Volker Köllner

Quality of life of patients with laryngeal carcinoma: a post-treatment study

Abstract This study was designed to determine the quality of life of patients successfully treated for laryngeal cancer. A questionnaire was mailed to 233 patients. A total of 124 responses were suitable for analysis. The questionnaire consisted of three components: sociodemographic data, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ – C 30, version 2.0), and EORTC QLQ, Head and Neck Module (H & N 35). The assessment included five treatment groups: chordectomy, partial laryngectomy, irradiation as primary therapy, laryngectomy, laryngectomy and radiotherapy. The evaluation for the functional scales of the EORTC QLQ – C 30 resulted in a higher quality of life of patients with maintained larynx in comparison to laryngectomised patients. In the symptom scales, patients after laryngectomy and/or radiotherapy suffered more from fatigue, pains and appetite loss. Laryngectomees stated more financial difficulties. The evaluation of the ENT-specific EORTC module showed that patients after laryngectomy had more symptoms. Typical symptoms after radiotherapy were a dry mouth, sticky saliva and coughing. Noticeably, no differences existed among the several groups with regard to voice production. The EORTC QLQ- H & N 35 does not appear to be sensitive enough to assess this parameter.

Psychosomatische Rehabilitation@@@Psychosomatic rehabilitation

ZusammenfassungDie Rehabilitation stellt neben der Krankenhausbehandlung und der ambulanten Versorgung die 3.xa0Säule im deutschen Gesundheitswesen dar. Ziel ist der Erhalt von Aktivität und Teilhabe der Betroffenen sowohl am Erwerbsleben als auch am Leben in der Gesellschaft. In diesem Beitrag werden die Entwicklung und die Bedeutung der psychosomatischen Rehabilitation in Deutschland, der Unterschied zur Krankenhausbehandlung, ihre Bedeutung im Gesamtbehandlungsplan und Grundlagen der sozialmedizinischen Beurteilung in der Rehabilitation dargestellt. Es folgen praktische Hinweise zur Indikationsstellung und zum Rehaantragsverfahren. Deutschland verfügt im internationalen Vergleich über ein sehr gut ausgebautes System der psychosomatischen Rehabilitation. Diese Ressource wird allerdings im Behandlungsverlauf häufig zu spät, weil bei bereits fortgeschrittener Chronifizierung, genutzt, und es gibt Schnittstellenprobleme zur nachfolgenden ambulanten Psychotherapie. Ziel dieses Beitrags ist es daher, zur besseren Vernetzung der Versorgungsbereiche beizutragen.AbstractBesides inpatient and outpatient treatment, rehabilitation represents the third column of the German healthcare system. The goal for the persons concerned is the conservation of activity and participation in the professional and social life. This article shows the importance and development of German psychosomatic rehabilitation in contrast to regular inpatient treatment. It also explains its place in the whole healthcare concept of rehabilitation and the basic principles of sociomedical assessment, followed by practical advice for the indications and the rehabilitation application process. Compared with other countries Germany has a very well-established system of psychosomatic rehabilitation but this resource is often used too late in the course of treatment, mostly not until severe chronification has occurred and in addition there are also problems with points of interaction concerning the subsequent outpatient treatment. The aim of this article is therefore to contribute to an improved cross-linking of the different areas in the healthcare system.