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Döring M, Dette AK, Werle D, Jendritza R, Malaval C, Thiel S, Michaelis S, Schlösser M, Lang P, Handgretinger R, Svaldi J, Cabanillas Stanchi KM. Screening for distress and quality of life in pediatric patients after allogeneic or autologous hematopoietic stem cell transplantation using a self-reporting instrument, blood stress biomarkers and an expert rating scale (PO-Bado). J Psychosom Res 2023; 170:111358. [PMID: 37196587 DOI: 10.1016/j.jpsychores.2023.111358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/07/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Hematopoietic stem cell transplantation (HSCT) is highly distressing and potentially traumatizing for pediatric and young adult patients (PYAP). At present, there is little evidence on their individual burdens. METHODS In this prospective cohort study, the course of the psychological and somatic distress was investigated on eight observation days (day -8/-12, -5, 0 (day of HSCT), +10, +20, and + 30 before/after HSCT), using the PO-Bado external rating scale and the EORTC-QLQ-C15-PAL self-assessment questionnaire. Stress-associated blood parameters were determined and correlated with the results of the questionnaires. RESULTS A total of 64 PYAP with a median age of 9.1 years (range 0-26 years) who underwent autologous (n = 20; 31%; autoHSCT) or allogeneic (n = 44; 69%; alloHSCT) HSCT were analyzed. Both were associated with a significant reduction in QOL. The reduction in self-assessed QOL correlated with somatic and psychological distress as assessed by medical staff. While somatic distress was similar in both groups with a maximum around day+10 (alloHSCT 8.9 ± 2.4 vs. autoHSCT 9.1 ± 2.6; p = 0.69), a significantly higher level of psychological distress was seen during alloHSCT (e.g. day0 alloHSCT 5.3 ± 2.6 vs. day0 autoHSCT 3.2 ± 1.0; p < 0.0001). CONCLUSIONS The maximum of psychological and somatic distress, as well as the lowest quality of life, ranges between day 0 and + 10 after both allogeneic and autologous pediatric HSCT. While somatic distress is similar during autologous and allogeneic HSCT, the allogeneic group seems to be affected by higher psychological distress. Larger prospective studies are needed to evaluate this observation.
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Affiliation(s)
- Michaela Döring
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Anna Karina Dette
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Dustin Werle
- Clinical Psychology and Psychotherapy, University of Tübingen, Schleichstr. 4, 72076 Tübingen, Germany.
| | - Ricarda Jendritza
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Carmen Malaval
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Stefanie Thiel
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Sebastian Michaelis
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Manuel Schlösser
- University Children's Hospital Tübingen, Psychosocial-therapeutic service, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany
| | - Peter Lang
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Rupert Handgretinger
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
| | - Jennifer Svaldi
- Clinical Psychology and Psychotherapy, University of Tübingen, Schleichstr. 4, 72076 Tübingen, Germany.
| | - Karin Melanie Cabanillas Stanchi
- University Children's Hospital Tübingen, General Pediatrics, Hematology and Oncology, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany.
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Weiss Lucas C, Renovanz M, Jost J, Sabel M, Wiewrodt D, Rapp M. Assessment Practice of Patient-Centered Outcomes in Surgical Neuro-Oncology: Survey-Based Recommendations for Clinical Routine. Front Oncol 2021; 11:702017. [PMID: 34458144 PMCID: PMC8386174 DOI: 10.3389/fonc.2021.702017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
The psycho-oncological burden related to the diagnosis of an intracranial tumor is often accompanied by neurocognitive deficits and changes in character, overall affecting health-related quality of life (HRQoL) and activities of daily living. Regular administration of adequate screening tools is crucial to ensure a timely detection of needs for support and/or specific interventions. Although efforts have been made to assure the quality of neuro-oncological care, clinical assessment practice of patient-reported outcomes (PROs) remains overall heterogeneous, calling for a concise recommendation tailored to neuro-oncological patients. Therefore, this survey, promoted by the German Society of Neurosurgery, was conducted to evaluate the status quo of health care resources and PRO/neurocognition assessment practices throughout departments of surgical neuro-oncology in Germany. 72/127 (57%) of registered departments participated in the study, including 83% of all university hospital units. A second aim was to shed light on the impact of quality assurance strategies (i.e., department certification as part of an integrative neuro-oncology cancer center; CNOC) on the assessment practice, controlled for interacting structural factors, i.e., university hospital status (UH) and caseload. Despite an overall good to excellent availability of relevant health care structures (psycho-oncologist: 90%, palliative care unit: 97%, neuropsychology: 75%), a small majority of departments practice patient-centered screenings (psycho-oncological burden: 64%, HRQoL: 76%, neurocognition: 58%), however, much less frequently outside the framework of clinical trials. In this context, CNOC affiliation, representing a specific health care quality assurance process, was associated with significantly stronger PRO assessment practices regarding psycho-oncological burden, independent of UH status (common odds ratio=5.0, p=0.03). Nevertheless, PRO/neurocognitive assessment practice was not consistent even across CNOC. The overall most commonly used PRO/neurocognitive assessment tools were the Distress Thermometer (for psycho-oncological burden; 64%), the EORTC QLQ-C30 combined with the EORTC QLQ-BN20 (for HRQoL; 52%) and the Mini-Mental Status Test (for neurocognition; 67%), followed by the Montreal Cognitive Assessment (MoCA; 33%). Accordingly, for routine clinical screening, the authors recommend the Distress Thermometer and the EORTC QLQ-C30 and QLQ-BN20, complemented by the MoCA as a comparatively sensitive yet basic neurocognitive test. This recommendation is intended to encourage more regular, adequate, and standardized routine assessments in neuro-oncological practice.
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Affiliation(s)
- Carolin Weiss Lucas
- Center of Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Mirjam Renovanz
- Department of Neurology & Interdisciplinary Neuro-Oncology, University Hospital Tuebingen, Tuebingen, Germany.,Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
| | - Johanna Jost
- Department of Neurosurgery, Muenster University Hospital, Muenster, Germany
| | - Michael Sabel
- Department of Neurosurgery, Heinrich Heine University Hospital of Duesseldorf, Duesseldorf, Germany
| | - Dorothee Wiewrodt
- Department of Neurosurgery, Muenster University Hospital, Muenster, Germany
| | - Marion Rapp
- Department of Neurosurgery, Heinrich Heine University Hospital of Duesseldorf, Duesseldorf, Germany
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Senf B, Bender B, Fettel J. Suicidal ideation, distress, and related factors in a population of cancer patients treated in a general acute hospital. Support Care Cancer 2021; 30:487-496. [PMID: 34324058 PMCID: PMC8636422 DOI: 10.1007/s00520-021-06429-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/11/2021] [Indexed: 11/26/2022]
Abstract
Purpose Suicidality and suicidal ideation (SI) in oncology has long been an underestimated danger. Although there are cancer-specific distress screening tools available, none of these specifically incorporates items for SI. We examined the prevalence of SI in cancer patients, investigated the relation between SI and distress, and tried to identify additional associated factors. Methods A cross-sectional study with patients treated for cancer in a primary care hospital was conducted. Psychosocial distress and SI in 226 patients was assessed. An expert rating scale (PO-Bado-SF) and a self-assessment instrument (QSC-R23) were used to measure distress. SI was assessed with item 9 of the PHQ-9. Data was descriptively analyzed, and correlations and group comparisons between clinically distressed and non-distressed patients were calculated. Results SI was reported by 15% of patients. Classified as clinically distressed were 24.8% (QSC-R23) to 36.7% (PO-Bado-SF). SI was correlated with externally (rτ = 0.19, p < 0.001) and self-rated distress (rτ = 0.31, p < 0.001). Symptoms sufficiently severe for at least a medium major depressive episode were recorded in 23.5% of patients (PHQ-9). Factors associated with SI were feeling bad about oneself, feeling down, depressed, and hopeless, deficits in activities of daily life, psycho-somatic afflictions, social restrictions, and restrictions in daily life. Being in a steady relationship seemed to have a protective effect. Conclusions SI is common in cancer patients. Distress and associated factors are increased in patients with SI. A distress screening with the ability to assess SI could be an important step in prevention, but more research is necessary. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06429-w.
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Affiliation(s)
- Bianca Senf
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
| | - Bernd Bender
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Jens Fettel
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
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Quality of life and distress assessed with self and external assessment screening tools in patients with hematologic malignancies attending treatment in an acute hospital. Qual Life Res 2020; 29:3375-3385. [PMID: 32815114 PMCID: PMC7686164 DOI: 10.1007/s11136-020-02602-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 12/17/2022]
Abstract
Purpose In this study, we examined distress levels and quality of life (QoL) of patients with hematologic malignancies under treatment in an acute setting. We used external- and self-assessment instruments for distress. Additionally, we investigated the relation between distress and QoL as well as whether highly distressed patients differed from less distressed patients concerning their QoL. Methods A cross-sectional study with patients of the Medical Clinic II of the University Hospital Frankfurt was conducted. One hundred and nine patients were assessed with an expert rating scale and completed self-report questionnaires. Data were exploratively analyzed and group comparisons between patients who scored above the cut-off of the respective screening instruments and those who did not were conducted. Results Patients with hematologic malignancies experience high levels of distress and low QoL. Especially, role and social functioning are affected. Patients suffer most from fatigue, appetite loss, and insomnia. Using established cut-offs, all screening instruments were able to differentiate between patients regarding distress and QoL. Patients scoring above the cut-off were significantly more distressed and had a lower QoL. There was a medium-to-strong correlation between distress and QoL indicators. Conclusion Cancer-specific screening instruments seem to be able to identify treatment needs more specifically. They also allowed a better differentiation concerning QoL. The close link between distress and QoL needs to be recognized to enable a holistic approach to treatment and thereby optimize the quality of treatment.
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Herschbach P, Britzelmeir I, Dinkel A, Giesler JM, Herkommer K, Nest A, Pichler T, Reichelt R, Tanzer-Küntzer S, Weis J, Marten-Mittag B. Distress in cancer patients: Who are the main groups at risk? Psychooncology 2020; 29:703-710. [PMID: 31876011 DOI: 10.1002/pon.5321] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Psychosocial distress is common in cancer patients and survivors and encompasses a broad range of concerns and psychological symptoms. The aim of the current study was to identify subgroups of respondents who experience a specific constellation of distress symptoms. METHODS This study uses data from a large data base (n = 21 680) of cancer patients from diverse settings who provided data in the Questionnaire on Distress in Cancer Patients-Short Form (QSC-R10). Cluster analysis was applied to identify subgroups with a distinct constellation of distress symptoms. RESULTS The results showed five distinct clusters: minimally distressed patients (46.6% of the sample), highly distressed patients (12.7%), mainly physically distressed patients (15.2%), mainly psychologically distressed patients (15.6%), and mainly socially distressed patients (9.9%). These groups differed with regard to age, sex, cancer site, treatment setting, and disease progression. CONCLUSION The results revealed large heterogeneity in the experience of distress. Distress clusters were associated with socio-demographic and clinical variables. These associations might aid a clinician to tailor interventions and to address specific types of distress.
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Affiliation(s)
- Peter Herschbach
- Comprehensive Cancer Center, Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | | | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Jürgen M Giesler
- Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center University of Freiburg, Freiburg, Germany
| | - Kathleen Herkommer
- Department of Urology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Alexandra Nest
- Department of Pediatric Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner University Children's Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | | | | | | | - Joachim Weis
- Comprehensive Cancer Center, Department of Self-Help Research, Faculty of Medicine and Medical Center University of Freiburg, Freiburg, Germany
| | - Birgitt Marten-Mittag
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
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Evaluation of the psychological burden during the early disease trajectory in patients with intracranial tumors by the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4). Support Care Cancer 2019; 27:4469-4477. [DOI: 10.1007/s00520-019-04718-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 02/25/2019] [Indexed: 12/29/2022]
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Saada Y, Gana K, Duguey-Cachet O, Stadelmaier N, Quintard B. French adaptation of the PO-Bado short form, an interview-based expert rating scale for distress screening. Health Psychol Behav Med 2019; 7:78-89. [PMID: 34040840 PMCID: PMC8114383 DOI: 10.1080/21642850.2019.1589375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 02/26/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Basic Documentation for Psycho-Oncology (PO-Bado) is a hetero-assessment and psychosocial burden documentation tool for cancer patient caregivers (across all types and stages). Recently, the psychometric properties of the standard 12-item version of PO-Bado were published. However, the standard version is relatively time-consuming for the caregivers. Here, we developed and examined psychometric properties of a French short-form of PO-Bado (PO-Bado-FSF) with seven items derived from the validated standard version. METHODS One hundred and twenty-one cancer patients (M age = 58.4 years, SD = 13.9 years; 68.6% were women) participated in this study during a supportive care following the first diagnosis of cancer or a relapse. All patients completed the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), in addition to the PO-Bado-FSF. RESULTS PO-Bado-FSF scores exhibit sound psychometric qualities such as internal consistency, test-retest reliability, inter-rater reliability, and scalability (i.e. Mokken's scalability coefficients); all items loaded significantly on the single CFA factor and yielded coefficients 0.40 or higher. CONCLUSIONS The results of this study highlight the value of using PO-Bado-FSF to identify psychological distress in cancer patients in research and practice. PO-Bado-FSF presents good psychometric properties and is less time-consuming than the standard version.
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Affiliation(s)
- Yaël Saada
- Laboratoire de Psychologie, Santé et Qualité de Vie, EA 4139, Université de Bordeaux, Bordeaux, France
| | - Kamel Gana
- Laboratoire de Psychologie, Santé et Qualité de Vie, EA 4139, Université de Bordeaux, Bordeaux, France
| | - Odile Duguey-Cachet
- Interdisciplinary Department of Supportive Care, Institut Bergonié, Bordeaux, France
| | - Nena Stadelmaier
- Interdisciplinary Department of Supportive Care, Institut Bergonié, Bordeaux, France
| | - Bruno Quintard
- Laboratoire EA 4136 ‘Handicap, Activité, Cognition, Santé’, Université de Bordeaux, Bordeaux, France
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Lenze F, Kirchhoff C, Pohlig F, Knebel C, Rechl H, Marten-Mittag B, Herschbach P, Eisenhart-Rothe RV, Lenze U. Standardized Screening and Psycho-oncological Treatment of Orthopedic Cancer Patients. In Vivo 2018; 32:1161-1167. [PMID: 30150439 DOI: 10.21873/invivo.11359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND/AIM Psycho-oncological distress is a relevant clinical problem. The aim of this study was to administer a standardized psycho-oncological distress screening for early identification and indication-based treatment of highly distressed orthopedic cancer patients as well as the evaluation of distress patterns. PATIENTS AND METHODS In total, 35 patients with cancer were psycho-oncologically screened using a cancer-specific expert rating scale (Basic Documentation for Psycho-Oncology Short Form) at three different time points (day of admission, day before discharge, 3 months postoperatively). Psycho-oncological support was offered to all patients whose distress exceeded a defined cut-off value. RESULTS Levels of distress in approximately 51% of patients exceeded the cut-off value at the time of admission and these patients received psycho-oncological support. The high distress levels decreased significantly over time. Patients whose distress did not exceed the cut-off value at the first assessment showed low distress levels at all time points. CONCLUSION A relevant number of orthopedic tumor patients suffer from psychosocial distress. Standardized screening might help to identify and adequately treat those patients.
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Affiliation(s)
- Florian Lenze
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Chlodwig Kirchhoff
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Florian Pohlig
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Carolin Knebel
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Hans Rechl
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Birgit Marten-Mittag
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Peter Herschbach
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Roman Herzog Comprehensive Cancer Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Rüdiger V Eisenhart-Rothe
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Ulrich Lenze
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Stadelmaier N, Duguey-Cachet O, Carton C. [An interview guide for screening for psychological pain in oncology]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2018; 63:11-13. [PMID: 30449462 DOI: 10.1016/j.soin.2018.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
An interview guide has been introduced with patients treated in oncology in order to assess their psychological pain. It helps to structure the nurse interview. It also combines the identification of the patient's psychological needs with the creation of an opportunity to talk, thereby initiating a help relationship.
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Affiliation(s)
- Nena Stadelmaier
- Département DISSPO-CARE, centre de lutte contre le cancer (CLCC), institut Bergonié, 229, cours de l'Argonne, CS 61283, 33076 Bordeaux, France.
| | - Odile Duguey-Cachet
- Centre de coordination, centre de lutte contre le cancer (CLCC), Institut Bergonié, 229, cours de l'Argonne, CS 61283, 33076 Bordeaux, France
| | - Coralie Carton
- Hôpital de jour d'oncologie médicale, hôpital Saint-André, CHU Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France
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Renovanz M, Tsakmaklis H, Soebianto S, Neppel I, Nadji-Ohl M, Beutel M, Werner A, Ringel F, Hickmann AK. Screening for distress in patients with intracranial tumors during the first 6 months after diagnosis using self-reporting instruments and an expert rating scale (the basic documentation for psycho-oncology short form - PO-Bado SF). Oncotarget 2018; 9:31133-31145. [PMID: 30123432 PMCID: PMC6089557 DOI: 10.18632/oncotarget.25763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/22/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Psychosocial screening in brain tumor patients is of high importance. We applied The Basic Documentation for Psycho-Oncology Short Form (PO-Bado SF) in primary brain tumor patients and patients with metastasis. The aim was to evaluating consistency between physicians' perception and the results of the patients' self-assessment. MATERIALS AND METHODS 140 patients with first diagnosis of a brain tumor were screened during their hospital stay (t1) using Distress Thermometer (DT) and Hornheide Screening Instrument (HSI), health-related quality of life was assessed by EORTC QLQ-C30 + BN20. After 3 (t2) and 6 months (t3), patients were re-evaluated. Attending neuro-oncologists completed the PO-Bado SF at all three time points (cut-off for being in need for support >8). RESULTS At t1, the mean of the PO-Bado SF total score was 7.71 (SD = 4.08), at t2 8.22 (SD = 5.40) and at t3 7.62 (SD = 5.72).The proportion of patients reaching a total score >8 was at t1: 43%, at t2: 41% and at t3: 47% (t1-3). Discrimination of PO-Bado SF total score, between patients in (DT ≥6) and those not in distress was more sensitive (cut-off 8.5, AUC 0.772, sens. 71.3%, spec. 67.6%) than discrimination compared to the HIS (cut-off 9.5, AUC 0.779, sens. 65.1%, spec. 77.7%). Higher PO-Bado-SF total score correlated with higher DT scores (r = 0.6, p < 0.0001) and lower EORTC GHS scores (r = -0.55, p < 0.0001). CONCLUSION Physicians' perception according to PO-Bado SF provides a different measure for psychosocial burden in patients with brain tumors, however does not completely reflect patients' wishes.
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Affiliation(s)
- Mirjam Renovanz
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University of Mainz, Mainz, Germany
| | - Helena Tsakmaklis
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University of Mainz, Mainz, Germany
| | - Sari Soebianto
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University of Mainz, Mainz, Germany
| | - Isabell Neppel
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University of Mainz, Mainz, Germany
| | - Minou Nadji-Ohl
- Department of Neurosurgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes-Gutenberg-University of Mainz, Mainz, Germany
| | - Andreas Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes-Gutenberg-University of Mainz, Mainz, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University of Mainz, Mainz, Germany
| | - Anne-Katrin Hickmann
- Department of Neurosurgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany
- Department of Spine Surgery and Neurosurgery, Schulthess Klinik, Zürich, Switzerland
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Valdes-Stauber J, Bachthaler S. Clinical and care intensity differences among patients suffering from somatic diseases electively referred to a consultation and liaison service. Int J Psychiatry Med 2018; 53:141-158. [PMID: 29264939 DOI: 10.1177/0091217417749794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UNLABELLED Background This investigation mainly explores possible care differences among patients hospitalized because of medical conditions being electively referred to a psychiatric-psychosomatic consultation and liaison service. Methods A four-year survey ( N = 2518 individuals) based on clinical and care variables selected from the basic documentation. STATISTICS Chi-square tests, analysis of variance, logistic and multivariate regression analyses, considering statistical modeling assumptions. Results A current psychiatric comorbidity has been found in 75% (less in cancer patients), mainly adjustment and anxiety (45%), mood (22%), and organic mental disorders (12%). The functioning score (Global Assessment of Functioning) was 59.4 and was especially low in patients suffering from unclear medical conditions. The performance status (Eastern Cooperative Oncology Group) amounted to 1.63 and was especially high in patients suffering from orthopedic conditions, infections, and cancer. Each patient received on average of 2.26 (SD = 2.81) contacts and 111 minutes (SD = 160) of total treatment time. In multivariate models, care differences among medical conditions are reduced. Men and older people have received less than the average amount of treatment, but psychiatrically comorbid patients and those with lower functionality and performance status have received more intensive psychological support. Conclusions As a quality feature of consultation and liaison service, patients suffering from psychiatric comorbidity, lower functionality, and lower performance status receive more intensive care and more post-discharge recommendations. Cancer patients and patients with pain as a leading diagnosis as well as strained mothers of hospitalized children have received more intensive treatment by consultation and liaison service despite lower psychiatric comorbidity levels. More attention has to be paid to men and older people independently of their physical condition.
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Differences in distress severity among oncology patients treated by a consultation–liaison service. A five-year survey in Germany. THE EUROPEAN JOURNAL OF PSYCHIATRY 2017. [DOI: 10.1016/j.ejpsy.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Sources of meaning in family caregivers of terminally ill patients supported by a palliative nursing care team: A naturalistic three-month cohort study. Palliat Support Care 2017; 16:246-259. [PMID: 28462752 DOI: 10.1017/s1478951517000220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACTObjective:Our aim was to identify possible patterns of change or durability in sources of meaning for family caregivers of terminally ill patients after the onset of support at home by an outreach palliative nursing team during a three-month survey period. METHOD The Sources of Meaning and Meaning in Life Questionnaire (SoMe) was administered to 100 caregivers of terminally ill patients at four measurement timepoints: immediately before the onset of the palliative care (t0), and at 1 week, 1 month, and 3 months after t0. Time-dependent changes were assessed for the completed subsample (n = 24) by means of bivariate linear as well as quadratic regression models. Multivariate regressions with dimensions of meaning in life as dependent variables were performed for the whole sample by means of random-effects models: dependent variables changed over time (four timepoints), whereas regressors remained constant. RESULTS No significant differences were found for psychosocial and clinical variables or for sources of meaning between the uncompleted and completed subsamples. Growth curve analyses revealed no statistically significant but tendentiously parabolic changes for any dimensions or for single sources of meaning. In multivariate models, a negative association was found between patient age, psychological burden of family caregivers, and changes in total SoMe score, as well as for the superordinate dimensions. SIGNIFICANCE OF RESULTS According to our hypothesis, sources of meaning and meaning in life seem to remain robust in relatives caring for terminally ill family members during the three-month survey period. A parabolic development pattern of single sources of meaning indicates an adjustment process. An important limitation of our study is the small number of participants compared with larger multivariate models because of high dropout rates, primarily due to the death of three-quarters of the participants during the survey period.
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