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.     

Psychological and Social Characteristics Associated with Religiosity in Women’s Health Initiative Participants

Measures of religiosity are linked to health outcomes, possibly indicating mediating effects of associated psychological and social factors. We examined cross-sectional data from 92,539 postmenopausal participants of the Women’s Health Initiative Observational Study who responded to questions on religious service attendance, psychological characteristics, and social support domains. We present odds ratios from multiple logistic regressions controlling for covariates. Women attending services weekly during the past month, compared with those not attending at all in the past month, were less likely to be depressed [OR = 0.78; CI = 0.74–0.83] or characterized by cynical hostility [OR = 0.94; CI = 0.90–0.98], and more likely to be optimistic [OR = 1.22; CI = 1.17–1.26]. They were also more likely to report overall positive social support [OR = 1.28; CI = 1.24–1.33], as well as social support of four subtypes (emotional/informational support, affection support, tangible support, and positive social interaction), and were less likely to report social strain [OR = 0.91; CI = 0.88–0.94]. However, those attending more or less than weekly were not less likely to be characterized by cynical hostility, nor were they less likely to report social strain, compared to those not attending during the past month.     

Googling for ghosts: a meditation on writers' block, mourning, and the Holocaust

The author describes her father's experience of being a Holocaust survivor and how his unfinished mourning contributed to her struggle with muteness, her own story being dwarfed by the magnitude of her father's losses. When her non-Jewish mother is chosen to be honored by Yad Vashem, the ceremony proves unexpectedly powerful. The witnessing by community, through the Internet, helps dissolve the shame and isolation, heals some of the trauma, and promotes greater psychological freedom. In creating this paper, the author memorializes her parents and her lost relatives, and succeeds in working through much that had haunted her.     

Langzeitergebnisse einer Funktionellen-Magnetresonanztomographie-Studie

In a controlled functional magnetic resonance imaging (fMRI) study the effect of psychodynamic short-term psychotherapy on cerebral activation of panic disorder patients was determined. In a linguistic go-no go paradigm behavioral measures and cerebral activation to affective word stimuli with threatening, neutral and positive content were assessed pretreatment and post-treatment in 9 patients with panic disorder. 18 healthy controls were scanned twice at the same intervals. In an additional long-term follow-up after approximately 3 years post-treatment the effect of brain activation changes during treatment on the long-term outcome of core symptoms (panic-related cognition and fear of body sensations) were determined. In accordance with the hypotheses increased limbic (hippocampus and amygdala) activation accompanied by low prefrontal activation to negative words were found. At treatment termination, panic-related symptoms had improved significantly and fronto-limbic activation patterns were normalized. Reduction of activation of the limbic system during treatment was predictive of a favorable long-term outcome. The results indicate that short-term psychodynamic treatment leads to changes in fronto-limbic networks, similar to previous findings on cognitive-behavioural treatment.     

Common patterns of prediction of literacy development in different alphabetic orthographies

Previous studies have shown that phoneme awareness, letter-sound knowledge, rapid automatized naming (RAN), and verbal memory span are reliable correlates of learning to read in English. However, the extent to which these different predictors have the same relative importance in different languages remains uncertain. In this article, we present the results from a 10-month longitudinal study that began just before or soon after the start of formal literacy instruction in four languages (English, Spanish, Slovak, and Czech). Longitudinal path analyses showed that phoneme awareness, letter-sound knowledge, and RAN (but not verbal memory span) measured at the onset of literacy instruction were reliable predictors, with similar relative importance, of later reading and spelling skills across the four languages. These data support the suggestion that in all alphabetic orthographies, phoneme awareness, letter-sound knowledge, and RAN may tap cognitive processes that are important for learning to read.     

Rater training revisited: An updated meta‐analytic review of frame‐of‐reference training

The present study updates Woehr and Huffcutt's (1994) rater training meta‐analysis and demonstrates that frame‐of‐reference (FOR) training is an effective method of improving rating accuracy. The current meta‐analysis includes over four times as many studies as included in the Woehr and Huffcutt meta‐analysis and also provides a snapshot of current rater training studies. The present meta‐analysis also extends the previous meta‐analysis by showing that not all operationalizations of accuracy are equally improved by FOR training; Borman's differential accuracy appears to be the most improved by FOR training, along with behavioural accuracy, which provides a snapshot into the cognitive processes of the raters. We also investigate the extent to which FOR training protocols differ, the implications of protocol differences, and if the criteria of interest to FOR researchers have changed over time.     

The Influence of Family Dynamics on Ethnic Identity Among Adult Latinas

The literature on the development of ethnic identity within the young adult years and during childhood is plentiful. There is less research that examines how this development continues beyond young adult or college years. Research suggests that major life events experienced in adulthood could cause individuals to enter a period of identity reconstruction, yet little is known about this process. Because family and/or familism has been established as an important aspect of Latinos’ identities and lived experiences, this study seeks to examine the dimensions around family dynamics and their potential influences on ethnic identity development processes among adult Latinas. Findings indicate that Latinas often make sense of their ethnic identity when major life events associated with family dynamics occur; such as marriage, childbearing, and negotiating relationships with family members as culture is being transmitted across several generations. These findings have implications for understanding adult education students as well as considering the influence of education on the family dynamics of Latinas.     

Hopelessness,Parent‐Adolescent Communication,and Suicidal Ideation among Chinese Adolescents in Hong Kong

Based on the responses of 5,557 Chinese secondary students in Hong Kong, the relationships among perceived hopelessness, family functioning, and suicidal ideation were examined. Results showed that suicidal ideation was positively related to hopelessness, but negatively related to parent‐adolescent communication. Compared with father‐adolescent communication, mother‐adolescent communication generally had a stronger association with adolescent suicidal ideation. It was further found that the linkage between hopelessness and adolescent suicidal ideation was stronger under a low parent‐adolescent communication condition, thus suggesting the moderating effect of parent‐adolescent communication on the effect of hopelessness on suicidal ideation. The theoretical and practical implications of the findings are discussed.     

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.