Versorgung und psychosozialer Betreuungsbedarf von Krebspatienten im Stadt-Land-Vergleich – eine Literaturübersicht

Zusammenfassung

Hintergrund und Fragestellung: Psychoonkologische Betreuungsbedürfnisse und entsprechende Versorgungsstrukturen mit Bezug auf Stadt-Land-Unterschiede sind bislang nur am Rande diskutiert worden. Dabei kann angenommen werden, dass es Disparitäten, z. B. hinsichtlich bestehender Betreuungsangebote, gibt oder bei Patienten in ländlichen Regionen spezifische Betreuungsbedürfnisse zu beobachten sind. Der vorliegende Beitrag geht dieser Frage auf der Grundlage einer systematischen Literaturübersicht nach.

Methode: Die aktuelle Literatur der letzten 10 Jahre wurde ausgewertet und die Problemfelder werden skizziert. 27 relevante Studien konnten selektiert werden.

Ergebnisse: Zwischen Stadt- und Land-Patienten bestehen Unterschiede hinsichtlich der medizinischen Versorgung, der psychosozialen Belastungen und der Unterstützungswünsche. Patienten aus ländlichen Gebieten sind bei der medizinischen Versorgung eher benachteiligt, sie sind häufig kumulativ belastet und äußern einen stärkeren Wunsch nach psychoonkologischer Betreuung. Die Vergleichbarkeit der Ergebnisse sowie deren Übertragung auf deutsche Verhältnisse sind nicht unproblematisch, da sie überwiegend außereuropäischen Studien entstammen.

Folgerung: Es besteht Bedarf an wissenschaftlichen Untersuchungen, die Stadt-Land-Unterschiede hinsichtlich des Umfangs psychosozialer Belastungen und des medizinischen Versorgungsbedarfs vergleichen. Hierbei sind klare Abgrenzungskriterien städtischer und ländlicher Lebensräume zu entwickeln.

Abstract

Background and objective: The psychological and oncological care needs of patients with cancer and an adequate structure for their medical care have so far been only marginally considered with regard to disparities in patients’ residence (rural or urban). Even though there are thought to be such differences, for example with regard to existing care services and obvious specific care needs for patients in rural areas. This study addresses these issues in a systematic survey of the pertinent literature.

Methods: Publications in the last ten years dealing with identified problems were reviewed. A total of 27 studies met the criteria for analysis.

Results: Significant differences between medical care, psychosocial stress and the desired support were reported. Rural patients were more likely to be at a disadvantage compared with their urban counterparts with regard to medical care, being more often burdened cumulatively, and they strongly expressed the wish for psychological and oncological care. But the comparability of these results and transferring these findings to conditions in Germany proved difficult.

Conclusion: When investigating the demand for psycho-oncological care, one needs to be aware of potential differences between rural and urban areas. Hence, in order to reliably distinguish between rural and urban living areas, a set of concrete criteria which define rural and urban surroundings needs to be established.

Psychoonkologie - Stadt-Land-Unterschiede - psychische Belastung - psychoonkologischer Versorgungsbedarf - Lebensqualität

psycho-oncological care - differences between rural and urban areas - psychological stress - quality of life

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