Article
Implementation of psycho-oncologic screening in the neuro-oncological treatment and electronic database based on a retrospective evaluation of 134 patients. A prospective bicentric study – Results of the first 29 patients
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Authors
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Mirjam Renovanz
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
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Anne-Katrin Hickmann
- Neurochirurgische Klinik, Klinikum Stuttgart, Katharinenhospital, Stuttgart
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Isabell Neppel
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
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Naureen Keric
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
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Christoph Richter
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
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Angelika Gutenberg
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
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Markus Haug
- Neurochirurgische Klinik, Klinikum Stuttgart, Katharinenhospital, Stuttgart
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Gerhard Strittmatter
- Abteilung für Psychosoziale Onkologie, Fachklinik Hornheide, Münster
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Christoph Bock
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Göttingen, Göttingen
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Minou Nadji-Ohl
- Neurochirurgische Klinik, Klinikum Stuttgart, Katharinenhospital, Stuttgart
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Nikolai J. Hopf
- Neurochirurgische Klinik, Klinikum Stuttgart, Katharinenhospital, Stuttgart
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Alf Giese
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Mainz, Mainz
| Published: | May 21, 2013 |
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Outline
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Objective: The detection of psychosocial distress in daily clinical routine is difficult and referral to mental health professionals is in many cases insufficient. Based on a retrospective analysis of 134 patients who had undergone psycho-oncological screening we designed a prospective study determining the distress, anxiety and depression of patients after surgery in the postoperative phase, after 3 and 6 months. Furthermore, we implemented the screening instruments in an electronic database.
Method: 134 patients, 47 male, 87 female, with brain tumors were postoperatively evaluated by the “Distress Thermometer” (DT) and “Hornheide Screening Instrument” (HSI). In addition clinical data were assessed. These data were retrospectively analyzed and a concept for a prospective study derived from this information. The psycho-oncological screening instruments were implemented in an electronic database application that is in clinical use for documentation of neuro-oncological treatment in the outpatient ambulance. To date, 29 patients are included in the prospective arm of this bicentric evaluation. Postoperatively screening with DT, HSI, PHQ-4 and BADO was assessed and further clinical data evaluated.
Results: Postoperatively 36 of the retrospectively analyzed patients (26.9%) were in psycho-oncological need according to the HSI and 50 patients (37.3%) were distressed (DT score ≥6), the mean DT score was 4.6 (SD= ±2.59, range 0–10). Women tended to be more in strain than men (p=0.007). No correlations with patients’ age, KPS or tumor localization were seen (p>0.05). After implementation of the screening instruments in the electronic database, the first results of the prospectively investigated patient population confirmed these findings. 29 patients were included so far, 6 of them were in psycho-oncological need by the time of first evaluation according to the HSI, mean score of DT was 5.9 (range 2–10), this decreased to 4.4 after 3 months. A cooperation with local psycho-oncologists was established, 6 of the patients went on to psycho-oncological intervention.
Conclusions: Due to the psycho-social needs of brain tumor patients a regular screening and referral to psycho-oncological therapy is necessary and needs sufficient infrastructures as well as interdisciplinary cooperation. We propose that physical and psychological balance optimizes the chances of neurooncological patients to go through the maximum of treatment options.
