Haun Markus W, Sklenarova Halina, Zimmermann-Schlegel Verena, Herzog Wolfgang, Hartmann Mechthild
Klinik für Allgemeine Innere Medizin und Psychosomatik, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland.
Abteilung für Forensische Psychiatrie und Psychotherapie, Universität Regensburg, Regensburg, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Jan;61(1):89-97. doi: 10.1007/s00103-017-2656-0.
Clinically relevant distress and unmet psychosocial needs frequently occur in the course of cancer diseases. Particularly for thinly populated rural areas in Germany rates of distressed patients and uptake of community-based psycho-oncology services are unknown.
Determination of a) the proportion of cancer patients with psychosocial distress and unmet needs and b) the utilisation of community-based psycho-oncology services in thinly populated rural areas.
Prospective cross-sectional study of 229 cancer patients (colon, breast, prostate cancer) living in thinly populated rural areas. Indicators for clinically relevant distress and utilisation of psychosocial services were assessed by applying screening instruments. We conducted descriptive and multivariate analyses.
More than one third of all cancer patients (39.3%) in thinly populated areas exhibited clinically relevant distress. However, only 15.6% of distressed patients consulted community-based psycho-oncology services. Most frequently, medical or psychological psychotherapists were contacted. Information deficits of patients and attending physicians alongside dispositional factors emerged as the main reasons for non-utilisation.
This study presents first data on psycho-oncology care in rural areas in Germany stratifying the degree of urbanisation in line with the standards of the European Commission. Concerning limitations, we only accounted for structural service coverage, leaving aside other indicators for socio-spatial deprivation.
临床上相关的困扰和未满足的心理社会需求在癌症病程中经常出现。特别是在德国人口稀少的农村地区，困扰患者的比例以及社区心理肿瘤学服务的使用情况尚不清楚。
确定a）有心理社会困扰和未满足需求的癌症患者比例，以及b）人口稀少农村地区社区心理肿瘤学服务的使用情况。
对居住在人口稀少农村地区的229名癌症患者（结肠癌、乳腺癌、前列腺癌）进行前瞻性横断面研究。通过应用筛查工具评估临床相关困扰和心理社会服务使用情况的指标。我们进行了描述性和多变量分析。
在人口稀少地区，超过三分之一（39.3%）的癌症患者表现出临床相关困扰。然而，只有15.6%的困扰患者咨询了社区心理肿瘤学服务。最常联系的是医学或心理治疗师。患者和主治医生的信息不足以及性格因素是未使用服务的主要原因。
本研究提供了德国农村地区心理肿瘤学护理的首批数据，按照欧盟委员会的标准对城市化程度进行了分层。关于局限性，我们只考虑了结构性服务覆盖范围，而忽略了社会空间剥夺的其他指标。
