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Schlaiss T, Singer S, Herbert SL, Diessner J, Bartmann C, Kiesel M, Janni W, Kuehn T, Flock F, Felberbaum R, Schwentner L, Leinert E, Woeckel A. Psycho-Oncological Care Provision in Highly Distressed Breast Cancer Patients. Geburtshilfe Frauenheilkd 2023; 83:702-707. [PMID: 37288248 PMCID: PMC10243917 DOI: 10.1055/a-2044-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/19/2023] [Indexed: 06/09/2023] Open
Abstract
Objective To evaluate the proportion of breast cancer (BC) patients with distress or psychological comorbidity as well as offer and use of psychological support in subgroups of BC patients with different extents of distress. Methods 456 patients with BC were evaluated at baseline (t1) and until 5 years after diagnosis (t4) at the BRENDA certified BC centers. Logistic regression was used to analyze if patients with distress at t1 received offers and actual psychological support more often than patients without distress at t1. Regression analyses were used to examine if acute, emerging or chronic disease was associated with higher rates of offer and use of psychotherapy as well as intake of psychotropic drugs. Results In 45% of BC patients psychological affection was detected at t4. The majority of patients with moderate or severe distress at t1 (77%) received the offer for psychological service, while 71% of those received the offer for support at t4. Patients, who were psychologically affected at t1, have not been offered psychological services more often than those without, but they significantly more often used services if offered. Especially patients with acute comorbidity received significantly more often an offer for psychotherapy compared to unimpaired patients, while those patients with emerging or chronic disease did not. 14% of BC patients took psychopharmaceuticals. This mainly concerns patients with chronic comorbidity. Conclusion Psychological services were offered to and used by a fair amount of BC patients. All subgroups of BC patients should be addressed, in order to improve the comprehensive supply with psychological services.
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Affiliation(s)
- Tanja Schlaiss
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
- University Cancer Centre Mainz, Mainz, Germany
| | | | - Joachim Diessner
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Catharina Bartmann
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Matthias Kiesel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Thorsten Kuehn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Elena Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Achim Woeckel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
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Aderhold C, Morawa E, Paslakis G, Erim Y. Protective factors of depressive symptoms in adult cancer patients: The role of sense of coherence and posttraumatic growth in different time spans since diagnosis. J Psychosoc Oncol 2019; 37:616-635. [PMID: 31272341 DOI: 10.1080/07347332.2019.1631931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Purpose: The purpose of this study was to investigate the impact of posttraumatic growth (PTG) and sense of coherence (SOC) as protective factors on depressive symptoms at different time spans after cancer diagnosis. Design: In a cross-sectional study, adult cancer patients were recruited from the tumor clinics of the University Hospital in Erlangen (Germany) and from peer-support groups for cancer survivors. Sample: Participants included 157 adult patients with primary cancer or in remission (53.5% female; mean age: 58.0 ± 14.1 years; mean time since diagnosis: 46.7 ± 72.8 months) with various forms of cancer. Methods: Multiple linear regression analyses were conducted. The patients were divided into two groups (≤1 year and >1 year since diagnosis) to test the impact of PTG and SOC on depressive symptoms at different time intervals after diagnosis. The Posttraumatic Growth Inventory (PTGI), Sense of Coherence Scale (SOC-13), and Hospital Anxiety and Depression Scale (HADS) were applied. Findings: After controlling for major demographic and clinical variables, SOC (β = -.489, p < .001) was found to be the only significant predictor for depressive symptoms ≤ 1 year after diagnosis; >1 year after diagnosis, SOC (β = -.571, p < .001), PTG (β = -.318, p = .002), and metastatic cancer (β = .231, p = .023) were significant predictors of depressive symptoms (high levels of SOC as well as PTG, and having no metastatic cancer were associated with low manifestations of depressive symptoms). Conclusions: These findings suggest that SOC may be a protective factor against depressive symptoms in both the short as well as in the long term after cancer diagnosis, but PTG only in the long term. Implications for psychosocial providers or policy: To prevent the development of depressive symptoms in cancer patients, individuals with a low SOC should be detected and should receive psychological assistance.
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Affiliation(s)
- Caroline Aderhold
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen , Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen , Germany
| | - Georgios Paslakis
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen , Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU) , Erlangen , Germany
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