Psychoonkologische Versorgungsforschung

[Cancer survivorship care programs and self-management]

BACKGROUND

Survivorship care programs (SCP) are increasingly being implemented in order to ensure long-term and comprehensive care of physical and psychosocial cancer-related sequelae among survivors. In this article, we provide a short overview of SCP and the importance of health-related self-management.

RESULTS

The broad definition of "survivorship" and the high diversity of impairments among cancer survivors warrants a personalized and multidimensional approach. This in turn requires both interdisciplinary and integrated care. To date, the state of knowledge on the efficacy of SCP is limited. A central aim of SCP is to increase health-related self-management, which in turn requires the ability to correctly evaluate and apply health-related information in order to resolve health-related problems (health literacy). Due to the technological developments, additional skills are needed to stay health literate (digital health literacy).

CONCLUSION

Further research on the efficacy of SCP is warranted. Both advantages and risks of digital health programs need to be carefully weighed to avoid inequalities in health care ("digital divide"). Specific education programs to improve digital health literacy may help to minimize such risks.

[Psycho-Oncological Care for People with a Migration Background and their Relatives - Results of Semi-Structured Interviews with Physicians]

BACKGROUND

People with a migration background represent a heterogeneous population group with different ethnic, cultural, and religious views and experiences. Cancer diagnosis and treatment are associated with a variety of psychosocial burdens.

OBJECTIVE

The aim of this study was to investigate the current perspective of physicians regarding barriers in psycho-oncological care of people with a migration background and to analyse the assistance they need. In addition, the study also aimed to determine the need for as well as structures and processes of psycho-oncological care in order to develop recommendations for improvements in this area of medical care.

METHODS

Eight physicians in private practices from the field of hematological-oncological care across Germany were interviewed individually in qualitative interviews that were digitally recorded and transcribed. The evaluation was carried out using content analysis with the software program MAXQDA 2020.

RESULTS

255 codes were identified in the main categories "Definition of people with a migration background", "Communication", "Cultural differences", "Psycho-oncological care", "Coordination and referral to psycho-oncological care services", and "Optimal psycho-oncological care". The results provided insight into daily and practical issues that arise while caring for this group of people, such as transcultural communication, barriers regarding the identification of needs, psycho-oncological continuing care, or translation by relatives.

DISCUSSION

Even the identification of needs during medical treatment is associated with barriers. Screening instruments for people with a migration background in different languages and for different cultures could help the identification. In addition, networks would have to be created in order to provide psycho-oncological care to patients afterwards.

[DNVF Memorandum Health Services Research in Oncology]

Health services research in oncology deals with all situations which cancer patients face. It looks at the different phases of care, i. e. prevention / early detection, prehabilitation, diagnostics, therapy, rehabilitation and palliative care as well as the various actors, including those affected, the carers and self-help. It deals with healthy people (e. g. in the context of prevention / early detection), patients and cancer survivors. Due to the nature of cancer and the existing care structures, there are a number of specific contents for health services research in oncology compared to general health services research while the methods remain essentially identical. This memorandum describes the subject, illustrates the care structures and identifies areas of health services research in oncology. This memorandum has been prepared by the Oncology Section of the German Network for Health Services Research and is the result of intensive discussions.

Health-related quality of life in rehabilitants with different cancer entities

The focus of the study is the analysis of changes in health-related quality of life in various cancer entities during and after an inpatient rehabilitation programme. In a multicentre longitudinal study, a total of 211 cancer patients (breast cancer: N = 84; prostate cancer: N = 90; colon cancer: N = 37) were asked about their quality of life (EORTC QLQ-C30; HADS) at the beginning, the end and 3 months after the end of the rehabilitation programme. In different domains of quality of life significant and mostly clinically relevant improvements were found during rehabilitation. The breast and prostate cancer patients improved most in emotional functioning, colon cancer patients in global quality of life. With regard to the severity of symptoms, the fatigue burden improved in breast and colon cancer patients, nausea in the prostate cancer patients. However, they are increases 3 months after rehabilitation. Functional burdens improved 3 months after the end of rehabilitation in the physical domain for all cancer patients. For breast cancer patients, emotional functioning decreased significantly 3 months after rehabilitation. An inpatient oncological rehabilitation programme can lead to an improvement in quality of life.