouses and patients underline the importance of considering HRQoL in patients with aPC from a dyadic perspective. It is important that physicians explore patients’ and spouses’ needs and psychological burden to offer support and access to psycho-oncological services. Future studies are needed to investigate the effects of suitable interventions on spouses’ anxiety and FoP.

Objective Aim of the study was to compare working and non-working patients over a period of 12 months regarding socio-demographic, cancer-specific and mental health parameters. Methods This study was conducted as part of a Germany-wide longitudinal survey among 1398 patients in 13 national Comprehensive Cancer Centers. The sample used for analysis consisted of n = 430 cancer patients younger than 65 years (age M = 52.4 years, SD = 8.1; 67.0% females). Socio-demographic, cancer-specific and mental health parameters (Depression: Patient Health Questionnaire, Anxiety: Generalized Anxiety Disorder Scale, Distress: Distress Thermometer) were assessed at baseline during hospitalization and at 12 months follow-up. Results 73.7% of all patients (n = 317) have returned to work after one year. While working and non-working patients did not differ in socio-demographic parameters, there were significant differences in the presence of metastases, tumor and treatment status. Mixed analysis of variances revealed significant interactions between working status and time for depression (p = 0.009), anxiety (p = 0.003) and distress (p = 0.007). Non-working patients reported higher levels of depression, anxiety and distress than working patients over time. A logistic regression showed significant associations between lower depression (p = 0.019), lower distress (p = 0.033) and the absence of a tumor (p = 0.015) with working status. Conclusions The majority of cancer survivors returned to work. Non-working patients had higher levels of depression, anxiety and distress than working patients. After controlling for cancer-specific factors, mental health parameters were still independently associated with working status. Return to work can thus be associated with an improved mental health in cancer survivors. In order to establish causality, further research is necessary.

Purpose Health-related quality of life (HRQOL) in older persons is influenced by physical and mental health, as well as by their social contacts and social support. Older women and men have disparate types of social networks; they each value social ties differently and experience loneliness in unique and personal ways. The aim of this study is, therefore, to determine the longitudinal association between loneliness and social isolation with HRQOL in older people—separated by gender. Methods Data stem from the third and fourth follow-up of the ESTHER study—a population-based cohort study of the older population in Germany. A sample of 2171 older women and men (mean age: 69.3 years, range 57–84 years) were included in this study; HRQOL was assessed by using the Short Form-12 questionnaire (SF-12). Data on physical and mental health, loneliness, and social networks were examined in the course of comprehensive home visits by trained study doctors. Gender-specific linear regression analyses were performed to predict physical quality of life (measured by the PCS, physical component score of the SF-12) and mental quality of life (measured by the MCS, mental component score) after three years, adjusted by socioeconomic variables as well as physical, mental, and social well-being. Results At baseline, PCS was 41.3 (SD: 10.0) in women and 42.2 (SD: 9.6) in men (p = .04). MCS was 47.0 (SD: 10.2) in women and 49.6 (SD: 8.6) in men (p p Conclusion HRQOL in elderly women and men is predicted by different biopsychosocial factors. Loneliness predicts decreased MCS after three years in both genders, but decreased PCS after three years only in women. Thus, a greater impact of loneliness on the health of older women can be surmised and should therefore be considered in the context of their medical care.

Zusammenfassung Ziel Eine Machbarkeitsstudie zur Überprüfung, ob onkologisch erkrankte PatientInnen an einem Angebot zu Funktioneller Entspannung teilnehmen und davon profitieren können. Methodik Eine Gruppenintervention (N=14) über 10 Sitzungen in Anlehnung an das Funktionelle Entspannung-Stressmanual; Messung der psychischen Belastung durch eine prä-post-Fragebogenerhebung. Ergebnisse Die Intervention scheint gut geeignet, psychisch belastete PatientInnen bei der Verarbeitung ihrer Beschwerden und im Umgang mit Stressoren zu unterstützen. Es zeigten sich Hinweise, dass das allgemeine Wohlbefinden stieg und Hyperarousal sank. Diskussion Die Intervention wurde gut angenommen, eine regelmäßige Teilnahme war jedoch aufgrund der Erkrankung nicht immer möglich. Der körpertherapeutische Ansatz und das Gruppensetting schienen besonders hilfreich. Aufgrund der starken körperlichen Belastung der PatientInnen wurden die Struktur der Gruppe sowie einzelne Übungen individuell angepasst. Schlussfolgerung Die körperbezogenen Interventionen machten unbewusste Anteile zugänglich und damit in begrenztem Umfang psychotherapeutisch bearbeitbar. Es benötigt weitere Forschung, um die Effektivität dieser Funktionellen Entspannungs-Gruppenintervention zu untersuchen.

Aim This study aimed to identify and compare age stereotypes of registered nurses and supervisors in clinical inpatient settings. Design Generic qualitative study using half‐standardized interviews. Method Nineteen face‐to‐face interviews and five focus groups (N = 50) were conducted with nurses of varying levels at a hospital of maximum medical care in Germany between August and November 2018 and were subjected to structured qualitative content analysis. Results Reflecting the ageing process and cooperation in mixed‐age teams, nursing staff and supervisors defined similar age stereotypes towards older and younger nurses reminiscent of common generational labels ‘Baby Boomers’ and Generations X. Their evaluation created an inconsistent and contradictory pattern differing to the respective work context and goals. Age stereotypes were described as both potentially beneficial and detrimental for the individual and the cooperation in the team. If a successfully implemented diversity management focuses age stereotypes, negative assumptions can be reduced and cooperation in mixed‐age teams can be considered beneficial. Conclusion Diversity management as measures against age stereotypes and for mutual acceptance and understanding should include staff from various hierarchical levels of the inpatient setting., publishedVersion

Jeder zweite Tumorpatient in stationarer Akutbehandlung ist psychisch so stark belastet, dass eine psychosoziale Unterstutzung angezeigt ist. Zur Erfassung dieser Belastung soll ein entsprechendes Distress-Screening erfolgen. Die vorliegende Arbeit gibt eine Handlungsempfehlung zur Implementierung und Durchfuhrung des psychoonkologischen Screenings in onkologischen Spitzenzentren (CCC). Die Best-Practice-Empfehlung entstand in einem mehrstufigen Prozess. Die Empfehlungen wurden zuerst innerhalb der Unterarbeitsgruppe Psychoonkologische Versorgung erarbeitet, danach von Vertretern der Arbeitsgruppe Psychoonkologie/Krebsselbsthilfe im CCC-Netzwerk diskutiert und konsentiert und zuletzt im Lenkungsausschuss der Deutschen Krebshilfe (DKH) diskutiert und von diesem final konsentiert. Die Handlungsempfehlung konkretisiert organisatorische und praktische Aspekte des Distress-Screenings und definiert zu erhebende Kennzahlen. Fur das Distress-Screening stehen verschiedene valide Instrumente zur Verfugung. Das eingesetzte Instrument soll Patienten elektronisch oder papierbasiert von der jeweils behandelnden Abteilung zur Beantwortung vorgelegt werden. Eine im Screening angegebene uberschwellige Belastung wie auch ein geausertes subjektives Bedurfnis nach Unterstutzung zeigen den Bedarf fur eine psychoonkologische Versorgung an. Wie schon in der S3-Leitlinie Psychoonkologie gefordert, soll das psychoonkologische Screening in die klinische Routine integriert werden. Hierfur sind v. a. zwei Dinge wichtig: Es werden genugend geschulte zustandige Personen benotigt, die aktiv die Verantwortung fur das Screening wahrnehmen, und es sind detaillierte, standardisierte und optimierte Prozeduren fur die Durchfuhrung, Auswertung, Dokumentation und Uberweisung notig. Die vorliegende Empfehlung erleichtert die Implementierung dieses Screenings in die klinische Routine.

Background Patients with metastatic melanoma and their physicians are confronted with a complex decision regarding first-line therapy. Risks and benefits vary considerably between various treatment options. With this in mind, we aim to develop and evaluate a patient decision aid (PtDA) to inform patients about the risks and benefits of treatment options, namely, immunotherapy as monotherapy, immunotherapy as combination therapy, and treatment with BRAF/MEK inhibitors. We aim to test whether the use of this PtDA before medical consultation will increase patients’ knowledge of treatment options and thus promote shared decision-making (SDM) and patient decision satisfaction. Methods In total, 128 patients with metastatic melanoma from two German cancer centers will be randomized to the intervention group (IG), receiving access to the PtDA before medical consultation, or the control group (CG), receiving treatment as usual (TAU), i.e., medical consultation alone. There will be three major assessment points (before intervention, T0; after intervention, T1; and 3 months after intervention, T2). The main outcome is the patient’s knowledge of their treatment options, measured by a self-developed, piloted multiple-choice test at T1. Secondary outcome measures will include the extent of SDM during medical consultation, assessed by Observer OPTION 5, and patient decision satisfaction, assessed by the Satisfaction with Decision Scale (SwD), at T1 and T2. Discussion This trial will assess the effectiveness of a developed PtDA to enhance patient knowledge of treatment options for metastatic melanoma, SDM, and patient decision satisfaction. If the efficacy can be proven, the PtDA will be implemented nationwide in Germany to close a relevant gap in the education and care of patients with metastatic melanoma. Trial registration ClinicalTrials.gov NCT04240717. Registered on 27 January 2020

Patients with cancer have a higher risk of suicidal ideation (SI) and suicidality than the general population. This study was designed to investigate the prevalence of SI and its association with psychosocial and sociodemographic factors and tumour entity.In this observational cross-sectional study, 4372 adult patients with different cancer entities were enrolled. We assessed the outcome variables (i.e. SI, depressive and anxiety symptoms, mental and physical fatigue and sociodemographic data) using self-report questionnaires. Data were analysed via descriptive statistics, binomial logistic regression and structural equation modelling (SEM).Among all patients, 627 (14.3%) reported SI, of whom 12.8% reported SI on several days, 0.9% on half of the days and 0.6% nearly every day. Age, anxiety, mental fatigue and the Patient Health Questionnaire-9 items 'feeling down, depressed and hopeless', 'feeling bad about oneself' and 'slowing or agitation' were significant predictors of SI. SEM, including all significant predictors with a latent depressiveness-demoralisation variable, explained 30.3% variance of SI, showing a good fit.Our results showed that a significant number of patients with cancer show SI. Future long-term studies are needed to address the differential contribution of depression and demoralisation on SI in patients with cancer.

Purpose: During active cancer treatment, there is a high prevalence of unmet supportive care needs and many patients suffer from increased psychological distress, which impairs health related quality of life (HRQoL) and lead to poorer treatment outcomes. Recent literature has emphasised the benefits of electronic health (eHealth) or the use of new technologies to improve health management and access to psychosocial support for patients with cancer. Since initially the main research area was cancer survivors, there are few reviews in the field of active cancer treatment, and they mainly focus on symptom tracking and symptom management. Methods: this review examines the impact of eHealth interventions on psychological distress, coping strategies, HRQoL and unmet psychosocial care needs among patients with cancer during treatment. A systematic literature search according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed.Results: Eighteen RCTs met the inclusion criteria and were included. The results indicated that the evidence of eHealth interventions for patients during anti-cancer treatment is currently limited, but there is a trend towards positive effects and encouraging results, especially for HRQoL and depressive symptoms. Conclusion: Overall, there was a high degree of heterogeneity in both interventions and outcomes, making it difficult to compare the results of individual studies. Therefore, to improve the quality of research, there is an urgent need to develop guidelines for the design and structure of interventions and for the evaluation and reporting of interventions.

Different patients want to take different roles in the treatment decision-making process; these roles can be classified as passive, collaborative, and active. The aim of this study was to investigate the correlation between decision-making preferences among patients with prostate cancer and personal, disease-related, and structural factors. In four survey studies, we asked 7169 prostate cancer patients about their decision-making preferences using the Control Preferences Scale (CPS) and collected clinical, psychological, and quality-of-life measures. Most patients (62.2%) preferred collaborative decision-making, while 2322 (32.4%) preferred an active role, and only 391 (5.5%) preferred a passive role. Age (p p p = 0.018), treatment status (p p p = 0.001), and quality of life (p

Versorgungsforschung in der Onkologie beschaftigt sich mit allen Situationen, in denen Menschen mit Krebs konfrontiert sind. Sie betrachtet die verschiedenen Phasen der Versorgung, also Pravention/Fruherkennung, Prahabilitation, Diagnostik, Therapie, Rehabilitation und Palliativversorgung ebenso wie die verschiedenen Akteure, darunter die Betroffenen, die Versorgenden und die Selbsthilfe. Sie befasst sich mit Gesunden (z. B. im Rahmen von Pravention/ Fruherkennung), Patientin-nen und Patienten und Krebs-Uberlebenden. Aus den Besonderheiten von Krebserkrankungen und den etablierten Versorgungsstrukturen ergeben sich eine Reihe von inhaltlichen Spezifika fur die Versorgungsforschung in der Onkologie im Vergleich zur allgemeinen Versorgungsforschung bei im Wesentlichen identischem Methodenkanon. Dieses Memorandum beschreibt den Gegenstand, illustriert die Versorgungsstrukturen und benennt Themenfelder der Versorgungsforschung in der Onkologie. Dieses Memorandum ist eine Ausarbeitung der Fachgruppe Onkologie des Deutschen Netzwerks Versorgungsforschung e. V. und Ergebnis intensiver Diskussionen.

Zusammenfassung Ziel der Studie Eine Krebserkrankung geht mit zahlreichen psychosozialen Stressoren einher, die bei über 50% der Patienten zu einer hohen psychischen Belastung führen. Etwa ein Drittel der Patienten nehmen psychoonkologische Unterstützung in Anspruch. Die Akzeptanz- und Commitment-Therapie (ACT), ein transdiagnostischer Ansatz der dritten Welle der Verhaltenstherapie, stellt eine vielversprechende Therapieform für die psychoonkologische Behandlung von Krebspatienten dar. Bislang fehlte jedoch im deutschsprachigen Raum eine manualisierte ACT-basierte Gruppentherapieintervention für onkologische Patienten, die hinsichtlich Machbarkeit und Wirksamkeit untersucht wurde. Methodik Um diese Lücke zu schließen, entwickelten wir ein auf die ACT basierendes-Gruppentherapiekonzept und untersuchten es im Rahmen einer einarmigen monozentrischen Pilotstudie. Es richtet sich an onkologische Patienten in allen Krankheitsstadien, die psychisch belastet sind. Im Rahmen von 8 Sitzungen werden die ACT-Kernprozesse Achtsamkeit, Werte und Akzeptanz mithilfe von Metaphern und erlebnisorientierten Übungen erarbeitet. Ergebnisse Die Prä-Post-Daten unserer Pilotstudie mit n=25 Patienten weisen auf eine Reduktion der Progredienzangst, der Depressivität und der Psychischen Inflexibilität sowie eine Steigerung der psychischen Lebensqualität und des Wohlbefindens hin. Regressionsanalysen zeigten, dass Veränderungen der Psychologischen Flexibilität Veränderungen in allen psychologischen Outcomemaßen vorhersagten. Zudem unterstreicht die sehr hohe Adhärenz die gute Machbarkeit der Intervention im integrierten klinisch-ambulanten Setting. Diskussion Unsere Pilotstudie liefert vielversprechende erste Hinweise für die gute Machbarkeit und Wirksamkeit einer ACT-basierten Gruppenintervention im deutschsprachigen Raum. Die Ergebnisse zur Wirksamkeit se ersten Ergebnisse sind aufgrund des Fehlens einer Kontrollgruppe zurückhaltend zu interpretieren. Schlussfolgerung Zukünftige Untersuchungen sollten die Effektivität des Gruppenkonzepts in randomisiert kontrollierten Studien (RCTs) mit einem längeren Katamnesezeitraum untersuchten. Schlüsselbergriffe: Psychoonkologie, Akzeptanz- und Commitment-Therapie, ACT, Gruppentherapie, Progredienzangst

Psychosocial and biological factors influence the perception of physical changes during pregnancy. Some pregnant women present to the obstetric emergency department (ED) with diverse symptoms not requiring urgent medical action. These visits result in over-consultation, tying up resources and inflating health care expenses. This study outlines factors associated with multiple ED visits during pregnancy, measures the prevalence of anxiety and depression, and explores the choice of maternity clinic for delivery aiming to elucidate options for care strategies. This prospective, cross-sectional, questionnaire-based bicentric study was performed in the obstetric outpatient departments of two university hospitals in Germany and recruited pregnant women between 12/2016 and 11/2017. The questionnaire included socio-demographics, obstetric history, anxiety (GAD-7), depression (PHQ-9), and health status (WHO-5, SF-12). This analysis included 496 women and showed that women with numerous ED visits were significantly younger (p

Hospitals are psychologically demanding workplaces with a need for context-specific stress-preventive leadership interventions. A stress-preventive interprofessional leadership intervention for middle management has been developed. This phase-II study investigates its feasibility and outcomes, including work-related stress, well-being and transformational leadership.This is a mixed-methods study with three measure points (T0: baseline, T1: after the last training session, T2: 3-month follow-up). Additionally, focus groups were conducted to assess participants' change in everyday work.A tertiary hospital in Germany.N=93 leaders of different professions.An interactive group setting intervention divided in five separate sessions ((1) self-care as a leader, (2) leadership attitudes and behaviour, (3) motives, needs and stressors of employees, (4) strengthen the resource 'team', (5) reflection and focus groups). The intervention was conducted between June 2018 and March 2020 in k=5 runs of the intervention.Feasibility and acceptance were measured with a self-developed intervention specific questionnaire. Psychological outcomes were assessed with the following scales: work-related strain with the Irritation Scale, well-being with the WHO-5 Well-being Index and transformational leadership with the Questionnaire of Integrative Leadership.After the intervention at T2, over 90% of participants reported that they would recommend the intervention to another coworker (92.1%, n=59) and all participants (n=64) were satisfied with the intervention and rated the intervention as practical relevant for their everyday work. Participants' self-rated cognitive irritation was reduced, whereas their well-being and transformational leadership behaviour were improved over time. Focus group discussions revealed that participants implemented intervention contents successfully in their everyday work.This intervention was feasible and showed first promising intraindividual changes in psychological outcomes. Participants confirmed its practical relevance. As a next step, the intervention will be evaluated as part of a multicentre-randomised controlled trial within the project SEEGEN (SEElische GEsundheit am Arbeitsplatz KrankeNhaus).

Zusammenfassung Ziel der Studie Befragung von Mitarbeitern im Krankenhaus zu arbeitsbedingten Fehlbelastungen und Stressfolgen sowie Konsequenzen für Interventionen zur Stressreduktion am Arbeitsplatz. Methodik Es wurden 6 Fokusgruppen und 7 semistrukturierte Interviews mit 34 Krankenhausmitarbeitern durchgeführt, welche inhaltsanalytisch ausgewertet wurden. Ergebnisse Mitarbeiter berichteten von Stressfolgen durch Personalmangel, hohes Arbeitsaufkommen, fehlende Rückzugs- und Versorgungsmöglichkeiten, fehlende Absprachen, intransparente Arbeitsabläufe, Teamkonflikte und fehlende Wertschätzung. Berichtete Faktoren, die zur Reduktion von Stressfolgen führten, waren soziale Unterstützung, Arbeitszeitreduktion, Sport und Entscheidungskompetenzen. Schlussfolgerung Interventionen zur Reduktion arbeitsbedingter Fehlbelastungen im Krankenhaus sollten sowohl berufsgruppenspezifische Interventionsangebote sowie organisationale Normen und strukturelle Rahmenbedingungen berücksichtigen.

Aims and objectives To test a mediating effect of compassion satisfaction on the relationship between personality traits (Big Five) and intent to leave. Background Nursing professionals work in high-stress environments and exhibit more emotional distress and mental health disorders than other hospital professionals. This translates to increased intention to leave their profession. Evidence suggests that compassion satisfaction reduces intention to leave. Research also indicates that personality factors are associated with compassion satisfaction and intent to leave. Design Using a cross-sectional design, we collected data from 536 nurses in a maximum-care hospital in Germany via questionnaires; the analyses included 518 participants. Method We applied the structural equation model and followed the STROBE checklist. Results 30% of our study participants reported high intent to leave. Compassion satisfaction mediated the relationship between agreeableness and intent to leave. Openness to experience and neuroticism had positive direct effects on intent to leave. Conclusions The results suggest that high compassion satisfaction levels may decrease intention to leave levels. Personality traits impact compassion satisfaction and intention to leave. Relevance to clinical practice Nursing professionals' compassion satisfaction needs to be improved, for example by resilience training. As personality factors remain relatively stable over time, caregivers need to consider them when identifying appropriate areas of work and responsibility.

A feasibility study to determine whether oncology patients in the acute phase of their disease can participate in and benefit from a functional relaxation (FR) program.A group intervention (N=14) over 10 sessions following the FR functional relaxation stress manual; measurement of psychological distress by a pre-post questionnaire survey.The intervention appears well suited to help psychologically distressed patients process their symptoms and cope with stressors. There was some indication that general well-being increased and hyperarousal decreased.Overall well-being increased; hyperarousal decreased.The intervention was well accepted, but regular participation was not always possible due to the disease. The body therapy approach and group setting seemed particularly helpful. Due to the heavy physical strain on the patients, the structure of the groups as well as individual exercises were adapted individually.The body-based interventions made unconscious elements accessible and thus to work with therapeutically to a limited extent. Further research is needed to show the effectiveness of this functional relaxation group intervention.ZIEL: Eine Machbarkeitsstudie zur Überprüfung, ob onkologisch erkrankte PatientInnen an einem Angebot zu Funktioneller Entspannung teilnehmen und davon profitieren können.Eine Gruppenintervention (N=14) über 10 Sitzungen in Anlehnung an das Funktionelle Entspannung-Stressmanual; Messung der psychischen Belastung durch eine prä-post-Fragebogenerhebung.Die Intervention scheint gut geeignet, psychisch belastete PatientInnen bei der Verarbeitung ihrer Beschwerden und im Umgang mit Stressoren zu unterstützen. Es zeigten sich Hinweise, dass das allgemeine Wohlbefinden stieg und Hyperarousal sank.Die Intervention wurde gut angenommen, eine regelmäßige Teilnahme war jedoch aufgrund der Erkrankung nicht immer möglich. Der körpertherapeutische Ansatz und das Gruppensetting schienen besonders hilfreich. Aufgrund der starken körperlichen Belastung der PatientInnen wurden die Struktur der Gruppe sowie einzelne Übungen individuell angepasst.Die körperbezogenen Interventionen machten unbewusste Anteile zugänglich und damit in begrenztem Umfang psychotherapeutisch bearbeitbar. Es benötigt weitere Forschung, um die Effektivität dieser Funktionellen Entspannungs-Gruppenintervention zu untersuchen.

Purpose Oncologists are at an increased risk of developing burnout, leading to negative consequences in patient care and in professional satisfaction and quality of life. This study was designed to investigate exhaustion and disengagement among German oncologists and assess the prevalence of burnout among oncologists within different professional settings. Furthermore, we wanted to examine possible relations between sociodemographic factors, the oncological setting, professional experience and different aspects of burnout. Methods In a cross-sectional study design, an Internet-based survey was conducted with 121 oncologists between April and July 2020 using the Oldenburg Burnout Inventory, which contains items on exhaustion, disengagement, and burnout. Furthermore, sociodemographic data of the participants were assessed. The participants were members of the Working Group Medical Oncology (Arbeitsgemeinschaft Internistische Onkologie) within the German Cancer Society. Results The survey showed a burnout prevalence of 43.8%, which correlated with age and professional experience; that is, the prevalence is particularly high among younger oncologists. Exhaustion is closely related to employment status; that is, it was significantly higher among employed oncologists. There were remarkably low levels of disengagement among oncologists, highlighting the own demand to fulfil job requirements despite imminent or actual overburdening in daily work. Conclusion More support is necessary to mitigate the professional stressors in the healthcare system. To ensure quality medical care, employees should be offered preventive mental health services early in their careers.

Patients with prostate cancer (PC) and their spouses are confronted with several treatment-related and psychosocial challenges that can reduce their health-related quality of life (HRQoL). Patients with advanced PC (aPC) and their spouses are at highest risk for psychological distress and show lower HRQoL compared with couples in other phases. The aim of this study was to investigate the psychological interdependencies between HRQoL and anxiety, fear of progression (FoP), and depression in patients with aPC and their spouses.Ninety-six heterosexual couples with aPC participated in this cross-sectional study. Patients and spouses provided information about anxiety and depression (Patient Health Questionnaire-4), fear of progression (short form of the Fear of Progression Questionnaire), and HRQoL (EORTC QoL-C30, version 3). Psychological interdependencies were analyzed with various actor-partner interdependence models using structural equation modeling.Anxiety, FoP, and depression were significant predictors of HRQoL for patients with aPC and their spouses (actor effects). Spouses' anxiety and FoP were negatively associated with patients' HRQoL (partner effects), showing that patients' HRQoL is associated with their own and their spouses' anxiety and FoP. No partner effect was revealed between depression and HRQoL in the patients or spouses.The resulted partner effects between spouses and patients underline the importance of considering HRQoL in patients with aPC from a dyadic perspective. It is important that physicians explore patients' and spouses' needs and psychological burden to offer support and access to psycho-oncological services. Future studies are needed to investigate the effects of suitable interventions on spouses' anxiety and FoP.

Zusammenfassung Ziel Ziel der vorliegenden Erhebung ist es, bislang existierende Erfahrungen von Mitarbeitern psychosozialer Krebsberatungsstellen in Deutschland mit der Nachbefragung von Ratsuchenden als Qualitätssicherungsmaßnahme zu beschreiben und zu bewerten. Methodik Vertreter verschiedener psychosozialer Krebsberatungsstellen wurden gebeten, einen Erfahrungsbericht über Nutzerbefragungen zur Qualitätssicherung zu erstellen. 9 Erfahrungsberichte werden vorgestellt und zusammenfassend durch die Arbeitsgruppe Krebsberatungsstellen der Arbeitsgemeinschaft Psychoonkologie der Deutschen Krebsgesellschaft (PSO) diskutiert. Besonderes Augenmerk galt dem von der Arbeitsgruppe empfohlenen Kurzfragebogen KBS-N (Krebsberatungsstellen-Nachbefragungsbogen). Ergebnisse Alle teilnehmenden psychosozialen Krebsberatungsstellen berichten von positiven Erfahrungen mit Nutzerbefragungen, die jedoch einen personellen und logistischen Aufwand darstellen. Neben dem KBS-N kamen auch ausführlichere Fragebögen zum Einsatz. Die Befragungen wurden entweder kontinuierlich oder stichprobenartig über einen begrenzten Zeitraum hinweg durchgeführt. Die Ratsuchenden werden meist zu einem definierten Zeitpunkt direkt nach den Erstgesprächen oder nach Abschluss der Beratungssequenz befragt. Die Rücklaufquote ist bei persönlicher Ausgabe des Fragebogens nach dem Erstgespräch und Abgabe noch in der Beratungsstelle höher (85–95%) als bei postalischer Zustellung und Rücksendung (47–89%). Alle Beratungsstellen berichten übereinstimmend von sehr positiven Rückmeldungen zu den Beratungsleistungen. Vereinzelte Kritikpunkte betreffen insbesondere organisatorische Rahmenbedingungen. Schlussfolgerung Nach Abwägung von Aufwand und Nutzen erscheint eine aktive Nachbefragung von Ratsuchenden mit dem Kurzfragebogen KBS-N, zumindest über einen begrenzten Zeitraum hinweg, eine praktikable Qualitätssicherungsmaßnahme darzustellen. Ausführlichere Nutzerbefragungen sind mit einem höheren Aufwand verbunden und daher eher für den Einsatz bei über die Qualitätssicherung hinausgehenden Forschungsfragestellungen geeignet.

Objective The study aimed to examine the 12-month course of cancer-related insomnia (CRI) and to identify possible predictors for the prevalence and persistence of CRI. Methods This longitudinal multicenter study included N = 405 patients with cancer (56% females, mean age: 58.6 years). CRI was measured by the Insomnia Severity Index (ISI). Socio-demographic and clinical data, as well as psychological parameters (Distress Thermometer, PHQ-9, GAD-7, and EORTC-Fatigue), were assessed at baseline (T1) and 12 months later (T2). Results In our sample, a high prevalence of relevant insomnia symptoms (49.4%, ISI > 7) was found, while a clinical insomnia diagnosis was verified in 12.8% (ISI > 14). When insomnia was present at T1, this problem was persistent after one year in 64%. At T2, however, significantly more women suffered from insomnia symptoms (53.3% women vs. 39.3% men; p = 0.003). Insomnia was associated with many clinical and psychological parameters, especially with fatigue (r = 0.5). Multiple regression analysis revealed that, in women, only insomnia at T1 was a significant predictor for insomnia at T2 (R2 = 0.40; F(5) = 12.5; p Conclusion Insomnia is a common disorder in cancer patients. Although medical and psychological parameters improved during the 12-month course of cancer treatment, our results show that insomnia is highly persistent, especially in women. This indicates that adequate support for those affected is needed. Clinical Trial Registration Number: DRKS00004860.

Zusammenfassung Hintergrund Internetforen sind onlinegestützte Diskussionsrunden, in denen Nutzer untereinander Erfahrungen, Ratschläge und Informationen austauschen. Der Bundesverband Prostatakrebs Selbsthilfe e. V. (BPS) betreibt das größte deutschsprachige Internetforum für Prostatakrebs-Betroffene. Material und Methoden Mehrere Aspekte des BPS-Forums wurden untersucht: Inhaltsanalyse, Sprachgebrauch und Umgang miteinander, Einfluss auf die Therapieentscheidung, Vergleich mit klassischen Selbsthilfegruppen und die Nutzung durch Angehörige und Freunde. Ergebnisse Im Internetforum herrscht ein tentativer Kommunikationsstil mit reservierten Sprachmerkmalen vor. Neben dem Informationsaustausch scheint eine emotionale Unterstützung vielen Nutzern sehr willkommen zu sein und stellt einen wesentlichen Teil des Austausches dar. Die Nutzung des Internetforums führt bei 29 % der Patienten zu einer Veränderung der initialen Therapieentscheidung. Im Vergleich mit der Allgemeinbevölkerung fanden wir unter den Nutzern 2- bis 3-mal so hohe Raten an mit Angst und Depression belasteten Patienten. Im Vergleich zu den Patienten selbst zeigen insbesondere Familienmitglieder höhere Werte für Angst und Depression und beschrieben eine höhere Rate an metastasierenden Erkrankungen bei den ihnen bekannten Patienten. Nutzer des Internetforums waren jünger, hatten ein höheres Bildungsniveau und ein höheres Einkommen als Teilnehmer an klassischen Selbsthilfegruppen. Schlussfolgerung Internetforen werden von ihren Nutzern positiv bewertet und tragen zur Informationssammlung und zur emotionalen Unterstützung bei. Sie haben wahrscheinlich einen signifikanten Einfluss auf die primäre Behandlungsentscheidung und gestalten so die Versorgungswirklichkeit bei Prostatakarzinompatienten aktiv mit.