Jürgen M. Giesler

Developing a self-rating measure of patient competence in the context of oncology: a multi-center study.

Objective: Concepts of patient competence (PC) are being increasingly used, but seldom clearly defined in the context of shared medical treatment decision making and coping with cancer. The meaning of such concepts should therefore be clarified, and measures developed that permit the assessment of different facets of this patient characteristic. Consequently, this study attempted to contribute to the definition and measurement of PC.

Self-efficacy for coping with cancer in melanoma patients: its association with physical fatigue and depression.

The purpose of this study was to explore the impact of self‐efficacy for coping with cancer (SECC) on physical fatigue and depressive symptoms in melanoma patients, in comparison with objective factors, such as treatment with interferon‐alpha (IFN‐α) and medical and sociodemographic variables. Current literature shows that psychological distress in melanoma patients is generally moderate, that they experience high quality of life, and that symptoms of depression and fatigue have been mostly associated with adjuvant IFN‐α treatment

Rehabilitation for cancer patients.

Rehabilitation for cancer patients aims at reducing the impact of disabling and limiting conditions resulting from cancer and its treatment in order to enable patients to regain social integration and participation. Given current trends in cancer incidence and survival along with progress in medical treatment, cancer rehabilitation is becoming increasingly important in contemporary healthcare. Although not without limitations, the International Classification of Functioning, Disability, and Health (ICF) provides a valuable perspective for cancer rehabilitation in understanding impairments in functioning and activity as the result of an interaction between a health condition and contextual factors. The structure of cancer rehabilitation varies across countries as a function of their health care systems and social security legislations, although there is a broad consensus with respect to its principal goals. Cancer rehabilitation requires a careful assessment of the individual patients rehabilitation needs and a multidisciplinary team of health professionals. A variety of rehabilitation interventions exist, including psycho-oncological and psycho-educational approaches. Research on the effectiveness of cancer rehabilitation provides evidence of improvements in relevant outcome parameters, but faces some methodological challenges as well.

Die Entwicklung von Qualitätsstandards für die ambulante psychosoziale Krebsberatung – Ergebnisse einer Delphibefragung

BACKGROUND The psychosocial outpatient care of cancer patients and their families is a central element of oncological care. To date, the provision of care to this group is very heterogeneous in terms of the spectrum of services offered and quality of care. The aim of this study was to develop a multidimensional classification of quality standards for psychosocial outpatient cancer counseling. METHOD We conducted a study using the Delphi method. 97 experts from more than 10 different fields of action or institutional contexts (e. g. mental health care professionals, cancer societies, self-help groups) were included in 3 rounds of Delphi assessment. Finally, 134 single criteria within 9 quality areas (e. g. staff, range of services, documentation) were generated and evaluated for their relevance, clarity, comprehensiveness and level of obligation. RESULT A total of 119 individual criteria (88.8%) achieved consensus within the 3 Delphi rounds. Hereof, 94 were basic criteria (79%) and 25 optional criteria (21%). The highest number of individual criteria referred to the service spectrum (26 individual criteria), documentation (21) as well as staff and accessibility (16 each). Fifteen criteria (11.2%) achieved no consensus and were removed. CONCLUSION For the first time, criteria for assessing the quality of psychosocial outpatient cancer counseling with expert consensus are available, facilitating the evaluation of psychosocial outpatient cancer counseling.

Psychoonkologische Versorgung von Melanompatienten in zertifizierten Hautkrebszentren: Psychoonkologie in zertifizierten Hautkrebszentren

Die Einrichtung und Zertifizierung von Hautkrebszentren (HKZ) entsprechend den Vorgaben der Deutschen Krebsgesellschaft stellt einen wesentlichen Beitrag zur qualitätsgesicherten Behandlung von Hautkrebserkrankungen dar. Die Bereitstellung eines qualifizierten psychoonkologischen Betreuungsangebotes ist durch die Zertifizierungskriterien vorgegeben. Es war davon auszugehen, dass die standortspezifische Umsetzung des psychoonkologischen Betreuungsangebotes mit unterschiedlichen Modellen verwirklicht wurde.

33 – Qualitätssicherung und Leitlinien in der Psychoonkologie

Over the past two decades, psycho-oncology has become increasingly more accepted in research and practice. In Germany, this is apparent from its increasing integration into the services of certified cancer centres as well as from its incorporation into fields of action outlined in the German National Cancer Plan. In addition, quality assurance issues have also gained increased recognition in medical care over the past years. Against this background, this chapter introduces some basic concepts of quality assurance and highlights the importance of clinical practice guidelines for psycho-oncologic treatment within this context. It outlines the process of guideline development in general and also refers the reader to selected examples of international psycho-oncologic guidelines or oncologic guidelines comprising psycho-oncologic recommendations, respectively. Furthermore, it presents a preview on a so-called S3-guideline for the psychological assessment, counselling and therapy of adults with cancer that is to be published in Germany shortly and that focuses, e. g., upon evidence-based interventions, standardized routine assessment of psychosocial distress, and a clear definition of treatment allocation pathways. In this process, issues of implementation represent the necessary next steps.