Disease specific stress of tumor patients at the beginning of radiotherapy. Effect on psychosocial support requirement

Purpose: Radiotherapy brings a tumor patient into a special Life situation in which different variables play a role of often unknown importance. The g oal of this study was to investigate disease specific stress of tumor patie nts at the beginning of radiotherapy with established psychodiagnostic ques tionnaires and to evaluate the effect on psychosocial support requirement i n order to reduce stress and to improve quality of Life and compliance duri ng radiotherapeutical treatment. Patients and Methods: 732 patients were sc reened, of whom 446 (60.9%) fulfilled the criteria for inclusion (refusals 21.0%, Low Karnofsky performance status 6.6%, management problems 3.4%, Lan guage barriers 3.0%, cognitive restrictions 2.6%, death 2.5%). Disease spec ific aspects of stress in the questionnaire (Fragebogen zur Belastung von K rebspatienten, FBK), Life situation (LS) and self-defined care requirements (BB) (Figure 1) were self-rated by patients with different tumor types bef ore radiotherapy. Medical and sociodemographic data were also documented. W e investigated 446 patients (262 male, 184 female; median age 60.0 years) w ith different diagnoses (Table 1). Results: Stress was observed mainly due to reduction of efficiency, anxiety and pain on the subscales (Figure 2). Women had a significant higher stres s on subscales of pain (p = 0.016) and anxiety (p = 0.009) (Table 2), patie nts younger than 45 years in the subscale information (p = 0.002) and patie nts older than 45 and younger than 60 years in the subscale anxiety (p = 0, 002) and the total score (p = 0.003) (Table 3). Patients with mamma carcino ma had the highest stress (Table 4). The maximum percentages of patients un der high stress were found for the subscales of efficiency (43%) and anxiet y (40%). The support requirement was characterized by the need of more medi cal information and dialogue with the doctor. We saw a significant correlat ion of high stress and high care requirement (Tables 5 and 6). Conclusions: Psychosocial support should be founded on psychosocial stress diagnostic and self-defined care requirement.