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Heuser C, Schneider JN, Heier L, Ernstmann N, Nakata H, Petermann-Meyer A, Bremen R, Karger A, Icks A, Brümmendorf TH, Geiser F. Family resilience of families with parental cancer and minor children: a qualitative analysis. Front Psychol 2024; 14:1251049. [PMID: 38314254 PMCID: PMC10836593 DOI: 10.3389/fpsyg.2023.1251049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/26/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Estimated 50,000 minor children in Germany experience a newly diagnosed cancer in one of their parents every year. Family resilience has proven to be an important concept against life crises. However, little research exists regarding family resilience in the context of parental cancer with minor children. Based on the "Family Resilience Framework," the aim of the study is to investigate the processes of family resilience of affected families. In addition, we explore which combinations of promoting family resilience processes can be characterized. Methods As part of the mixed-method quasi-experimental interventional study "F-SCOUT," a qualitative content analysis was used to analyze the documentation of the "Family-Scouts" (a fixed contact person who advises, accompanies, and supports the families). Documentation was performed by families' study inclusion (T0), after 3 months (T1) and 9 months (T2) concerning current family situation, organization of everyday life, emotional coping, open communication within the family, and planned tasks. Results The N = 73 families had between one and six children. In 58 (79%) families, the mother had cancer. In the course of the analysis, a category system with 10 main categories and 36 subcategories emerged. Family resilience processes were described to different extents. Combinations of categories promoting family resilience were characterized by the use of social resources, flexibility, economic resources, and open communication. Discussion The findings are consistent with existing assumptions about family resilience in terms of the importance of social resources, family cohesion, mutual support, flexibility, open communication, and psychological well-being. In contrast to the findings of previous research, spirituality, and collaborative problem-solving indicate less centrality here. In turn, the findings on economic resources and information-seeking provide a valuable addition to the family resilience literature in the context of parental cancer with minor children. Clinical trial registration ClinicalTrials.gov, identifier NCT04186923.
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Affiliation(s)
- Christian Heuser
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Juliane Nora Schneider
- Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Lina Heier
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, Netherlands
- CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, Netherlands
| | - Nicole Ernstmann
- Chair of Health Services Research, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Hannah Nakata
- Center for Health Communication and Health Services Research, Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
| | - Andrea Petermann-Meyer
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Rebecca Bremen
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - André Karger
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Clinical Institute for Psychosomatic Medicine and Psychotherapy, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Faculty of Medicine, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center, Düsseldorf, Germany
| | - Tim H. Brümmendorf
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Franziska Geiser
- Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Germany
- Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, University of Bonn, Bonn, Germany
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Maier L, Engesser D, Paul R, Reuter K, Petermann-Meyer A, Singer S. [The Structural Reform of The Psychotherapy Guidelines in Germany]. Psychiatr Prax 2024; 51:31-38. [PMID: 37678409 DOI: 10.1055/a-2112-3549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Our study investigates how psychotherapists implement and assess the newly introduced elements of the structural reform of the psychotherapy guideline in Germany. METHODS We asked psychotherapists about their experiences with the structural reform in semi-structured interviews. The data was analysed using qualitative content analysis. RESULTS A total of 37 h of audio material from 41 psychotherapists were available. The interviews showed that acute treatment and relapse prevention are welcomed by psychotherapists. However, due to lack of appointment capacity as well as conceptual barriers, these are rarely used. Concerning psychotherapeutic assessment consultations, the opinions were heterogeneous. CONCLUSION Individual aspects of the new care elements are assessed positively. However, these can only be implemented to a limited extent and are not sufficient to significantly improve the strained supply situation.
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Affiliation(s)
- Lena Maier
- Institut für Medizinische Biometrie, Epidemiologie und Versorgungsforschung, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Deborah Engesser
- Institut für Medizinische Biometrie, Epidemiologie und Versorgungsforschung, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | | | | | | | - Susanne Singer
- Institut für Medizinische Biometrie, Epidemiologie und Versorgungsforschung, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
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Maier L, Engesser D, Petermann-Meyer A, Paul R, Reuter K, Singer S. ["It's Left a Bitter Taste" Psychotherapists' Perspectives on the Abolition of the German Assessment Procedure for Outpatient Psychotherapy]. Psychother Psychosom Med Psychol 2023; 73:16-24. [PMID: 35793669 DOI: 10.1055/a-1850-1886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND RESEARCH QUESTION In 2019, the abolition and replacement of the present German assessment procedure for outpatient psychotherapy was resolved and adopted into law. This study examined what psychotherapists think about the new plan. METHODS We conducted semi-guided interviews with psychotherapists about their experience and opinion of the current psychotherapeutic care situation in Germany. Statements about the assessment procedure were evaluated using qualitative text analyses. We compared the psychotherapists' opinion on the assessment procedure with the psychotherapeutic approach as well as the age group. RESULTS Of 41 psychotherapists 27 reported their thoughts about the assessment procedure. The following themes could be drawn from their statements: Appreciation as well as criticism of quality control of the procedure, worries about a future loss of economic and treatment certainty, perception that the assessment procedure questions one's competence, disapproval of the low remuneration of the reports, the connection between individual attitudes towards the assessment report and conscientiousness in writing the reports, and the lack of transparency of the legislative initiative. Psychodynamic psychotherapists wanted to keep the assessment procedure slightly more often compared to behavioural psychotherapists; child and youth psychotherapists wanted to keep it more often than psychotherapists for adults. DISCUSSION Psychotherapists perceive the reform of the assessment procedure as a process with a substantial impact on their current clinical practice as well as their psychotherapeutical identity. To improve the quality and acceptance of the future quality assurance procedure, psychotherapists should be an active part of the development process.
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Affiliation(s)
- Lena Maier
- Epidemiologie und Versorgungsforschung, Johannes-Gutenberg Universität Mainz Institut für Medizinische Biometrie Epidemiologie und Informatik, Mainz, Germany
| | - Deborah Engesser
- Epidemiologie und Versorgungsforschung, Johannes-Gutenberg Universität Mainz Institut für Medizinische Biometrie Epidemiologie und Informatik, Mainz, Germany
| | | | - Rainer Paul
- Psychotherapie, Psychotherapeutische Praxis, Wiesbaden, Germany
| | - Katrin Reuter
- Psychotherapie, Psychotherapeutische Praxis, Freiburg, Germany
| | - Susanne Singer
- Epidemiologie und Versorgungsforschung, Johannes-Gutenberg Universität Mainz Institut für Medizinische Biometrie Epidemiologie und Informatik, Mainz, Germany
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Karger A, Petermann-Meyer A, Vitinius F, Geiser F, Kraus D, Ernsten L, Mayers AJ, Heuser C, Hiltrop K, Bremen R, Marx A, Ernstmann N. Effectiveness of interprofessional communication skills training for oncology teams: study protocol for a three-arm cluster randomised trial (KommRhein Interpro). BMJ Open 2022; 12:e062073. [PMID: 36581438 PMCID: PMC9806046 DOI: 10.1136/bmjopen-2022-062073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Patient-provider communication is an important factor influencing the quality of care in oncology. The study examines the comparative effectiveness of a 10-hour interprofessional communication skills training (CST) programme for physicians and nurses in cancer centres. METHODS AND ANALYSIS KommRhein Interpro is a cluster-randomised trial sponsored by the German Cancer Aid (Deutsche Krebshilfe, DKH) and conducted at the cancer centres of the university hospitals of Aachen, Bonn, Cologne and Düsseldorf. Thirty oncology teams of four cancer centres are randomly assigned to three study arms, providing healthcare professionals with either (a) only written information on patient-centred communication or (b) written information plus CST for physicians or (c) written information plus interprofessional CST for physicians and nurses. For summative evaluation, standardised surveys from three measurement points for patients (T0pat: study enrollment; T1pat: after discharge; T2pat: 3 months' follow-up) and two measurement points for physicians and nurses (T0hcp: before the intervention; T1hcp: after the intervention) are used. N=1320 valid patient cases are needed for data evaluation. The primary endpoint is fear of progression in patients with cancer after discharge. Data will be analysed according to the intention-to-treat principle using a mixed model for repeated measurement. Secondary outcome is the providers' self-efficacy in patient centeredness. Individual confounders and possible moderating effects of organisational factors will be considered. Secondary analysis will be performed by means of multilevel analysis and structural equation modelling. ETHICS AND DISSEMINATION A vote of approval has been obtained from the ethics committees of the medical faculties of RWTH Aachen University (EK325/20), University of Bonn (391/20), University of Cologne (20-1332) and Heinrich Heine University Düsseldorf (2019-796). Data protection regulations are adhered to for all processed data. The conduct of the study will be monitored. Dissemination strategies include a transfer workshop with cancer teams and distribution of the final study report to participants. TRIAL REGISTRATION NUMBER DRKS00022563; DRKS (German Clinical Trials Register).
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Affiliation(s)
- Andre Karger
- Institute for Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Center for Integrated Oncology Aachen, RWTH Aachen University, Medical Faculty and University Hospital, Aachen, Germany
| | - Frank Vitinius
- Department for Psychosomatics and Psychotherapy, University Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
| | - Franziska Geiser
- Psychosomatic Medicine and Psychotherapy, University Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Daria Kraus
- Clinical Trials Center Cologne, University of Cologne, Cologne, Germany
| | - Luisa Ernsten
- Institute for Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Antonia J Mayers
- Institute for Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Christian Heuser
- Center for Health Communication and Health Services Research, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Kati Hiltrop
- Center for Health Communication and Health Services Research, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Rebecca Bremen
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Center for Integrated Oncology Aachen, RWTH Aachen University, Medical Faculty and University Hospital, Aachen, Germany
| | - Ambra Marx
- Psychosomatic Medicine and Psychotherapy, University Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
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Maier L, Engesser D, Petermann-Meyer A, Paul R, Reuter K, Singer S. [Correction: "It's Left a Bitter Taste" Psychotherapists' Perspectives on the Abolition of the German Assessment Procedure for Outpatient Psychotherapy]. Psychother Psychosom Med Psychol 2022. [PMID: 35921845 DOI: 10.1055/a-1897-0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Lena Maier
- Epidemiologie und Versorgungsforschung, Johannes-Gutenberg Universität Mainz Institut für Medizinische Biometrie Epidemiologie und Informatik, Mainz, Germany
| | - Deborah Engesser
- Epidemiologie und Versorgungsforschung, Johannes-Gutenberg Universität Mainz Institut für Medizinische Biometrie Epidemiologie und Informatik, Mainz, Germany
| | | | - Rainer Paul
- Psychotherapie, Psychotherapeutische Praxis, Wiesbaden, Germany
| | - Katrin Reuter
- Psychotherapie, Psychotherapeutische Praxis, Freiburg, Germany
| | - Susanne Singer
- Epidemiologie und Versorgungsforschung, Johannes-Gutenberg Universität Mainz Institut für Medizinische Biometrie Epidemiologie und Informatik, Mainz, Germany
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Krüger L, Panse J, Hugot J, Dohmen M, Bremen R, Habel U, Brümmendorf TH, Ernstmann N, Petermann-Meyer A. [Implementation of a Pilot Project Supporting Parents Suffering from Cancer with Underage Children]. Gesundheitswesen 2022. [PMID: 35654397 DOI: 10.1055/a-1775-8181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Families with one parent suffering from cancer are exposed to extraordinary emotional and organizational burdens, affecting underaged children. To help coordinated access to social and logistic support options and thus reduce the stress on family members, the project Brückenschlag was founded. The aim of this paper was to evaluate the implementation of this pilot project following the healthcare utilization model by Andersen. METHODS A cross-sectional observational study was conducted using a mixed-method approach. Semi-structured written expert surveys (n=10) and secondary analysis of routine data of the care model (n=171 families) were combined. RESULTS Quantitative secondary analysis: The participating families had 1-7 children (median (m) 2, range (s) 6). In 66% of the cases, the mother was affected by cancer, in 20% the diseased parent was in a single parent household. The communication structure in these families was rated "limited" to "rather open". Of the total of 171 contacts (study period 9/14 to 11/17), 133 families made use of Brückenschlag; 59.2% of the contacts were made by psycho-oncologists and the social services department of the hospital. If the contact was initiated by the patients themselves or by psycho-oncologists, a guidance was established significantly more frequently (significance of chi-squared test 0.047). Qualitative analysis: There was a lack of awareness and coordination of existing support services and a lack of family resources to use existing support offers. Both the desired and the established support fell primarily in the area of organizational support. Brückenschlag improved networking and took on a navigating function for the families. CONCLUSION The data collected indicate that in families, matching the German average in their socio-demographic characteristics, a great need for organizational support develops as soon as one parent becomes sick with cancer. The model project Brückenschlag creates an access to support services for families with one parent suffering from cancer.
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Affiliation(s)
- Lea Krüger
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Fakultät, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Germany
| | - Jens Panse
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Fakultät, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Germany.,Centrum für integrierte Onkologie, CIO ABCD, Aachen Bonn Cologne Duesseldorf, Germany
| | - Jessica Hugot
- Caritasverband für die Regionen Aachen-Stadt und Aachen-Land e.V., Aachen, Germany
| | - Marc Dohmen
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Fakultät, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Germany.,Centrum für integrierte Onkologie, CIO ABCD, Aachen Bonn Cologne Duesseldorf, Germany
| | - Rebecca Bremen
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Fakultät, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Germany.,Centrum für integrierte Onkologie, CIO ABCD, Aachen Bonn Cologne Duesseldorf, Germany
| | - Ute Habel
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Germany
| | - Tim H Brümmendorf
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Fakultät, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Germany.,Centrum für integrierte Onkologie, CIO ABCD, Aachen Bonn Cologne Duesseldorf, Germany
| | - Nicole Ernstmann
- Centrum für integrierte Onkologie, CIO ABCD, Aachen Bonn Cologne Duesseldorf, Germany.,Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Universitätsklinikum Bonn, Bonn, Germany.,Institut für Patientensicherheit (IfPS), Universitätsklinikum Bonn, Bonn, Germany
| | - Andrea Petermann-Meyer
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Fakultät, Rheinisch-Westfalische Technische Hochschule Aachen, Aachen, Germany.,Centrum für integrierte Onkologie, CIO ABCD, Aachen Bonn Cologne Duesseldorf, Germany
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Hebestreit H, Zeidler C, Schippers C, de Zwaan M, Deckert J, Heuschmann P, Krauth C, Bullinger M, Berger A, Berneburg M, Brandstetter L, Deibele A, Dieris-Hirche J, Graessner H, Gündel H, Herpertz S, Heuft G, Lapstich AM, Lücke T, Maisch T, Mundlos C, Petermann-Meyer A, Müller S, Ott S, Pfister L, Quitmann J, Romanos M, Rutsch F, Schaubert K, Schubert K, Schulz JB, Schweiger S, Tüscher O, Ungethüm K, Wagner TOF, Haas K, Akkaya F, Babka C, Bârlescu L, Bärsch-Michelmann A, Bergbreiter A, Blömeke J, Böhm L, Böttger B, Braun B, Brinkmann F, Britz V, Cario H, Celiker M, de Greck M, Debatin KM, Dillmann-Jehn K, Ertl M, Ettinger M, Eymann J, Frommer J, Gabrian M, Glode A, Gödecke V, Grasemann C, Grauer E, Greger H, Haas A, Haase M, Haisch L, Heinrich I, Held M, Hennermann J, Herrmann-Werner A, Hett J, Hilbig B, Holthöfer L, Imhof C, Jacob T, Junne F, Karl S, Kassubek J, Kick L, Koschitzki KT, Krassort H, Kratz C, Kristensen K, Kropff B, Kuhn J, Latzko P, Loew T, Lorenz D, Ludolph AC, dos Santos IM, Meyer T, Mohnike K, Monninger M, Musacchio T, Nanciu AN, Nießen M, Nöhre M, Papagianni A, Pfeifer-Duck C, Piduhn LS, Rampp C, Richter A, Rieß O, Schmidt A, Schneider S, Schoels L, Schwalba M, Selig U, Spangenberger A, Sroka A, Steinbüchel T, Stösser S, Suchant S, Vogel M, Volk D, Vollmuth C, Volnov S, Walter S, Warrings B, Weiler C, Witt S, Zajt KK, Zeltner L, Zenker K, Zhang KD, Zipfel S. Dual guidance structure for evaluation of patients with unclear diagnosis in centers for rare diseases (ZSE-DUO): study protocol for a controlled multi-center cohort study. Orphanet J Rare Dis 2022; 17:47. [PMID: 35164804 PMCID: PMC8842899 DOI: 10.1186/s13023-022-02176-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/16/2022] [Indexed: 11/12/2022] Open
Abstract
Background In individuals suffering from a rare disease the diagnostic process and the confirmation of a final diagnosis often extends over many years. Factors contributing to delayed diagnosis include health care professionals' limited knowledge of rare diseases and frequent (co-)occurrence of mental disorders that may complicate and delay the diagnostic process. The ZSE-DUO study aims to assess the benefits of a combination of a physician focusing on somatic aspects with a mental health expert working side by side as a tandem in the diagnostic process. Study design This multi-center, prospective controlled study has a two-phase cohort design. Methods Two cohorts of 682 patients each are sequentially recruited from 11 university-based German Centers for Rare Diseases (CRD): the standard care cohort (control, somatic expertise only) and the innovative care cohort (experimental, combined somatic and mental health expertise). Individuals aged 12 years and older presenting with symptoms and signs which are not explained by current diagnoses will be included. Data will be collected prior to the first visit to the CRD’s outpatient clinic (T0), at the first visit (T1) and 12 months thereafter (T2). Outcomes Primary outcome is the percentage of patients with one or more confirmed diagnoses covering the symptomatic spectrum presented. Sample size is calculated to detect a 10 percent increase from 30% in standard care to 40% in the innovative dual expert cohort. Secondary outcomes are (a) time to diagnosis/diagnoses explaining the symptomatology; (b) proportion of patients successfully referred from CRD to standard care; (c) costs of diagnosis including incremental cost effectiveness ratios; (d) predictive value of screening instruments administered at T0 to identify patients with mental disorders; (e) patients’ quality of life and evaluation of care; and f) physicians’ satisfaction with the innovative care approach. Conclusions This is the first multi-center study to investigate the effects of a mental health specialist working in tandem with a somatic expert physician in CRDs. If this innovative approach proves successful, it will be made available on a larger scale nationally and promoted internationally. In the best case, ZSE-DUO can significantly shorten the time to diagnosis for a suspected rare disease. Trial registration ClinicalTrials.gov; Identifier: NCT03563677; First posted: June 20, 2018, https://clinicaltrials.gov/ct2/show/NCT03563677.
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Ernstmann N, Nakata H, Meurer L, Weiß J, Geiser F, Vitinius F, Petermann-Meyer A, Burgmer M, Sonntag B, Teufel M, Karger A. Participative development and evaluation of a communication skills-training program for oncologists-patient perspectives on training content and teaching methods. Support Care Cancer 2021; 30:1957-1966. [PMID: 34626250 PMCID: PMC8794992 DOI: 10.1007/s00520-021-06610-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/30/2021] [Indexed: 11/09/2022]
Abstract
Background Using the 6-step approach to curriculum development for medical education, we developed a communication skills training (CST) curriculum for oncology and evaluated this curriculum from the perspective of cancer patients. Methods We conducted a qualitative interview study with cancer patients, collecting data using semi-structured face-to-face or telephone interviews with a short standardized survey. We fully transcribed the audiotaped interviews and conducted the content analysis using MAXQDA 2020. We analyzed the quantitative sociodemographic data descriptively. Results A total of 22 cancer patients participated, having a mean age of 60.6 (SD, 13.2) years and being predominantly female (55%). The patients believed that the CST curriculum addressed important aspects of patient-centered communication in cancer care. They emphasized the importance of physicians acquiring communication skills to establish a trusting relationship between doctor and patient, show empathy, inform patients, and involve them in treatment decisions. The patients had some doubts concerning the usefulness of strict protocols or checklists (e.g., they feared that protocol adherence might disturb the conversation flow). Discussion Although it was a challenge for some participants to take the perspective of a trainer and comment on the CST content and teaching methods, the patients provided a valuable perspective that can help overcome blind spots in CST concepts.
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Affiliation(s)
- Nicole Ernstmann
- Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany. .,Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany.
| | - Hannah Nakata
- Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany
| | - Lena Meurer
- Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany
| | - Johanna Weiß
- Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research (CHSR), University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany
| | - Franziska Geiser
- Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany.,Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Frank Vitinius
- Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany.,Department of Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Andrea Petermann-Meyer
- Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany.,Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Markus Burgmer
- Department of Psychosomatics and Psychotherapy, LWL-Hospital Münster and University Hospital of Münster, Münster, Germany
| | - Bernd Sonntag
- Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany.,Department of Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,West German Cancer Center (WTZ), University Hospital Essen, Essen, Germany
| | - André Karger
- Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf (CIO ABCD), Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
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9
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Dohmen M, Petermann-Meyer A, Blei D, Bremen R, Brock-Midding E, Brüne M, Geiser F, Haastert B, Halbach SM, Heuser C, Holsteg S, Heier L, Icks A, Karger A, Montalbo J, Nakata H, Panse J, Rottmann TP, Sättler K, Viehmann A, Vomhof M, Ernstmann N, Brümmendorf TH. Comprehensive support for families with parental cancer (Family-SCOUT), evaluation of a complex intervention: study protocol for a non-randomized controlled trial. Trials 2021; 22:622. [PMID: 34526078 PMCID: PMC8442380 DOI: 10.1186/s13063-021-05577-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/27/2021] [Indexed: 11/11/2022] Open
Abstract
Background Families with minor children affected by parental cancer are at risk of considerable emotional and organizational stress that can severely burden all family members. So far, there has been a lack of comprehensive support services for affected families. The aim of this project is to implement and evaluate a complex psychosocial intervention for these families by providing advice, information, and care on an emotional, psycho-social, and communicative level during and after the cancer experience and across healthcare sectors. Methods Family-SCOUT is a project supported by the German Innovation Fund (https://innovationsfonds.g-ba.de/). The evaluation is based on a mixed-methods quasi-experimental design with the intervention and control groups. A standardized postal survey at three measurement points (T0: study enrollment; T1: 3 months of follow-up; T2: 9 months of follow-up), secondary data from the participating health insurance funds, and semi-structured qualitative interviews are used for summative and formative evaluation. The study aim is to include n=560 families. Data will be analyzed according to the intention-to-treat principle. The primary analysis is the comparison of the Hospital Anxiety and Depression Scale (HADS) response rates (minimal important difference (MID) ≥ 1.6 in at least one of the two parents) at T2 between the intervention and control group using Fisher’s exact test. The conduct of the study as well as the development and implementation of the intervention will be accompanied by comprehensive study monitoring following the principles of an effectiveness-implementation hybrid study. Discussion The results will allow to test the effectiveness and efficiency of the intervention for the target group. The first experience with the implementation of the intervention in model regions will be available. The evaluation results will serve as the basis to assess the need of including the intervention in the catalog of services of the statutory health insurance funds in Germany. Trial registration ClinicalTrials.gov, NCT04186923. Retrospectively registered on 4 December 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05577-y.
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Affiliation(s)
- Marc Dohmen
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany. .,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.
| | - Daniel Blei
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Rebecca Bremen
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
| | - Evamarie Brock-Midding
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Manuela Brüne
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Franziska Geiser
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Burkhard Haastert
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany.,mediStatistica, Neuenrade, Germany
| | - Sarah Maria Halbach
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Christian Heuser
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Steffen Holsteg
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Lina Heier
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Institute for Patient Safety (IfPS), University Hospital Bonn, Bonn, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Andre Karger
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Joseph Montalbo
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Hannah Nakata
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Jens Panse
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
| | - Till-Philip Rottmann
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kristina Sättler
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Anja Viehmann
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Markus Vomhof
- Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Duesseldorf, Germany
| | - Nicole Ernstmann
- Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.,Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Institute for Patient Safety (IfPS), University Hospital Bonn, Bonn, Germany
| | - Tim H Brümmendorf
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.,Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany
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10
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Dinkel A, Goerling U, Hönig K, Karger A, Maatouk I, Petermann-Meyer A, Senf B, Woellert K, Wünsch A, Zimmermann T, Schulz-Kindermann F. Psychooncological care for patients with cancer during 12 months of the Covid-19 pandemic: Views and experiences of senior psychooncologists at German Comprehensive Cancer Centers. Psychooncology 2021; 30:1982-1985. [PMID: 34184361 PMCID: PMC8420502 DOI: 10.1002/pon.5759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/17/2021] [Accepted: 06/25/2021] [Indexed: 12/03/2022]
Abstract
A monthly videoconference was maintained over 1 year, allowing senior psychooncologists from German Comprehensive Cancer Centers to discuss the implications of the Covid‐19 pandemic for psychooncological care. In the early phase of the pandemic, a widespread disruption of psychooncological services was noted. Rapidly developed adaptations of regular services worked well and sometimes brought about unexpected, creative solutions. In March 2021, the high numbers of infections, the occurrence of new variants of the coronavirus, and the slow progress in vaccination raise fears about new disruptions and restrictions in service provision. In coping with the pandemic, many therapists have felt like many cancer patients do feel in the process of coping with cancer, and this might help to better understand our patients.
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Affiliation(s)
- Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Ute Goerling
- Charité Comprehensive Cancer Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany.,Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
| | - André Karger
- Center of Integrated Oncology, University Hospital Duesseldorf, Duesseldorf, Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Imad Maatouk
- Psycho-oncology Service, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.,Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Section Psychooncology, Center for Integrated Oncology - Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Bianca Senf
- Department of Psycho-Oncology, University Cancer Center, Johann Wolfgang Goethe University, Frankfurt, Germany
| | - Katharina Woellert
- Institute for History and Ethics of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Wünsch
- Psychosocial Counselling for Cancer Outpatients, Comprehensive Cancer Center, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Frank Schulz-Kindermann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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11
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Bremen R, Petermann-Meyer A, Ernstmann N, Jost E, Panse J, Brümmendorf TH. Sollen Kinder onkologischer Patienten während der COVID-19-Pandemie Kitas oder Schulen besuchen? Onkologe 2021; 27:282-286. [PMID: 33519099 PMCID: PMC7831236 DOI: 10.1007/s00761-021-00901-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/25/2022]
Affiliation(s)
- R. Bremen
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Klinik IV, Centrum für Integrierte Onkologie (CIO-A), Medizinische Fakultät, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - A. Petermann-Meyer
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Sektion Psychoonkologie, Medizinische Klinik IV, Centrum für Integrierte Onkologie (CIO-A), Uniklinik der RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Deutschland
| | - N. Ernstmann
- Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung, Klinik und Poliklinik für psychosomatische Medizin und Psychotherapie, Centrum für integrierte Onkologie (CIO-B), Universitätsklinikum Bonn, Bonn, Deutschland
| | - E. Jost
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Klinik IV, Centrum für Integrierte Onkologie (CIO-A), Medizinische Fakultät, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - J. Panse
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Klinik IV, Centrum für Integrierte Onkologie (CIO-A), Medizinische Fakultät, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - T. H. Brümmendorf
- Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzelltransplantation, Medizinische Klinik IV, Centrum für Integrierte Onkologie (CIO-A), Medizinische Fakultät, Uniklinik RWTH Aachen, Aachen, Deutschland
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12
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Taylor K, Singer S, May M, Durdu G, Petermann-Meyer A. Outcome comparison of integrated psycho-oncological care versus unstructured care-Results of a non-randomised open-label two-arm trial. Eur J Cancer Care (Engl) 2019; 28:e13127. [PMID: 31245886 DOI: 10.1111/ecc.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/29/2019] [Accepted: 06/07/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare patients' experiences with a systematic, integrated psycho-oncological care (IC) model to experiences with "care as usual" (CAU). METHODS To improve patients' knowledge about psychosocial support options and to facilitate use, an IC model was developed by psycho-oncologists and a health insurance company and implemented in one German cancer care facility. Using a parallel, non-randomised design, these patients' experiences were compared to CAU patients. In 2015, both patient groups received questionnaires 6-12 months post-inpatient treatment. Main outcomes were awareness, use and opinion of psycho-oncological care (PC) and anxiety level (Generalized Anxiety Disorder Scale (GAD-7)). RESULTS 228 patients (IC = 90; CAU = 138) participated (response rate 24%). More IC patients felt adequately informed about PC (63% vs. 46%, ORadj : 2.5 (CI: 1.3-4.8); p = 0.008). More IC patients recalled being offered various support options and had had at least one PC discussion (44% vs. 33%, ORadj of IC patient saying "yes" instead of "No, didn't want to" compared to a CAU patient: 0.4 (CI: 0.2-0.8); p = 0.01). More IC patients rated their care as good/excellent (49% vs. 38%, ORadj : 1.8 (CI: 0.7-4.1; p = 0.2)). Anxiety levels were similar (GAD-7 score>=10: IC 34% vs. CAU 28%; p = 0.4). CONCLUSION Structured psycho-oncological care had some positive results on the outcomes, but anxiety levels did not differ.
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Affiliation(s)
- Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Melanie May
- Allgemeine Ortskrankenkasse (General Medical Insurance Plan) Rheinland/Hamburg (AOK-RH), Dusseldor, Germany
| | - Gülsemin Durdu
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Section Psychooncology, Euregionales Comprehensive Cancer Center, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Section Psychooncology, Euregionales Comprehensive Cancer Center, Medical Faculty, RWTH Aachen University, Aachen, Germany
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13
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Schell JT, Petermann-Meyer A, Kloss-Brandstätter A, Bartella AK, Kamal M, Hölzle F, Lethaus B, Teichmann J. Distress thermometer for preoperative screening of patients with oral squamous cell carcinoma. J Craniomaxillofac Surg 2018; 46:1111-1116. [PMID: 29789211 DOI: 10.1016/j.jcms.2018.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 12/15/2022] Open
Abstract
In this study, we evaluate the association between distress, various demographic and medical variables, and the prevalence of psychosocial distress in preoperative patients with oral squamous cell carcinoma. A total of 100 consecutive patients were recruited into the study and asked to complete the Distress Thermometer (DT) form with the Problem List questionnaire prior to surgical intervention; the average distress score was 5.7 ± 2.7. The distress score was neither correlated with age (r = -0.025; p = 0.804) nor with tumor size (r = 0.028; p = 0.785). General worries, anxiety, sadness, depression, pain, exhaustion, sleeping disorders, or problems with nutrition resulted in significantly higher distress scores compared to patients without these complaints. Individuals with a DT score of 5 or higher (p = 0.006) were advised to seek out psychological support. There is a strong correlation between a high DT score and emotional disorders, as well as physical problems.
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Affiliation(s)
- Juliana-Theresa Schell
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Section Psychooncology, Euregionales Comprehensive Cancer Center, RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Anita Kloss-Brandstätter
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Mohammad Kamal
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany.
| | - Jan Teichmann
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
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14
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Karger A, Geiser F, Vitinius F, Sonntag B, Schultheis U, Hey B, Radbruch L, Ernstmann N, Petermann-Meyer A. Communication Skills Trainings: Subjective Appraisal of Physicians from Five Cancer Centres in North Rhine, Germany. Oncol Res Treat 2017; 40:496-501. [PMID: 28750399 DOI: 10.1159/000479113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 06/23/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Physician-patient communication is an essential component of high-quality health care provision for cancer patients. To date, communication skills training programmes have not been systematically implemented in oncology and have low physician participation rates. METHODS As a part of a needs assessment a written questionnaire was used to explore needs and preferences (structural conditions and content) regarding communication skills training programmes for physicians working in oncology settings in 5 university hospitals in North Rhine, Germany. RESULTS 207 physicians took part in the survey. Analyses revealed positive attitudes and high willingness to attend such training programmes, with a preference for short trainings that are compatible with clinical practice. Suggested topics included breaking bad news, conversations about death and dying and dealing with difficult emotions. CONCLUSION Communication skills training approaches should not only pay attention to evidence regarding their efficacy, but also take into consideration physicians' needs and preferences. Further research is required on the subject of barriers to participation in such training programmes.
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15
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Groth M, Singer S, Niedeggen C, Petermann-Meyer A, Röth A, Schrezenmeier H, Höchsmann B, Brümmendorf TH, Panse J. Development of a disease-specific quality of life questionnaire for patients with aplastic anemia and/or paroxysmal nocturnal hemoglobinuria (QLQ-AA/PNH)-report on phases I and II. Ann Hematol 2016; 96:171-181. [PMID: 27837250 PMCID: PMC5226974 DOI: 10.1007/s00277-016-2867-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 10/23/2016] [Indexed: 11/25/2022]
Abstract
Acquired aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria (PNH) are interrelated ultra-rare diseases. Quality of life (QoL) evaluation tools used in studies for AA and PNH are unspecific and designed for cancer patients (e.g., the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, EORTC QLQ-C30). Given the complexity of AA and PNH, variation in symptoms and treatments, younger age of many patients, and the fact that AA and PNH are not classified as malignant diseases, it is likely that cancer-specific questionnaires are inappropriate. We generate an AA/PNH-specific QoL questionnaire (QLQ-AA/PNH), performed according to EORTC guidelines. QoL issues were obtained from the literature and interviews with patients and physicians (phase I), then ranked by patients and physicians. In phase II, items were created. Patients in more than 25 German and Swiss cities were interviewed face to face. In phase I, interviews of 19 patients and 8 physicians specialized in AA/PNH treatment resulted in 649 QoL issues; these were condensed to 175 and graded according to their importance by 30 patients and 14 physicians (phase II). Five physicians took part in phases I and II. Altogether, 97 issues were rated important. Twelve EORTC QLQ-C30 items were not rated important, while several new QoL aspects were brought up. Modifications in wording and phrasing led to two questionnaires with 77 items regarding general QoL aspects and 20 items regarding medical care. Important QoL aspects of PNH/AA patients are inappropriately captured with available QoL tools. Developing a new QoL questionnaire specific for this patient group is warranted.
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Affiliation(s)
- Martha Groth
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Mainz, Germany
| | - Cathrin Niedeggen
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Andrea Petermann-Meyer
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Alexander Röth
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service and Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Britta Höchsmann
- Institute of Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service and Institute of Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Tim H Brümmendorf
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Jens Panse
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, Medical Faculty, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
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16
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Vitinius F, Sonntag B, Barthel Y, Brennfleck B, Kuhnt S, Werner A, Schönefuß G, Petermann-Meyer A, Gutberlet S, Stein B, Söllner W, Kruse J, Keller M. [KoMPASS--design, implementation and experiences concerning a structured communication skills training for physicians dealing with oncology]. Psychother Psychosom Med Psychol 2013; 63:482-8. [PMID: 23677627 DOI: 10.1055/s-0033-1341468] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Goal of the KoMPASS project is to develop and test a training program that effectively improves oncologists' communication skills. The training draws with regard to concept, content and didactic methods to the specific challenges arising in interactions with cancer patients. Concept and didactical methods for an intensive training (KoMPASS Training) are being presented and complemented with experiences gathered during 39 trainings with 335 physicians, as well as findings from the training evaluation by participants. The participants' feedback after 4 months indicates successful transfer into clinical practice along with personal relief, improved self-efficacy, and communicative competencies. Even experienced practitioners ascribe high practical usefulness, and personal learning achievements to the KoMPASS training. The results of the concomitant study concerning self-efficacy, empathy, work-related stress and communicative competence will be published later.
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Affiliation(s)
- Frank Vitinius
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, -Universitätsklinikum Köln
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Panse JP, Athanatou E, Kayser C, Simon MA, Singer S, Brummendorf TH, Petermann-Meyer A. Clinical and sociodemographic data of cancer patients seeking out-patient based psycho-oncological psychotherapy. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e19610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19610 Background: Although there is a defined need for out-patient psychosocial care for cancer patients, data about out-patient psycho-oncological health care services and patients’ usage of ambulatory infrastructure outside certified cancer centres are scarce. Methods: We retrospectively analyzed charts and treatment protocols from 1,369 patients treated between 1998 and 2009 in a psycho-oncology (PO) practice retrieving socio-demographic and cancer-specific data plus data regarding PO intervention. Results: Of 1,180 patients analysed so far, 808 were documented cancer patients and 372 were relatives or friends of cancer patients. Median age of cancer patients was 50 (range 21-81) years, the majority being female (91%). Although PO interventions are not generally covered by most health care insurances in Germany, 87.7% of patients had public health insurance and only 12.7% had private insurance. 62,5% of patients (n=505) were diagnosed with breast cancer, followed by colorectal cancer (n=46), ovarian cancer (n=42), leukemia/lymphoma (n=38) and lung cancer (n=34), although all types of malignancies were represented. 60.1% received curative and 20.3% palliative treatment, while 19.6% could not specify their treatment intention. 503/663 (n=186 not specified) patients had at least one child with 39.5% being less than 18 years of age. 75.9% (176/232) had received high school education, and 37.1% (151/407) were actively working, while 40.3% (164/407) were incapable of work or on retirement pay (22.6%, 92/407). Half of the patients (50.2%) were Aachen residents, while the other half resided within a 50 km radius. Median number of therapy sessions was 12 (range 1-97). Other treatment specific aspects are still being analysed and will be presented at the meeting. Conclusions: Despite the clear demand for all cancer patients, the majority of cancer patients actively seeking out-patient psycho-oncological support are women with breast cancer, while men and other cancer subtypes are clearly underrepresented. Better information, optimized resources, allocation strategies and comprehensive coverage of PO services are needed in order to address more cancer patients with psycho-social distress.
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Affiliation(s)
- Jens Peter Panse
- University Hospital Aachen, Department of Oncology, Hematology and Stem Cell Transplantation, Aachen, Germany
| | | | - Clarissa Kayser
- University Hospital Aachen, Department of Oncology, Hematology and Stem Cell Transplantation, Aachen, Germany
| | - Marike Anna Simon
- Universtiy Hospital Aachen, Department of Oncology, Hematology and Stem Cell Transplantation, Aachen, Germany
| | - Susanne Singer
- University of Leipzig, Department of Medical Psychology and Sociology, Leipzig, Germany
| | - Tim H. Brummendorf
- Klinik für Onkologie, Hämatologie und Stammzelltransplantation, Medizinische Klinik IV, Aachen, Germany
| | - Andrea Petermann-Meyer
- University Hospital Aachen, Department of Oncology, Hematology and Stem Cell Transplantation, Aachen, Germany
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