Sinnorientierte Interventionen in der Psychoonkologie

Patients with advanced cancer often suffer from existential distress. Although a variety of effective psychotherapeutic interventions for the treatment of psychological distress in cancer patients are available, concerns such as hope and meaning of life are only occasionally at the center of therapeutic attention. During recent years growing efforts have been made to develop and evaluate meaning-based interventions for cancer patients, particularly in the Anglo-American research literature. Meaning-based interventions are often realized as group therapy approaches to reduce emotional and spiritual distress and to promote hope, courage and control, to mobilize internal resources and to discuss future goals despite a noticeable limited life expectancy. Further aims include strengthening a patient??s self-esteem and sense of dignity, to appreciate strengths and past achievements, to reduce feelings of isolation, to strengthen the relationship with the partner and family members and to improve communication with the professional healthcare team.     

Psychosoziale Versorgung von Krebspatienten

Objectives

The aim of this study was to determine rates of psychooncological care for cancer inpatients and outpatients under routine conditions in a large University hospital. The percentage of patients who received care was analyzed and compared with self-rated and expert rated supportive care needs.

Methods

The percentage of inpatients who received psychooncological care was calculated by comparing the number of cancer patients treated at the hospital as documented by the local tumor registry (n=1,979) with the number of patients treated by a psychooncologist in that hospital as documented by the hospital??s psychooncological consultation liaison service. The percentage of outpatients who received psychooncological care was calculated by comparing the number of incident cancer cases as documented by the local tumor registry (n=5,886) with the number of patients who received at least one consultation at the local tumor counseling centre. Supportive care needs were estimated by analyzing data of a prospective patient survey in the same hospital (n=1,803) using the Hospital Anxiety and Depression Scale and single items to determine social burden and the wish for emotional support.

Results

The results showed that 11% of inpatients and outpatients (n=234 and n=638, respectively) received psychooncological care. Social care needs were prevalent in 37% and psychological care needs in 52% of the patients during the stay in hospital and in 42% (social and psychological) 6 months later. Of the patients 41% expressed the need to see a social worker and 29% to see a psychologist. Large differences were found between patients with different tumor entities.

Conclusion

Psychooncological care delivered to cancer patients under routine conditions was below the actual rate required as estimated by screening instruments and as expressed by the patients.     

Career transitions and career success in the ‘new’ career era

The ‘new’ career, most notably the boundaryless career, is associated with high career mobility, which is in turn associated with employability and career success of individuals. The current study examined how frequency, form (organisational, horizontal or vertical) and impact (objective career success) of career transitions have changed across two cohorts of Austrian business graduates (1970 and 1990) throughout the first 15 years of their careers (n = 291). Data for the study were collected by way of standardised questionnaires; participants' career transitions (n = 807) were plotted based on curriculum-vitae type lists of their successive jobs. This research examined two assumptions: (1) that careers have become more turbulent and complex and (2) that this is generally a positive evolution for individuals. Results indicate that overly dramatic claims about the ‘death’ of the traditional-organisational career need to be reconsidered.     

Exploring the robustness of cross-situational learning under Zipfian distributions

Cross-situational learning has recently gained attention as a plausible candidate for the mechanism that underlies the learning of word-meaning mappings. In a recent study, Blythe and colleagues have studied how many trials are theoretically required to learn a human-sized lexicon using cross-situational learning. They show that the level of referential uncertainty exposed to learners could be relatively large. However, one of the assumptions they made in designing their mathematical model is questionable. Although they rightfully assumed that words are distributed according to Zipf's law, they applied a uniform distribution of meanings. In this article, Zipf's law is also applied to the distribution of meanings, and it is shown that under this condition, cross-situational learning can only be plausible when referential uncertainty is sufficiently small. It is concluded that cross-situational learning is a plausible learning mechanism but needs to be guided by heuristics that aid word learners with reducing referential uncertainty.     

Verbal descriptions of spatial information can interfere with picture processing

Two studies are reported that tested the assumption that learning is improved by presenting text and pictures compared to text only when the text conveys non-spatial rather than spatial information. In Experiment 1, 59 students learned with text containing either visual or spatial contents, both accompanied by the same pictures. The results confirmed the expected interference between the processing of spatial text contents and pictures: Learners who received text containing spatial information showed worse text and picture recall than learners who received text containing visual information. In Experiment 2, 85 students were randomly assigned to one of four conditions, which resulted from a 2×2 between-participants design, with picture presentation (with vs without) and text contents (visual vs spatial) as between-participants factors. Again the results confirmed the expected interference between processing of spatial text information and pictures, because beneficial effects of adding pictures to text were observed only when the texts conveyed visual information. Importantly, when no pictures were present no differences were observed between learners with either visual or spatial texts contents, indicating that the observed effects are not caused by absolute differences between the two texts such as their difficulty. The implications of these results are discussed.