Lena Ansmann

Patient–physician communication and health-related quality of life of patients with localised prostate cancer undergoing radical prostatectomy – a longitudinal multilevel analysis

To examine whether patient–physician communication is associated with health‐related quality of life (HRQoL) in a sample of patients with localised prostate cancer undergoing radical prostatectomy (RP).

Changes Over Time in the Utilization of Disease-Related Internet Information in Newly Diagnosed Breast Cancer Patients 2007 to 2013

Background As the number of people with Internet access rises, so does the use of the Internet as a potentially valuable source for health information. Insight into patient use of this information and its correlates over time may reveal changes in the digital divide based on patient age and education. Existing research has focused on patient characteristics that predict Internet information use and research on treatment context is rare. Objective This study aims to (1) present data on the proportion of newly diagnosed breast cancer patients treated in German breast centers from 2007 to 2013 who used the Internet for information on their disease, (2) look into correlations between Internet utilization and sociodemographic characteristics and if these change over time, and (3) determine if use of Internet information varies with the hospitals in which the patients were initially treated. Methods Data about utilization of the Internet for breast cancer–specific health information was obtained in a postal survey of breast cancer patients that is conducted annually in Germany with a steady response rate of 87% of consenting patients. Data from the survey were combined with data obtained by hospital personnel (eg, cancer stage and type of surgery). Data from 27,491 patients from 7 consecutive annual surveys were analyzed for this paper using multilevel regression modeling to account for clustering of patients in specific hospitals. Results Breast cancer patients seeking disease-specific information on the Internet increased significantly from 26.96% (853/3164) in 2007 to 37.21% (1485/3991) in 2013. Similar patterns of demographic correlates were found for all 7 cohorts. Older patients (≥70 years) and patients with <10 years of formal education were less likely to use the Internet for information on topics related to their disease. Internet use was significantly higher among privately insured patients and patients living with a partner. Higher cancer stage and a foreign native language were associated with decreased use in the overall model. Type of surgery was not found to be associated with Internet use in the multivariable models. Intraclass correlation coefficients were small (0.00-0.03) suggesting only a small contribution of the hospital to the patients’ decision to use Internet information. There was no clear indication of a decreased digital divide based on age and education. Conclusions Use of the Internet for health information is on the rise among breast cancer patients. The strong age- and education-related differences raise the question of how relevant information can be adequately provided to all patients, especially to those with limited education, older age, and living without a partner.

Career development for early career academics: benefits of networking and the role of professional societies.

Whilst effective networking is vitally important for early career academics, understanding and establishing useful networks is challenging. This paper provides an overview of the benefits and challenges of networking in the academic field, particularly for early career academics, and reflects on the role of professional societies in facilitating networking.

Organizational factors and the attitude toward health promotion in German ICT-companies

This study takes a first step toward examining the relationship between organizational characteristics and the perceived attitude toward health promotion in companies from the perspective of chief executive officers (CEOs). Data for the cross-sectional study were collected through telephone interviews with one CEO from randomly selected companies within the German information and communication technology (ICT) sector. Multivariate logistic regression analysis (LRA) was performed, and further LRA was conducted after stratifying on company size. LRA of data from a total of n = 522 interviews found significant associations between the attitude toward health promotion and the companys market position, its number of hierarchical levels, the percentage of permanent positions and the percentage of employees with an academic education. After stratification on company size, the association between the attitude toward health promotion and both market position and the percentage of employees with an academic education was still present in small companies. There were no significant relationships between the attitude toward health promotion and the structural characteristics of medium-sized and large companies. The preliminary results of the study indicate that a perceived attitude toward health promotion in companies can be explained, to a certain degree, by the intraorganizational characteristics analyzed. Our key findings highlight that efforts toward establishing a positive attitude toward health promotion should focus on small companies with a lower market position and a greater number of employees with a lower education level.

Meeting patients’ health information needs in breast cancer center hospitals – a multilevel analysis

BackgroundBreast cancer patients are confronted with a serious diagnosis that requires them to make important decisions throughout the journey of the disease. For these decisions to be made it is critical that the patients be well informed. Previous studies have been consistent in their findings that breast cancer patients have a high need for information on a wide range of topics. This paper investigates (1) how many patients feel they have unmet information needs after initial surgery, (2) whether the proportion of patients with unmet information needs varies between hospitals where they were treated and (3) whether differences between the hospitals account for some of these variation.MethodsData from 5,024 newly-diagnosed breast cancer patients treated in 111 breast center hospitals in Germany were analyzed and combined with data on hospital characteristics. Multilevel linear regression models were calculated taking into account hospital characteristics and adjusting for patient case mix.ResultsYounger patients, those receiving mastectomy, having statutory health insurance, not living with a partner and having a foreign native language report higher unmet information needs. The data demonstrate small between-hospital variation in unmet information needs. In hospitals that provide patient-specific information material and that offer health fairs as well as those that are non-teaching or have lower patient-volume, patients are less likely to report unmet information needs.ConclusionWe found differences in proportions of patients with unmet information needs between hospitals and that hospitals’ structure and process-related attributes of the hospitals were associated with these differences to some extent. Hospitals may contribute to reducing the patients’ information needs by means that are not necessarily resource-intensive.

Can a stressed oncologist be good in a consultation? A qualitative study on the oncologists' perception

The aim of this exploratory study was to examine how the working conditions and job stress of private practice oncologists (PPOs) affect their interaction with patients. Data for the study were collected through semi-structured interviews with PPOs selected based on purposeful sampling criteria. The data were evaluated using content analysis. Factors perceived by PPOs to influence their level of stress and patient care were some of their own personal characteristics as well as working conditions both within and outside their practices. Apart from being able to name specific stressors (e.g., dysfunctional organisational workflow and interruptions during medical encounters), the oncologists also mentioned individual and organisational resources (e.g., professional experience, well-educated nurses and good work organisation) for coping with job stress and improving interaction with patients. Within this study, we identified some obstacles on the individual and organisational level for good patient care, as working conditions which might lead to time pressure and stress, which subsequently have an impact on quality in patient care (e.g., less time for personal issues during patient consultations). Future stress research should conduct a more in-depth investigation of these and other interventions at both the individual and organisational levels in order to improve patient care.

Work Engagement von Krankenhausärzten: Welche Rolle spielen Sozialkapital und Persönlichkeitseigenschaften?

Work engagement has been proven to be a viable indicator of physical and mental well-being at work. Research findings have shown a link between work engagement and both individual and organizational resources. The aim of the present study is to test the hypothesized relationships between personal traits (Big-5), the quality of the social work environment (social capital) and work engagement among hospital (n=35) physicians (n=387) in North-Rhine-Westphalia, Germany. Structural equation modeling (SEM), combining confirmatory factor analysis (CFA) and path analysis, was employed to conduct the statistical analyses. The results of the SEM indicated that social capital and neuroticism were significantly associated with work engagement. The relationship between agreeableness and work engagement was fully mediated by social capital. Findings suggest that social capital plays a key role in promoting work engagement of physicians.

In-house information about and contact with self-help groups in breast cancer patients: associated with patient and hospital characteristics?

The number of breast cancer patients who are informed about and have contact with patient self-help groups (SHGs) during their hospital stay varies across hospitals. The aim of this study is to investigate which patient and hospital characteristics contribute to these differences. Multilevel regression analysis was applied, using data on hospital characteristics and data from a patient survey, which catalogued the disease and socio-demographic characteristics of newly diagnosed breast cancer patients, and recorded if they were informed about and had contact with SHGs during their hospital stay. Data from 2639 patients from 82 hospitals were analysed. The odds of being informed about SHGs were significantly lower if patients were treated at a teaching hospital. Patients aged 40 to 59 years significantly more often reported that they were informed about SHGs than patients aged 60 to 69 years. Patients with the highest education certificates significantly more often reported that they both were informed about and have had contact with SHGs. These results suggest that in teaching hospitals, information provided to patients about SHGs is reduced. Furthermore, patients are differentially given information about SHGs and have different levels of contact with SHGs, based on their age and education.

Patients’ Trust in Physician, Patient Enablement, and Health-Related Quality of Life During Colon Cancer Treatment

In cancer care, where patients and their families experience significant emotional distress and patients have to deal with complex medical information, patient centeredness is an important aspect of quality of care. The aim of this study is to examine the impact of patients’ trust in their oncologists and patients’ enablement on changes in health-related quality of life of colon cancer patients during follow-up care. We conducted a prospective study in a representative sample of private practices of German oncologists (N = 44). Patients (N = 131) filled out a standardized questionnaire prior to their first consultation (T0), directly after the first consultation (T1) and after two months (T2). Data were analyzed by structural equation modeling. Significant associations were found between trust in physician and changes in physical functioning between T1 and T2, and between trust in physician and patient enablement. Patient enablement is significantly associated with changes in physical functioning between T1 and T2. The results underline the importance of building a close and trustful patient-physician relationship in the oncology encounter. A central mechanism of the association between the quality of the relationship and health outcomes seems to be patient enablement. To enable patients to cope with their situation by making them understand their diagnosis, treatments, and side effects can impact health-related quality of life in physical domains.

Health-related quality of life in active surveillance and radical prostatectomy for low-risk prostate cancer: a prospective observational study (HAROW - Hormonal therapy, Active Surveillance, Radiation, Operation, Watchful Waiting)

To compare health‐related quality of life (HRQOL) between patients with localised prostate cancer in an active surveillance (AS) group and a radical prostatectomy (RP) group, as evidence shows that both groups have similar oncological outcomes. Thus, comparative findings on the patients’ HRQOL are becoming even more important to allow for informed treatment decision‐making.