Psychosoziale Informationsbedürfnisse multimorbider Brustkrebspatientinnen^[*] in nordrhein-westfälischen Brustzentren

Zusammenfassung

Einleitung: Die Bedeutung einer adäquaten Informationsversorgung von Brustkrebspatientinnen (BP) ist hinreichend bekannt. In dieser Studie wurden die unerfüllten psychosozialen Informationsbedürfnisse von multimorbiden BP untersucht.

Methodik: Die Studie erfasst die unerfüllten psychosozialen Informationsbedürfnisse von 4166 BP, die an einem der 50 nordrhein-westfälischen Brustzentren behandelt worden sind. Der in der poststationären postalischen Befragung eingesetzte Kölner Patientenfragebogen für Brustkrebs 2.0 erfasst die Informationsbedürfnisse mit einer adaptierten Version der „Cancer patient information needs“-Skala. Mittels univariater Analyse, unter Verwendung des χ²-Tests, wurde überprüft, ob multimorbide BP signifikant andere psychosoziale Informationsbedürfnisse hatten als BP ohne weitere Begleiterkrankungen.

Ergebnisse: Allgemein ergaben sich bei den BP hinsichtlich Beruf (20,7 %), Alltag (26,8 %), Erkrankung (27,4 %) und Therapie (35,7 %) eher geringe und bez. des Gesundheitsverhaltens (54,2 %) größere unerfüllte Informationsbedürfnisse. Multimorbide BP hatten bez. des Berufs signifikant geringere und hinsichtlich der Therapie signifikant größere unerfüllte Informationsbedürfnisse im Vergleich zu BP ohne Begleiterkrankungen. Nierenerkrankungen und psychische Begleiterkrankungen waren mit besonders großen Informationsbedürfnissen assoziiert (p < 0,05).

Schlussfolgerung: Die Ergebnisse unserer Studie sollen den in der onkologischen Versorgung Tätigen die Komplexität und Heterogenität der Informationsbedürfnisse von Brustkrebspatientinnen verdeutlichen und helfen, die Informationsversorgung patientenorientierter zu gestalten.

Abstract

Introduction: The importance of breast cancer patients (BPs) being supplied with sufficient information is well known. This study investigated the unfulfilled psychosocial information requirements of multimorbid BPs.

Methods: This study records the unfulfilled psychosocial information requirements of 4166 patients, who were treated at one of the fifty breast centres in North Rhine Westphalia. The Cologne patient questionnaire for breast cancer 2.0 included in the postal survey following hospital stays records the information requirements using an adapted version of the “Cancer patient information needs” scale. Through a univariate analysis using the χ² test, it was investigated whether multimorbid BPs had significantly different psychosocial information requirements than BPs without further concomitant illnesses.

Results: In general, it transpired that BPs had relatively low unfulfilled information requirements regarding work (20.7 %), everyday life (26.8 %), illness (27.4 %) and treatment (35.7 %), though such requirements were higher when it came to health-related behaviour (54.2 %). Multimorbid BPs had significantly lower unfulfilled information requirements regarding work and significantly larger ones regarding treatment in comparison to BPs without concomitant illnesses. Renal diseases and concomitant mental illnesses were associated with particularly high information requirements (p < 0.05).

Conclusion: The results of our study should clarify the complexity and heterogeneity of information requirements of breast cancer patients in oncological care and should help to design the supply of information to be more patient-oriented.

Schlüsselwörter

Mammakarzinom - psychosoziale Informationsbedürfnisse - Multimorbidität

Key words

mammary carcinoma - psychosocial information requirements - multimorbidity

^* Aus Gründen der besseren Lesbarkeit verwenden wir zumeist nur den Begriff „Brustkrebspatientinnen“. Damit sind auch die männlichen Patienten gemeint, die an der Befragung teilgenommen haben. Ist umgekehrt von „Patienten“ die Rede, so sind auch immer die Patientinnen eingeschlossen.

• Literatur

• 1 Robert Koch-Institut, Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V.. Krebs in Deutschland 2009/2010. 9. Ausgabe. Berlin: 2013
• 2 Hewitt ME, Herdman R, Holland JC. Meeting psychosocial needs of women with breast cancer. Washington, D.C.: National Academies Press; 2004
• 3 Loibl S, Lederer B. The importance of supportive care in breast cancer patients. Breast Care (Basel) 2014; 9: 230-231
• 4 Fortin M, Bravo G, Hudon C et al. Psychological distress and multimorbidity in primary care. Ann Fam Med 2006; 4: 417-422
• 5 World Health Organization. The World Health Report 2008. Primary Health Cared. Now more than ever. New York: The World Health Report; 2008: 7-11
• 6 Harlan LC, Klabunde CN, Ambs AH et al. Comorbidities, therapy, and newly diagnosed conditions for women with early stage breast cancer. J Cancer Surviv 2009; 3: 89-98
• 7 Marengoni A, Angleman S, Melis R et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011; 10: 430-439
• 8 Uchida M, Akechi T, Okuyama T et al. Patientsʼ supportive care needs and psychological distress in advanced breast cancer patients in Japan. Jpn J Clin Oncol 2011; 41: 530-536
• 9 Choi K, Park J, Park J et al. Psychosocial needs of cancer patients and related factors: a multi-center, cross-sectional study in Korea. Psychooncology 2013; 22: 1073-1080
• 10 Maslow AH. A theory of human motivation. Psychol Rev 1943; 50: 370-396
• 11 Harrison JD, Young JM, Price MA et al. What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 2009; 17: 1117-1128
• 12 Jenkins V, Fallowfield L, Saul J. Information needs of patients with cancer: results from a large study in UK cancer centres. Br J Cancer 2001; 84: 48-51
• 13 Sowden AJ, Forbes C, Entwistle V et al. Informing, communicating and sharing decisions with people who have cancer. Qual Health Care 2001; 10: 193-196
• 14 Miyashita M, Ohno S, Kataoka A et al. Unmet information needs and quality of life in young breast cancer survivors in Japan. Cancer Nurs 2014; [Epub ahead of print]
• 15 Park B, Hwang SY. Unmet needs and their relationship with quality of life among women with recurrent breast cancer. J Breast Cancer 2012; 15: 454-461
• 16 Rutten LJ, Arora NK, Bakos AD et al. Information needs and sources of information among cancer patients: a systematic review of research (1980–2003). Patient Educ Couns 2005; 57: 250-261
• 17 Beckjord EB, Arora NK, McLaughlin W et al. Health-related information needs in a large and diverse sample of adult cancer survivors: implications for cancer care. J Cancer Surviv 2008; 2: 179-189
• 18 Cox A, Jenkins V, Catt S et al. Information needs and experiences: an audit of UK cancer patients. Eur J Oncol Nurs 2006; 10: 263-272
• 19 Brokalaki EI, Sotiropoulos GC, Tsaras K et al. Awareness of diagnosis, and information-seeking behavior of hospitalized cancer patients in Greece. Support Care Cancer 2005; 13: 938-942
• 20 Choi K, Park J, Park S. Cancer patientsʼ informational needs on health promotion and related factors: a multi-institutional, cross-sectional study in Korea. Support Care Cancer 2011; 19: 1495-1504
• 21 Neumann M, Wirtz M, Ernstmann N et al. Identifying and predicting subgroups of information needs among cancer patients: an initial study using latent class analysis. Support Care Cancer 2011; 19: 1197-1209
• 22 Gijsen R, Hoeymans N, Schellevis FG et al. Causes and consequences of comorbidity. J Clin Epidemiol 2001; 54: 661-674
• 23 Äkzert. Anforderungskatalog-BZ. Verfahren zur Zertifizierung von Brustzentren in NRW. 2014
• 24 Dillman DA. Mail and Telephone Surveys: the total Design Method. New York: Wiley & Sons; 1978
• 25 Ansmann L, Kowalski C, Ernstmann N et al. Patientsʼ perceived support from physicians and the role of hospital characteristics. Int J Qual Health Care 2012; 24: 501-508
• 26 Ansmann L, Kowalski C, Ernstmann N et al. Do breast cancer patients receive less support from physicians in German hospitals with high physician workload? A multilevel analysis. Patient Educ Couns 2013; 93: 327-334
• 27 Kowalski C, Nitzsche A, Scheibler F et al. Breast cancer patientsʼ trust in physicians: the impact of patientsʼ perception of physiciansʼ communication behaviors and hospital organizational climate. Patient Educ Couns 2009; 77: 344-348
• 28 Pfaff H, Freise DC, Mager G et al. Der Kölner Patientenfragebogen (KPF): Entwicklung und Validierung eines Fragebogens zur Erfassung der Einbindung des Patienten als Kotherapeuten. Sankt Augustin: Asgard; 2003
• 29 Raupach JC, Hiller JE. Information and support for women following the primary treatment of breast cancer. Health Expect 2002; 5: 289-301
• 30 Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol 2011; 77: 109-130
• 31 Peteet JR. Cancer and the meaning of work. Gen Hosp Psychiatry 2000; 22: 200-205
• 32 Schaeffer D. Bewältigung chronischer Krankheit im Lebenslauf. Bern: Huber; 2009
• 33 van den Bussche H, Koller D, Kolonko T et al. Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health 2011; 11: 101
• 34 Stark D. Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life. J Clin Oncol 2002; 20: 3137-3148
• 35 Mehnert A, Berg P, Henrich G et al. Fear of cancer progression and cancer-related intrusive cognitions in breast cancer survivors. Psychooncology 2009; 18: 1273-1280
• 36 Gazmararian JA. Health literacy among medicare enrollees in a managed care organization. JAMA 1999; 281: 545
• 37 Halkett GK, Kristjanson LJ, Lobb E et al. Information needs and preferences of women as they proceed through radiotherapy for breast cancer. Patient Educ Couns 2012; 86: 396-404