gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

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Emotional Burden on Palliative Care Patients in Germany - Results of the German Standard Documentation of Palliative Care (HOPE) and the “Po-Bado”-Instrument of the German Cancer Society-group PSO and DAPO

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  • corresponding author presenting/speaker Karl Neuwöhner - Zentrum Palliativmedizin, Klinik Dr. Hancken, Stade, Deutschland
  • Gabriele Lindena - CLARA Clinical research application, Kleinmachnow
  • HOPE 2005 steering board

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP534

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dkk2006/06dkk644.shtml

Published: March 20, 2006

© 2006 Neuwöhner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: Psychological and social burden on patients are important for decision-making and quality of life in palliative care and cancer treatment. Palliative care teams in different institutions have to consider emotions such as anxiety, helplessness, grieve, depression, shame and disappointment. How can staff detect them carefully and seriously?

Method: The “Po-Bado”-Instrument of the German Cancer Society-group PSO and the German Working-group of Psycho-Social Oncology (DAPO) is used as an optional module of the Hospice and Palliative care Evaluation (HOPE). The instrument is based on standardized interviews of the patients and distinguishes somatic, emotional and other (social) burden. Burden were assessed with 5-step Likert-scales (0 – 4). Selected results are compared to the outcomes of the “Po-Bado”-study group in departments of oncology in general hospitals.

Results: In two randomised selections 1038 (2004) and 787 (2005) patients were interviewed in the first week of admission. The emotional burden did not depend on different tumour-entities (no significance - except head & neck-tumours) nor on the (TN)M-status of the disease. However, symptoms of weakness and restrictions in activity (ADLs) caused more emotional distress (2,7 / 4) than pain (1,7 / 4). The emotional burden of psychological symptoms (anxiety, helplessness, grieve, disappointment …) were reported less severe (in summary 11,6 / 32 points) than the burden of physical symptoms (in summary 10 / 16 points). Emotional burden caused by psycho-social problems were more often documented in hospices (in summary 43%) than in palliative care units (PCU: 31%) but professional psycho-social support seemed to be indicated more often in PCUs (50,8%) and departments of oncology (68,8%) than in inpatient hospices (17%).

Discussion: The “Po-Bado”-instrument of the German-Cancer-Society-group PSO and DAPO provided effective assessment of emotional burden even in the final stages of the disease. The results present significant differences in emotional burden depending on symptoms of the disease and treatment setting (!). Correlations with specific symptoms and the influence of treatment on emotional burden warrant further investigation.