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皮肤癌患者的心理社会困扰和支持需求——治疗环境的影响。

Psychosocial distress and desire for support among skin cancer patients - impact of treatment setting.

机构信息

Institute of Medical Psychology, University Medical Center, Greifswald, Germany.

Department of Dermatology, University Medical Center, Greifswald, Germany.

出版信息

J Dtsch Dermatol Ges. 2018 Jul;16(7):861-871. doi: 10.1111/ddg.13578. Epub 2018 Jun 25.

Abstract

BACKGROUND

Diagnosis and treatment of malignancies are frequently associated with a variety of problems for affected individuals and their relatives. In order to ensure adequate psycho-oncological and social care, it is recommended to routinely assess patients' psychosocial distress. While psychosocial services for inpatients have been expanded in recent years, the outpatient care structure in terms of psycho-oncological support is far from satisfactory, especially in Mecklenburg-Western Pomerania. We therefore set out to investigate the following questions: Does the need for psychosocial care vary in relation to (a) the treatment setting (inpatients vs. outpatients) and (b) the diagnosis? (c) Do patients experiencing psychological distress desire support?

PATIENTS AND METHODS

We asked both inpatients and outpatients to rate their psychosocial situation using the Hornheide Questionnaire. Patients were also asked about their desire for psychological support and the preferred contact person.

RESULTS

(a) The treatment setting had no impact on the need for psychosocial care and the desire for support. (b) Depending on the type of skin cancer, there were significant differences in the need for such care among the 251 patients surveyed. (c) Despite a certain discrepancy, there was a significant correlation between psychosocial distress (39.0 %; n = 98/251) and desire for support (14.3 %; n = 35/245). (d) Patients experiencing distress primarily chose physicians (n = 21) and psychologists (n = 20) as potential contact persons.

CONCLUSIONS

(1) In addition to the level of distress, the desire for support should be inquired. (2) Recommendations by physicians represent an important means of access to psycho-oncological services. (3) Services for outpatient support should be expanded.

摘要

背景

恶性肿瘤的诊断和治疗常常给患者及其亲属带来各种问题。为了确保充分的心理肿瘤学和社会关怀,建议常规评估患者的心理社会困扰。尽管近年来住院患者的心理社会服务有所扩大,但在心理肿瘤学支持方面,门诊护理结构远不能令人满意,尤其是在梅克伦堡-前波美拉尼亚州。因此,我们着手调查以下问题:(a)治疗环境(住院患者与门诊患者)和(b)诊断是否会影响心理社会护理的需求?(c)是否有心理困扰的患者需要支持?

患者和方法

我们使用霍恩海德问卷要求住院患者和门诊患者评估他们的心理社会状况。还询问了患者对心理支持的渴望和首选联系人。

结果

(a)治疗环境对心理社会护理的需求和支持的渴望没有影响。(b)根据皮肤癌的类型,251 名调查患者中对这种护理的需求存在显著差异。(c)尽管存在一定差异,但心理困扰(39.0%;n=98/251)和支持需求(14.3%;n=35/245)之间存在显著相关性。(d)有困扰的患者主要选择医生(n=21)和心理学家(n=20)作为潜在联系人。

结论

(1)除了困扰程度外,还应询问支持的需求。(2)医生的建议是获得心理肿瘤学服务的重要途径。(3)应扩大门诊支持服务。

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