Oncologic Rehabilitation in the COVID-19 Pandemic: The Situation in Clinics.

BACKGROUND: Oncological rehabilitation is an important pillar in the treatment of cancer patients. Due to the COVID-19 pandemic, this form of therapy is particularly challenged, as it relies heavily on group therapies. The aim of the study was to find out what impact the pandemic has had on oncological rehabilitation so far and how the rehabilitation clinics have dealt with it. METHODS: A web-based survey was used to collect data from 14 oncological rehabilitation clinics on the impact of the COVID-19 pandemic on occupancy, staffing trends, and hygiene measures for the observation period from March 1, 2020, to February 28, 2021. The data were compared with the same period 1 year earlier. In addition, the compensatory measures taken with regard to therapy were recorded. RESULTS: While only 15,272 patients were rehabilitated in the period under review, 21,257 patients were rehabilitated in the same period 1 year earlier. This corresponds to a decrease in occupancy of 28%. Three clinics were affected by temporary closures due to the pandemic. In 39% of the clinics, screening tests for patients had already been started for more than 8 months, while this was also offered to staff in only 23% of the clinics. With regard to changes in the therapeutic offer, more physiotherapeutic small groups with a reduced number of participants were used. This was also used in the area of sports therapy and education offers by 73% and 60% of the clinics, respectively. Overall, 92% of the participants assumed an economic recovery at the time of the survey. CONCLUSION: Despite a considerable decrease in occupancy in the oncological rehabilitation clinics, the therapies could be changed and carried out in a hygiene-compliant manner. Screening tests were offered at an early stage for patients as well as somewhat delayed for staff. The data show that pandemic-consistently changes in oncological rehabilitation are possible and that supply chains can be maintained.

Patient competencies, coping self-efficacy, and coping: Do they change during oncological inpatient rehabilitation and beyond?

OBJECTIVE: The construct of Patient Competencies (PCs) has been suggested to allow a more comprehensive understanding of cancer patients' abilities to confront emotion- and problem-focused coping tasks arising from the diagnosis, treatment and survivorship of cancer. While providing a reliable and valid measure of PCs, research thus far has not clarified whether PCs change across time and/or through intervention. This study asks whether PCs change during oncological inpatient rehabilitation and beyond. METHODS: N = 377 breast, colorectal, and prostate cancer patients from clinics for oncological rehabilitation were included to complete self-report measures of PC, coping and self-efficacy for coping with cancer at the beginning and the end of rehabilitation and 9 months afterward. In order to determine differences between tumor diagnostic groups and changes across time 3 (tumor site) x 3 (time) repeated measures analyses of variance were computed. RESULTS: Tumor diagnostic groups differed only marginally in PCs, coping self-efficacy and coping. The PCs of self-regulation and managing distress and coping self-efficacy improved slightly during rehabilitation but returned to initial levels at 9 months. Differential improvement was evident in the competencies of seeking information and interest in social services. Two of five coping behaviors decreased markedly from the end of rehabilitation to follow-up. CONCLUSIONS: This study suggests that oncological inpatient rehabilitation may contribute to advancing PCs, albeit to a limited extent. Aside from addressing conceptual, diagnostic and measurement issues, future research should clarify which interventions may be most effective for advancing problem- and emotion-focused PCs.

Fertility Preservation for Patients with Malignant Disease. Guideline of the DGGG, DGU and DGRM (S2k-Level, AWMF Registry No. 015/082, November 2017) - Recommendations and Statements for Girls and Women.

AIM: The aim of this official guideline published by the German Society of Gynecology and Obstetrics (DGGG) and coordinated with the German Society of Urology (DGU) and the German Society of Reproductive Medicine (DGRM) is to provide consensus-based recommendations, obtained by evaluating the relevant literature, on counseling and fertility preservation for prepubertal girls and boys as well as patients of reproductive age. Statements and recommendations for girls and women are presented below. Statements or recommendations for boys and men are not the focus of this guideline. METHODS: This S2k guideline was developed at the suggestion of the guideline commission of the DGGG, DGU and DGRM and represents the structured consensus of representative members from various professional associations (n = 40). RECOMMENDATIONS: The guideline provides recommendations on counseling and fertility preservation for women and girls which take account of the patient's personal circumstances, the planned oncologic therapy and the individual risk profile as well as the preferred approach for selected tumor entities.

[Cancer Related Fatigue in Rehabilitation Care]. / Tumorassoziierte Fatigue in der onkologischen Rehabilitation.

Aim of the study was to provide information about the prevalence of cancer related fatigue and the association between treatment-related factors and fatigue in cancer patients during the rehabilitation care. In a multicenter study 693 cancer patients (27% breast cancer, 17% prostate cancer etc.) completed the Multidimensional Fatigue Inventory (MFI-20) and sociodemographic and treatment information was noted. 51% of the patients suffer from fatigue (n=356). Fatigue prevalence differed according to tumour localization (p≤0.001). There was a substantial association between fatigue and treatment condition in terms of the combination of surgery and radiation (p≤0.05). Fatigue was high prevalent in patients in the rehabilitation care. Thus, fatigue should be routinely screened and after differentiated diagnostics be considered in rehabilitation care plans.