Claudia Lehmann

Die deutsche Version des NCCN Distress-Thermometers

Zusammenfassung: Das NCCN Distress-Thermometer ist ein vom National Comprehensive Cancer Network (NCCN) entwickeltes Screeninginstrument zur Erfassung psychosozialer Belastungen bei onkologischen Patienten. Es besteht aus einer Skala von 0 bis 10 und einer Problemliste als Uberweisungsschema zu entsprechenden professionellen Diensten. International wird ein Cut-off-Wert von 5 als Signal empfohlen, dass ein Patient auffallig belastet ist und Unterstutzung benotigt. Die deutsche Adaptation erfolgte an einer Stichprobe von n = 475 Krebspatienten in der onkologischen Rehabilitation. Zur Validierung wurde die Hospital Anxiety and Depression Scale (HADS-D) und die Kurzform des Fragebogens zur Progredienzangst (PA-F 12) eingesetzt. Die Diskriminationsfahigkeit des Distress-Thermometers ist besonders zur Identifikation einer hohen Belastung (HADS Cut-off > 11) mit AUC-Werten von 0.71 bis 0.76 gut. Bei einem Cut-off-Wert von 5 im Distress-Thermometer zeigen sich bei moderater Belastung in den Merkmalen Angst und/o...

Is advanced cancer associated with demoralization and lower global meaning? The role of tumor stage and physical problems in explaining existential distress in cancer patients.

Objective: This longitudinal study examines the extent to which global meaning, existential distress in terms of demoralization, and depression are predicted by tumor stage (UICC stages 0–II vs III/IV), palliative treatment, and physical problems in cancer patients.

Presence of Symptom Distress and Prostate Cancer-Related Anxiety in Patients at the Beginning of Cancer Rehabilitation

Background: A growing body of research points towards a substantial number of prostate cancer patients experiencing distress and anxiety. This study examines the frequency and character of cancer- and treatment-related problems and its association with symptom distress and prostate cancer-related anxiety in patients at the beginning of an oncological rehabilitation programm. Patients and Methods: 197 prostate cancer patients who had undergone prostatectomy (92.5% participation rate) completed the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), the NCCN Distress Thermometer and EORTC QLQ-C30 subscales emotional function and global quality of life. Results: 88% of patients report cancer- or treatment-related problems with a mean of 5 problems, and 104 patients (53%) experience distress and/or prostate cancer-related anxiety. The most prevalent symptoms are changes in urination, sexual problems, difficulties getting around, pain, fatigue and sleep problems. Emotional problems such as nervousness, worries, fears and sadnessness are prevalent in at least 53% of patients. Patients with distress and anxiety are confronted with a higher number and a wider range of problems and experience significantly lower levels of quality of life. Conclusion: Findings emphasize the role of cancer rehabilitation and underline the importance of psychosocial screening measures and the provision of psychosocial support in prostate cancer patients.

Prävalenz und Diagnostik psychischer Störungen in der Onkologie

ZusammenfassungEin substanzieller Anteil von Krebspatienten weist im Verlauf der Erkrankung und deren Behandlung psychische Belastungsreaktionen auf, die sich bis hin zu schweren psychischen Störungen und psychosozialen Krisen entwickeln können. Dennoch wird in der onkologischen Versorgung gegenwärtig nur ein Teil dieser behandlungsbedürftigen Störungen erkannt und angemessen behandelt. Das Wissen über psychosoziale Belastungen und psychische Störungen bei Krebspatienten ist deshalb für die Verbesserung der psychosozialen Versorgung ein dringendes Anliegen. Der Beitrag gibt einen Überblick über psychosoziale Belastungen und die Epidemiologie häufiger psychischer Störungen bei Krebspatienten. Anschließend werden Zielsetzungen und Probleme der psychosozialen Diagnostik erläutert und es werden ausgewählte psychoonkologische Unterstützungsangebote dargestellt.AbstractDuring the course of the disease and its treatment, a substantial percentage of cancer patients suffer from mental disorders ranging from psychosocial distress to severe mental illness and psychosocial crisis. At present, however, only a small percentage of patients with severe psychosocial distress and mental disorders are accurately identified, diagnosed, and appropriately treated. Therefore, sufficient knowledge of psychosocial distress and mental disorders is urgently needed to improve the psychosocial care of cancer patients. The article provides an overview of psychosocial distress and the epidemiology of mental disorders in cancer patients. A few of the most important objectives and problems of psychosocial assessment in cancer patients are explained. The following part will offer an overview of selected psycho-oncological interventions.

Gauge theories with non-unitary parallel transporters : a soluble Higgs model

Abstract.It has been proposed to abandon the requirement that parallel transporters in gauge theories are unitary (or pseudo-orthogonal). This leads to a geometric interpretation of Vierbein fields as parts of gauge fields, and non-unitary parallel transport in extra directions yields Higgs fields. In such theories, the holonomy group H is larger than the gauge group G. Here we study a one-dimensional model with fermions which retains only the extra dimension, and which is soluble in the sense that its renormalization group flow may be exactly computed, with G = SU(2) and non-compact

Depression, anxiety, post-traumatic stress disorder and health-related quality of life and its association with social support in ambulatory prostate cancer patients

H\subseteq GL(2,\mathbf{C})

Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer

, or G = U(2), H = GL(2,C). In all cases the asymptotic behavior of the Higgs potential is computed, and with one possible exception for G = SU(2), H = GL(2,C), there is a flow of the action from a UV fixed point which describes a SU(2)-gauge theory with unitary parallel transporters, to a IR fixed point. We explain how exponential mass ratios of fermions of different flavor can arise through spontaneous symmetry breaking, within the general framework.