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Objectives: Addressing information and supportive care needs could enhance cancer survivors' ability to cope with the long-term and/or late effects of their disease. The study examines how long-term cancer survivors evaluate information received during the course of cancer and aims to identify supportive care needs., Methods: The data were collected in a cross-sectional cancer registry cohort study including 1002 patients (participation rate 53%, five years post diagnosis n=660 (65.9%), 10 years post diagnosis n=342 (34.1%), mean age 66.7 years, male 52.9%, prostate cancer 25.5%). The survey instruments used included the SCNS-SF34-G, the PHQ-9, GAD-7, the Distress-Thermometer (DT) and a questionnaire measuring comorbidities. Descriptive and inference statistics were applied., Results: Cancer Survivors perceived information on treatment decision-making as most helpful, whereas information about support offers was perceived as least helpful. One in 5 patients (19.6%) expressed a desire for further information. The majority of patients (81.3%) indicated at least one specific unmet supportive care need, on average 11 (SD=7.14) unmet supportive care needs. Most frequent supportive care needs are related to fear of cancer progression or recurrence, physical comorbidities and the wish for one member of the professional health care team with whom they can talk to continuously about medical issues across the treatment period. Higher physical comorbidity and distress are associated with an increased likelihood of further supportive care needs (p<0.001)., Conclusion: There is a need for survivorship care models that take into account medical aspects and psychosocial needs through a multidisciplinary approach., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Causal attributions can result in self-incrimination and psychosocial burden. Therefore, the present study assessed assumptions about subjective causes of cancer and examines their relationships with social factors and perceived stigmatization., Methods: In a bicentric study, 858 patients with breast, colon, prostate or lung cancer were given standardized questionnaires. Of these, n=815 were included in the analyses. Causal attributions were assessed using a set of 17 items including main causes of cancer. Stigmatization was assessed with the Social Impact Scale (SIS-D). The data are evaluated uni-and multivariable., Results: The mean age is 60 years, 54% are male. The majority of the patients (95%) state multiple causes of their disease. Environment is considered to be the most important influencing factor (M=3.0) by all cancer sites. The lowest influence is attributed to guilt/god's punishment (M=1.1). Causal attributions which are due to the lifestyle factors showed no higher correlations with stigmatizing attitudes than external attributions (r=0.07-0.38). Psychosocial factors (Beta=- 0.051 bis -0.086), smoking (Beta=- 0.087) and guilt/god's punishment (Beta=- 0.023) have been stated lowest in patients with high income. The lower the education of the patient the higher rated is the influence of contagion (Beta=- 0.019)., Conclusion: Actual cancer risks are only partially taken into account as disease causes (e. g. nutrition), while others are underestimated (e. g. alcohol). Future cancer education interventions should focus on low-educated patients., Competing Interests: Alle Autoren erklären, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

This narrative review gives a broad summary of the psychosocial strain in patients with amyotrophic lateral sclerosis (ALS) and psychotherapeutic interventions addressing these issues. ALS is a fatal, rapidly progressing neurodegenerative disease, which leads to weakness and atrophy in almost all muscles of the body, resulting in impairment and finally inability in all domains of daily life including mobility, food intake, respiration or communication. In addition to these mainly motor impairments, most patients are also affected by severe cognitive-emotional and behavioral alterations and deficits which may lead to additional distress. Due to the severe symptomatology and poor diagnosis, ALS can lead to significant psychosocial strain including heightened levels of depressive and anxious symptomatology, hopelessness and even the wish for hastened death. A large body of research demonstrates the strong effect of psychosocial aspects on quality of life (QoL) in ALS patients. Nevertheless, research on psychotherapeutic interventions for patients with ALS is very sparse to date. Besides the general lack of interventions and the methodological limitations in testing their efficacy, few of these therapeutic concepts incorporate the palliative character and the specific symptomatology of the disease such as impaired communication or problems with emotion control. Further research on psychosocial interventions in this patient group is therefore urgently needed. Future research could aim to adapt therapy programs that already have been proven to be effective in other populations with advanced diseases. Such research should also test the applicability of the therapy models using alternative communication including computer with a voice synthesizer or brain-computer-interfaces., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: There are only a few valid instruments measuring couples' communication in patients with cancer for German speaking countries. The Couple Communication Scale (CCS) represents an established instrument to assess couples' communication. However, there is no evidence regarding the psychometric properties of the German version of the CCS until now and the assumed one factor structure of the CCS was not verified for patients with advanced cancer yet., Method: The CCS was validated as a part of the study "Managing cancer and living meaningfully" (CALM) on N=136 patients with advanced cancer (≥18 years, UICC-state III/IV). The psychometric properties of the scale were calculated (factor reliability, item reliability, average variance extracted [DEV]) and a confirmatory factor analysis was conducted (Maximum Likelihood Estimation). The concurrent validity was tested against symptoms of anxiety (GAD-7), depression (BDI-II) and attachment insecurity (ECR-M16)., Results: In the confirmatory factor analysis, the one factor structure showed a low, but acceptable model fit and explained on average 49% of every item's variance (DEV). The CCS has an excellent internal consistency (Cronbachs α=0,91) and was negatively associated with attachment insecurity (ECR-M16: anxiety: r=- 0,55, p<0,01; avoidance: r=- 0,42, p<0,01) as well as with anxiety (GAD-7: r=- 0,20, p<0,05) and depression (BDI-II: r=- 0,27, p<0,01)., Conclusion: The CCS is a reliable and valid instrument measuring couples' communication in patients with advanced cancer., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: Quality assurance has become increasingly relevant in the field of outpatient psychosocial cancer counseling. At the same time, no studies are currently available that analyze outpatient psychosocial cancer counseling centers in Germany with respect to standards of service quality. Therefore, this study aimed to determine whether these centers meet selected quality criteria of outpatient psychosocial cancer counseling., Methods: Based on quality standards of outpatient psychosocial cancer counseling previously developed by us in a Delphi study, we surveyed 106 out of 151 German psychosocial outpatient cancer counseling centers registered in a publicly accessible data base of Germany's cancer information service in Heidelberg with respect to the selected quality characteristics. Data analysis used descriptive statistical techniques., Results: The centers of the sample differ in how many of them fulfill the quality standards selected for analysis here. More than 90% provide the services described by the standards as required. In contrast, in the personnel domain, there appears to be room for improvement with respect to the amount of service hours available for psychologists and the number of counselors with advanced training in psycho-oncology. Also, external supervision and case conferences turn out to be quality characteristics with room for improvement in the domain of quality assurance as do distress screening in the domain of diagnostics and using systematic documentation., Conclusion: Referring to recent standards of quality of outpatient psychosocial cancer counseling allowed us to delineate strength and weaknesses that may serve as starting points for quality improvement in the centers providing psychosocial cancer counseling. However, further research is necessary to arrive at a more comprehensive picture of the degree to which outpatient psychosocial cancer counseling centers in Germany comply with current standards of service quality., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Despite high distress the majority of head and neck cancer patients does not use any psycho-oncological counselling or psychotherapeutic support. Additionally, patients with head and neck cancer have an increased risk of not returning to work compared to other cancer patients. Therefore, we have developed a group intervention program which aims at improving work ability in patients with head and neck cancer as well as their quality of life, self-efficacy and psychological well-being., Material and Methods: In a randomized controlled trial head and neck cancer patients either receive a group intervention or socio-legal counselling. Male head and neck cancer patients with elevated levels of psychological and work-related distress are included. The group intervention consists of eight sessions. Groups are led by both a psychotherapist and a former head and neck cancer patient (peer). Feasibility and acceptability of the group intervention were tested by means of a pilot group. Each session was evaluated by pilot group participants. Semi-structured interviews were used to assess relevance of content and practicability., Results: 113 patients were personally addressed, of which four patients participated in the pilot group. Patients reported that the intervention fit very well with their daily life and expressed satisfaction with it. Three patients emphasized the importance of the peer., Discussion: The presence of the peer as identification figure seems to be of crucial importance. To increase recruitment numbers inclusion criteria will be modified and participation costs will be reduced., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Aim of the Study: The aim of the study was to assess the level of psychosocial distress and satisfaction with care in family caregivers after the death of a close relative., Method: Anxiety and depression (HADS) of family caregivers were evaluated in both bereaved family caregivers and a comparable group from the general population. Furthermore, satisfaction with care (ZUF-8) and social support (HOPE-Module, ESSI) were assessed after the patients had died. Regression models were employed to analyze associations between psychological distress and sociodemographic and care-related variables., Results: We conducted an online survey with 200 bereaved family caregivers (93% female, time since death of the relative: M=306 days). Of these, 31% were the primary caregiver. The bereaved caregivers were highly psychologically distressed (high anxiety: 41%/high depression: 35%). From the survivors' point of view, care at the end of life was partially insufficient: about one in three of the dying patients had suffered from pain and 20% had not been treated with dignity. After the relative had passed away, 44% of the bereaved caregivers did not get information about support offers; one in three missed emotional assistance. Dissatisfaction with care and support was associated with increased psychological distress, higher age and a shorter period of care., Conclusion: The high level of psychological distress in bereaved family caregivers suggests high supportive care needs, which are often not met in practice. Family caregivers need to be prepared for the time after their relative's death and should be offered psychosocial support., Competing Interests: Die Autoren versichern, dass kein Interessenkonflikt vorliegt., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Psychosocial care for cancer patients has gained importance in recent years and psycho-oncological counselling centers (POCC's) offer a wide range of services in this area. We investigated the scope and content of a POCC at a university medical center., Methods: The presented data were collected at the POCC at University Medical Center Leipzig in 2014. In total, 469 cancer patients participated (mean age 60 years, 67% female, 36% breast cancer). Psychosocial distress and psychopathology were assessed with the PHQ-9, GAD-7 and the NCCN Distress Thermometer. Descriptive statistics were analyzed., Results: 1 in 4 patients (24%) reported at least moderate levels of depressive symptoms. Patients with hematological malignancies and head and neck tumors showed stronger depressive symptoms. 15% of patients suffered from elevated levels of anxiety. The average number of reported problems on the Distress Thermometer and Problem List was 14 out of 39. Physical and psychosocial problems were most prevalent (e. g. fatigue, problems getting around, anxiety). Supportive care needs were less common than reported problems., Conclusions: We found that a close network of POCS, oncological inpatient and outpatient care can help direct patients toward psychosocial care at an early stage. Psychosocial screening enables psycho-oncologists to identify problem areas and offer tailored counselling services., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Liebe Kolleginnen und Kollegen,wir freuen uns, Sie im Namen beider Fachgesellschaften und des Leipziger Kongressteams zur gemeinsamen Jahrestagung der Deutschen Gesellschaft für Medizinische Psychologie (DGMP) und der Deutschen Gesellschaft für Medizinische Soziologie (DGMS) einzuladen, die vom 26. bis 28. September 2018 auf dem Campus der Universität Leipzig stattfindet (www.dgmp-dgms-2018.de)., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Cancer is often associated with negative psychosocial consequences not only for patients but also for their partners. These consequences are also influenced by the applied coping strategies., Objective: The study examines the influence of Dyadic Coping (DC) on social support and psychological distress (symptoms of depression and anxiety) in haemato-oncological patients and their partners. Of particular interest is the significance of dyadic accordance (conformity) of the assessment of DC ("discrepancy indexes")., Methods: The study investigates 330 couples (haemato-oncological patients and their partners, average age patient 57.0 years, 63.3 percent male, 25.8 percent acute leukemia). In addition to Dyadic Coping Inventory (DCI), standardized instruments are used. Research data is being analyzed with t-tests, partial correlation and regression., Results: Patients and partners use similar dyadic coping strategies, whereby partners assess coping behaviors of patients more accurately than vice versa. Regarding social support, the DC total score plays a more decisive role than discrepancy indexes, in particular with patients (R 2 =20.4%). Conversely, discrepancy indexes explain a large part of the patients' variance (R 2 =10.2%); regarding psychological stress, the DC total score shows no effects in this model., Discussion: The results demonstrate the relevance of the DC discrepancy indexes as a measure for interpersonal accordance for psychosocial outcomes, especially for psychological distress. Further application-related research is necessary to generate reliable statements about these associations., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives Breaking bad news can be a very distressing situation for both patients and physicians. Physician communication behavior should therefore match patients' communication preferences. The aim of this study was to characterize the content of bad news from the patients' perspective. Patients' preferences for communication of bad news as well as the fit to communication behavior displayed by physicians were also investigated. Finally, consequences of a mismatch between patients' preferences and physician communication were investigated in relation to psychological distress in patients. Methods The sample consisted of N=270 cancer patients (mean age=56.8 years, 48% female) with various cancer entities and different stages of disease (n=115 patients with early stage of cancer, n=155 patients with advanced cancer). The content of bad news was assessed with a specifically developed list of questions. The Measure of Patients' Preferences Scale (MPP) was used to assess patients' preferences for communication of bad news. Patients further completed the NCCN Distress Thermometer (cancer specific distress), the Hospital Anxiety and Depression Scale (HADS- anxiety and depression) and the Demoralization Scale (DS-Scale) to gain information about psychological distress. Results Patients with early stage breast cancer received bad news M=1.6 times (SD=1.1, range: 1-5), patients with advanced cancers M=2.1 times (SD=1.6, range: 1-12). For 77% of early stage cancer patients and 70% of advanced cancer patients, the subjectively worst consultation was receiving the diagnosis and discussing treatment options. Patients' most important communication preferences were physicians' clinical competence and patient-centered communication, clear and direct communication and asking about patients information preferences. Patients in advanced stages report significantly more (29%) unmet communication needs than patients' in early stages (20%; p<0.01). Breaking bad news without considering patients' preferences was associated with higher psychological distress in patients. Conclusion Physicians should communicate in a patient-centered way to reduce mismatch with patients' preferences and thereby potentially reduce patients' psychological distress., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background The stigma of cancer patients can lead to far-reaching consequences, both for the individual and for the society. Quantitative studies on the stigmatization of cancer patients are scarce. The present study assessed the stigma of cancer patients in relation to their status of employment, and analyzes sociodemographic, disease and occupational predictors. Methods In a bicentric study, 858 patients with breast, bowel, lung or prostate cancer were included. Of these, n=305 were employed and entered into the analyses (age average 55 years, 43% female, 47% breast cancer). As a comparison group, a matched sample of non-employed persons (n=213) is used from our data set. In addition to questions on work and health aspects, stigmatization was measured using the SIS-D (Social Impact Scale). The data are evaluated uni- and multivariable. Results Employed persons with prostate or breast cancer are less stigmatized (p<0.01) than non-employed persons, with effects between d=0.35-0.97. The strongest influence on perceived stigma is the lack of support from the employer, further predictors are poor health, low mental workability and diagnosis of breast cancer (R2 of the final model=0.35). Conclusion The employment of cancer patients is associated with lesser perceived stigmatization. Occupational stigmatization depends above all on the work environment or the employer's supportive attitude., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Outpatient psychosocial counselling (OPC) centers for those affected by cancer fulfill 2 main purposes: (a) to offer low-threshold psychological, social and legal counselling, and (b) to refer clients to other services. Here we report findings from a user-based assessment of OPC in the state of Saxony, Germany. This study was funded in part by the Saxon State Ministry of Social Affairs and Consumer Protection. We used a paper-based questionnaire to survey 213 clients of OPC in Saxony at 2 points (t1: up to one week after first contact, t2: 4 months after t1). All participants were cancer patients. The survey assessed utilization of services, depressive symptoms (PHQ-9), anxiety (GAD-7), quality of life (SF-8) as well as clients' satisfaction with the counselling service (ZUF-8). The majority of clients (81%) were referred to the OPC from a hospital or rehabilitation center. 46% of patients only had one contact. 78% of counselling sessions treated matters of social law. Patients suffered from 13 problems on average, the most common being fatigue and exhaustion, worries, anxiety, uncertainty about the future, and pain. Half the patients (49%) reported moderate to severe anxiety and 68% showed elevated levels of depressive symptoms. Psychosocial distress did not change significantly over time (GAD-7: p=0.580, PHQ-9: p=0.101). Patients' quality of life was low overall (cut-off<50). At t2, quality of life had particularly increased in physical aspects, but overall quality of life remained lower than in the general population (all subscales: p<0.05). We identified younger age and lower income as risk factors for higher psychosocial distress and lower quality of life. Patients were very satisfied with the counselling they received, 9% reported to be dissatisfied. Our results show that psychosocial distress remains high over a longer period of time at least for some patients. This illustrates the persisting need for long-term support regarding physical, mental and social impairments as a consequence of cancer and its treatments. It also shows the challenging demands which OPC centers are faced with. As a consequence, psychosocial support in the outpatient setting needs to be extended and developed further., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: To investigate stigmatizing attitudes towards cancer patients in the general population and to examine their association with socio-structural characteristics and perceived causes of disease., Methods: We recruited a representative sample from the German general population (n=2420; mean age: 52 years; 54% women). Stigmatizing attitudes were assessed with a 9-item scale. Predictors of stigmatizing attitudes were identified using a regression analysis., Results: Agreement with stigmatization items ranged from 3.6% (item: work together with a cancer patient) to 18.9% (item: use the same dishes as a cancer patient). Perceived causes of disease with a high levels of personal responsibility showed only weak correlations with stigmatizing attitudes (all r<0.31) and were partially statistical significant (e. g. food intake) or not significant (e. g. alcohol). The strongest predictors of stigmatizing attitudes were lack of cancer-related experiences (Beta=-0,26), age <60 years (Beta=0,1) and the assumption that one cannot protect oneself from cancer (Beta=0,11) (all p<0.001). Further predictors were male gender and living in rural area (p<0.01)., Conclusion: The results demonstrate a need for further research and the development of valid methodological instruments to assess stigmatization towards cancer patients., (© Georg Thieme Verlag KG Stuttgart · New York.)

Psychosocial cancer counseling centers represent an increasingly important part of comprehensive psychosocial cancer care. Research on the services provided by those centers is sparse, however, as is research on person-, disease-, and treatment-related characteristics of their clients. Therefore, the present study analyzes the services provided by 26 psychosocial cancer counseling centers temporarily being funded by the German Cancer Aid as well as selected characteristics of their clients. Analyses are based on data collected during 2011 by means of a documentation system specifically designed for the purposes of psychosocial cancer counseling. Testing focuses on whether cancer patients and cancer patients' relatives differ with respect to various characteristics and the services used. The results show that psychosocial and benefit counseling represent a major part of counseling services, followed by giving information and employing relaxation techniques. Clients seek counseling primarily in early phases of disease and treatment. Women with breast cancer are over-represented among clients. Analyses also reveal significant differences between cancer patients and patients' relatives. Psychotherapeutic interventions and grief-counseling are more frequent in counseling relatives, whereas benefit counseling is more frequent in working with patients. The results emphasize the relevance of outpatient psychosocial cancer counseling. They may also help support initiatives aiming at establishing psychosocial cancer counseling targeted to the needs of each individual client., (© Georg Thieme Verlag KG Stuttgart · New York.)

Loss is a universal human experience. Within the context of cancer and especially in the palliative care of oncological patients, anticipated and real losses and their management play a crucial role. A high proportion of patients and family members develop a treatment requiring psychiatric comorbidity (for both groups between 20 and 30%, mainly adjustment and anxiety disorders and depression). Approximately 15% of the bereaved persons suffer from complicated grief after the death of their relative. Within the early palliative care, the implementation of the Family Focused Grief Therapy (FFGT) has the potential to reduce psychological distress incl. mental comorbidities in patients and their relatives. Simultaneously, the incidence of the prolonged grief disorder in bereaved persons could be diminished (after the death of their relative). Thus, the FFGT can make a substantial contribution in order to improve the palliative care of cancer patients and their bereaved persons., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: PURPOSE of this study was to investigate the psychometric properties of the newly adapted German Version of the Social Impact Scale (SIS), a multidimensional questionnaire measuring perceived stigmatization., Methods: The SIS was translated into the German language following state-of-the-art criteria and completed in a sample of 139 outpatients with mixed tumor entities. In addition to the SIS-D, participants answered questions about their experience of discrimination and perceived visibility of their disease as well as about illness beliefs and perceptions of cancer control., Results: Comparably to the original scale, exploratory factor analysis resulted in a 4-factor solution and the following dimensions: "social isolation" (Cronbachs α=0.89), "social rejection" (α=0.81), "internalized shame" (α=0.81) and "financial insecurity" (α=0.81)., Discussion: Considering the results of this pilot study, it can be concluded that the German version of the SIS is an instrument measuring perceived stigmatization in cancer patients with very good psychometric properties. However, further validation studies are considered necessary., (© Georg Thieme Verlag KG Stuttgart · New York.)

This article describes the development of an oncology-specific adaptation of the Composite Diagnostic International Interview (CIDI) for the assessment of comorbid mental disorders in cancer patients. The specific problems related to the assessment of mental disorders in cancer patients are described, in particular the overlap of somatic and mental symptoms as well as the insufficiently elaborated assessment of adjustment disorders and cancer related posttraumatic stress using structured and standardized procedures. The modification strategies that fostered the development of the CIDI-Oncology (CIDI-O) are described. Primary purpose of this adaptation is to enhance the diagnostic spectrum of the CIDI adding the diagnostic group of stress-related mental disorders., (© Georg Thieme Verlag KG Stuttgart · New York.)

We aimed to systematically summarize the empirical evidence on the 4-week-, 12-month-, and lifetime prevalence of adjustment disorders, acute and posttraumatic stress disorders as well as somatoform disorders in cancer patients. We evaluated 64 English or German language original papers and systematic reviews that assessed the prevalence of affective and anxiety disorders using structured clinical interviews published between 1995 and 2010. Adjusted prevalence rates were calculated using a random-intercept model. We found the following pooled adjusted 4-week prevalence rates: For adjustment disorder 12.5% (95% CI 9.9-15.7), for posttraumatic stress disorder 2.6% (95% CI 1.7-4.0), for acute stress disorder 4.8% (95% CI 2.2-10.0) and for somatoform disorders 3.1% (95% CI 1.6-5.8). Our findings show the need for further research on representative studies that take into account the range of psychosocial stressors and supportive care needs., (© Georg Thieme Verlag KG Stuttgart · New York.)

We aimed to systematically summarize the empirical evidence on the 4-week-, 12-month-, and lifetime prevalence of affective and anxiety disorders in cancer patients. We evaluated 89 English or German language original papers and systematic reviews that assessed the prevalence of affective and anxiety disorders using structured clinical interviews published between 1995 and 2010. Adjusted prevalence rates were calculated using a random-intercept model. The pooled adjusted 4-week prevalence of affective disorders was 11.1% (95% CI 8.1-15.1), and 10.8% (95% CI 6.8-16.7) based on German studies. The pooled adjusted 4-week prevalence of anxiety disorders was 10.2% (95% CI 6.9-14.8), and 13.5% (95% CI 7.1-24.3) based on German studies. The findings show the need for further research on representative studies that take into account the range of psychosocial stressors and supportive care needs in addition to the prevalence of mental disorders., (© Georg Thieme Verlag KG Stuttgart · New York.)

Supportive care needs of family members of cancer patients are often overlooked within psychosocial care. A screening measure was sent to 132 family members and 362 cancer patients (response rate > 95 %) after telephone registration at a specialized outpatient clinic for psycho-oncology at the University Medical Center Hamburg-Eppendorf. The majority of participants was informed about the outpatient clinic for psycho-oncology through advice by third parties. More than 90 % of family members and cancer patients show high levels of distress; 49 % of family members and 59 % of patients had moderate to high levels of depression; 58 % of family members and 61 % of patients had moderate to high levels of anxiety. No gender differences were observed in both groups. Most frequent supportive care needs in both groups refer to fear of recurrence, dealing with uncertainty, sadness and keeping a positive outlook. Our findings emphasize the need for specific psycho-oncological interventions., (© Georg Thieme Verlag KG Stuttgart · New York.)

A poor doctor-patient-communication in cancer care has negative effects on psychological well being and causes high economic costs. This review analyses the current literature on the impact of communication on distress, satisfaction and utilization of psychosocial services among cancer patients with regard to patients' communication preferences. Crucial to a successful communication seems to be the match of patients' preferences and actual physician's behaviour. However, preferences depend on various factors and can change during the illness trajectory. As preferences often remain unconsidered in everyday practice, they should be assessed repeatedly. For the lack of theoretical foundation, future research should be designed according to theoretical assumptions. In this respect we developed and suggest a model on the impact of patients' preferences on physician-patient-communication, knowledge and use of psychosocial treatment offers that particularly considers psychosocial distress of cancer patients.

A substantial percentage of cancer patients suffers from psychosocial distress to severe mental disorders and psychosocial crisis during the course of the illness and cancer treatment. However, only a small percentage of patients with severe psychosocial distress and mental disorders in the present oncological practice is accurately identified, diagnosed, and appropriately treated. Therefore, sufficient knowledge about psychosocial distress and mental disorders as well as screening procedures are urgent concerns to improve psychosocial care for cancer patients. First, the article provides an overview of psychosocial distress and the epidemiology of mental disorders in cancer patients. Then a few of the most important objectives and problems of psychosocial assessment in cancer patients will be explained. The following part will offer an overview of questionnaires and screening procedures that are frequently used to assess psychosocial distress, mental disorders, personal and social resources, and health related quality of life in cancer patients.

In 2002 a survey of institutes of Medical Psychology was accomplished in order to describe the situation of the subject. As regards the content the survey referred to five scopes: structural conditions, teachings, research, health care as well as general questions about the situation of the discipline. All 35 addressed departments and institutes of Medical Psychology in Germany took part in the situation analyses of the subject and responded to a questionnaire. The results indicate strengths and weaknesses of the current situation of the discipline and will be discussed in terms of research, teaching, and clinical work.