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首页> 美国卫生研究院文献>Neuro-Oncology >P19.04 Psychosocial counseling in neuro-oncology - analysis of topics and needs of brain tumor patients
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P19.04 Psychosocial counseling in neuro-oncology - analysis of topics and needs of brain tumor patients

机译：P19.04神经肿瘤学的社会心理咨询-脑肿瘤患者的主题和需求分析

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>Objective: In the field of neuro-oncology an increasing focus is being directed towards the psychosocial needs of patients diagnosed with brain tumors. However, it remains challenging to establish psycho-oncological therapies and interventions that meet the specific needs of these patients. Therefore, the aim of this study was to identify major concerns and burdens of brain tumor patients on the basis of our clinical experience. >Methods: This retrospective chart analysis included 53 patients attending supportive psycho-oncological counseling at the Department of Neurosurgery, University of Münster between 2010 and 2014. All patients were counseled by the same therapist, a neurosurgeon with specialization in psycho-oncology. Notes were analyzed based on qualitative content analysis. With regard to physical and psychological symptoms, coping strategies and further concerns mentioned by the patients, thematic categories were established. Notes were then assigned to the categories to analyze their frequency distribution and identify the patients’ main concerns. >Results: The cohort had a mean age of 48 years. 30 (56.6%) were female. 23 (43.4%) were diagnosed with high grade glioma, 16 (30.2%) with low grade glioma, 10 (8.9%) with a benign brain tumor and 4 (7.5%) had cerebral metastasis. The median number of consultations per patient was 4 (range 1 - 47). During their first consultation, 36 (67.9%) patients listed their physical symptoms and limitations. 40 (75.5%) suffered psychological symptoms, often accompanied by a depressive disorder. The majority of patients expressed issues related to questions concerning meaning of and priorities in life (71.7%), medical topics and questions (62.3%) and death and mortality (56.6%). Furthermore, the following concerns were primarily mentioned: the shock of being diagnosed with a brain tumor, work and occupation, loss of roles and tasks in daily life, family conflicts, reduced mobility, excessive demand and reduced capacity. Concerning coping modes, more patients showed appropriate strategies (including an active attitude toward the disease; 39.6%) than inappropriate strategies, comprising resignation (20.8%) and rumination (18.9%). Concerning psychological symptoms and topics of conversations, there were no significant differences among patients regardless of the dignity of tumor (p= n.s.). >Conclusion: These results provide an insight into major concerns and issues that patients diagnosed with a brain tumor are frequently dealing with. Therefore, they can serve as an important basis for the development of psychosocial intervention concepts. No significant differences between the diagnosis groups were found. This suggests that, regardless of prognosis and tumor natural history, the burdens of patients diagnosed with a brain tumor are similar and all patients, despite of their diagnosis, might benefit from psychosocial support.
机译：>目的：在神经肿瘤学领域，越来越多的注意力集中在诊断出患有脑肿瘤的患者的社会心理需求上。但是，建立满足这些患者特定需求的心理肿瘤疗法和干预措施仍然具有挑战性。因此，本研究的目的是根据我们的临床经验来确定脑肿瘤患者的主要担忧和负担。 >方法：这项回顾性图表分析包括2010年至2014年间在明斯特大学神经外科系接受支持性心理肿瘤咨询的53例患者。所有患者均由同一位治疗师（一家专门从事神经外科的神经外科医生）进行咨询。心理肿瘤学。基于定性内容分析对笔记进行了分析。关于身体和心理症状，应对策略以及患者提到的其他问题，建立了主题类别。然后将注释分配给类别，以分析其频率分布并确定患者的主要关注点。 >结果：该队列的平均年龄为48岁。 30名（56.6％）为女性。诊断为高级别脑胶质瘤的23例（43.4％），低级别脑胶质瘤的16例（30.2％），脑良性肿瘤10例（8.9％）和脑转移瘤4例（7.5％）。每位患者的诊症中位数为4（范围1-47）。在他们的第一次会诊中，有36名（67.9％）患者列出了他们的身体症状和体征。 40（75.5％）人患有心理症状，经常伴有抑郁症。大多数患者表达的问题涉及生活的意义和优先级（71.7％），医学主题和问题（62.3％）以及死亡和死亡率（56.6％）。此外，主要提到以下问题：被诊断出患有脑瘤，工作和职业，在日常生活中失去角色和任务，家庭冲突，行动不便，需求过大和能力下降的震惊。关于应对方式，更多的患者表现出适当的策略（包括对疾病积极的态度； 39.6％），而不是适当的策略，包括辞职（20.8％）和反刍（18.9％）。关于心理症状和谈话主题，无论肿瘤的尊严如何，患者之间均无显着差异（p = n.s.）。 >结论：这些结果提供了对诊断为脑肿瘤的患者经常处理的主要问题和关注的深刻见解。因此，它们可以作为发展社会心理干预概念的重要基础。诊断组之间没有发现显着差异。这表明，不管预后和肿瘤的自然史如何，被诊断患有脑肿瘤的患者的负担都是相似的，尽管诊断出来，所有患者都可以从社会心理支持中受益。

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