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Use of psychosocial services by lung cancer survivors in Germany

Results of a German multicenter study (LARIS)

Nutzung psychosozialer Angebote bei Lungenkrebsüberlebenden in Deutschland

Ergebnisse einer deutschen Multizenterstudie (LARIS)

Abstract

Purpose

Little is known about the use of psychosocial services in lung cancer survivors and patients who have survived the diagnosis for at least one year. We investigated the frequency of use, stratified by radiation therapy received, its associated factors, and the reasons for non-use of those services.

Methods

We performed a multicenter (n = 6 hospitals) cross-sectional study using data from medical records, patient reported questionnaires, and computer-assisted telephone interviews. Odds ratios (OR) for factors potentially associated with the use of any type of psychosocial services were calculated using multivariable logistic regression.

Results

We included 604 lung cancer patients/survivors. Of them, 60% (69% of those who had received radiotherapy) had used some kind of psychological and/or social service in the past (47% psychological, 42% social); 39% had used inpatient care, 24% outpatient care (cancer counselling center, general counselling center, psychological counselling by family doctor, psychotherapy, patient support group, pastoral work). Of those who visited a rehabilitation clinic, 66% received psychosocial care there. Factors associated with using psychosocial services in general were female gender (OR 1.96, 95% CI 1.32–2.93), poor emotional functioning (per unit decrease: OR 0.99, 95% CI 0.98–0.996), and younger age (per year decrease: OR 0.95, 95% CI 0.93–0.97).

Conclusions/implications

The high proportion of psychosocial care users among lung cancer survivors in Germany indicates that patients are interested in using it and that an unmet need exists. The creation of a broad spectrum of easily accessible services with high quality is important to enable and facilitate use.

Zusammenfassung

Zweck

Über die Nutzung psychosozialer Angebote bei Lungenkrebsüberlebenden ist wenig bekannt. Wir untersuchten die Häufigkeit der Nutzung – stratifiziert nach Patienten, welche eine Strahlentherapie erhielten –, mögliche Einflussflussfaktoren und die Gründe für die Nichtnutzung der Angebote.

Methoden

Multizentrische (n = 6 Krankenhäuser) Querschnittsstudie unter Nutzung von Krankenakten, patientenbezogener Fragebögen und computergestützter Telefoninterviews. Odds Ratios (OR) möglicher Einflussfaktoren wurden durch multivariable logistische Regressionen ermittelt.

Ergebnisse

Es wurden 604 Patienten/Überlebende mit Lungenkrebs ausgewertet. Von diesen hatten 60% – und 69% der Strahlentherapiepatienten – in der Vergangenheit psychologische und/oder soziale Angebote in Anspruch genommen (47% psychologisch, 42% sozial); 39% nahmen stationäre und 24% ambulante Angebote wahr (Krebsberatungsstellen, allgemeine Beratungsstellen, psychologische Beratung durch Hausarzt, Psychotherapie, Selbsthilfegruppe, Seelsorge). Von jenen, die eine Rehabilitationsklinik besuchten, erhielten 66% dort eine psychosoziale Betreuung. Faktoren, die mit der Nutzung psychosozialer Dienstleistungen verbunden sind, waren weibliches Geschlecht (OR 1,96; 95%-Konfidenzintervall [KI] 1,32–2,93), abnehmende emotionale Funktionsfähigkeit (OR 0,99; 95%-KI 0,98–0,996) und jüngeres Alter (OR 0,95; 95%-KI 0,93–0,97).

Schlussfolgerungen/Implikationen

Die häufige Inanspruchnahme psychosozialer Angebote unter Lungenkrebsüberlebenden zeigt sowohl das hohe Interesse der Patienten als auch den großen Bedarf. Um ihre Nutzung zu ermöglichen und zu erleichtern, ist die Schaffung eines breiten Spektrums leicht zugänglicher und qualitativ hochwertiger Angebote auf allen Ebenen der Versorgung wichtig.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors, but was conducted within the framework of the German Cancer Consortium (DKTK) based on general funds for the “Cancer Prevention, Early Detection, and Outcomes” research program at the DKTK partner site in Frankfurt/Mainz.

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Authors

Corresponding author

Correspondence to Martin Eichler.

Ethics declarations

Conflict of interest

M. Eichler, B. Wehler, R. Buhl, J. Stratmann, M. Sebastian, H. Schmidberger, C. Kortsik, U. Nestle, H. Wirtz, T. Wehler and M. Blettner declare that they have no competing interests. M. Hechtner is an employee of Boehringer Ingelheim. S. Singer has received lecture fees from Bristol-Myers Squibb, Pfizer, and Boehringer-Ingelheim, all of them unrelated to this study.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (primary ethical approval from the Ethics Committee of Rhineland–Palatinate [number 837.376.14]) and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Eichler, M., Hechtner, M., Wehler, B. et al. Use of psychosocial services by lung cancer survivors in Germany. Strahlenther Onkol 195, 1018–1027 (2019). https://doi.org/10.1007/s00066-019-01490-1

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Keywords

  • Lung cancer
  • Cancer survivorship
  • Psychosocial care
  • Psychosocial services
  • Psycho-oncology

Schlüsselwörter

  • Lungenkrebs
  • Krebsüberleben
  • Psychosoziale Versorgung
  • Psychosoziale Angebote
  • Psychoonkologie