Men's Access to Outpatient Psychosocial Cancer Counseling.

BACKGROUND: Men make use of outpatient cancer counseling less commonly than women, even when they stand to benefit from it. METHODS: In a cluster-randomized trial (registered under DRKS00032181), we studied whether measures on multiple levels (information for referring physicians, public information, structural changes, offerings specifically for male patients) over a period of 12 months would be able to increase the percentage of men among patients seeking outpatient cancer counseling (primary endpoint, initial contact; secondary endpoint, all contacts). The intervention effect was quantified by the fitting of generalized linear mixed models to obtain an odds ratio, which was adjusted for cluster structure and for the percentages of first contacts and of all contacts during the 12 months before the start of the intervention. RESULTS: In 12 regions of Germany (6 each in the intervention arm and the control arm), 11 986 people had first contacts with outpatient cancer counseling, 6004 of them during the intervention phase. The percentage accounted for by men was 30.7% in the intervention arm and 25.7% in the control arm, corresponding to a statistically insignificant model-based adjusted odds ratio (OR) of 1.2 (95% confidence interval [1.0; 1.4], p = 0.08) for the primary endpoint. There were a total of 51 842 counseling sessions (both initial contacts and subsequent contacts), 26 651 of them in the intervention phase. The percentage of these that was accounted for by men was 27.6% in the intervention arm and 22.2% in the control arm; the adjusted OR for this secondary endpoint was 1.3 [1.1; 1.6], p = 0.01). CONCLUSION: The targeted implementation of malespecific measures on multiple levels can increase, by a small amount, the percentage of men among persons seeking outpatient cancer counseling.

[Special Consultation Hour for Patients with Cancer-Related Fatigue: Study Protocol of an Observational Study of a Nationwide Health Care Structure by the Bavarian Cancer Society (BKG) in Bavaria]. / Tumor-Fatigue-Sprechstunde der Bayerischen Krebsgesellschaft e.V.: Studienprotokoll einer Beobachtungsstudie zur flächendeckenden Versorgungsstruktur in Bayern.

Cancer-related fatigue (CRF) is a burdensome condition of persistent tiredness, weakness, and lack of energy on physical, emotional, and cognitive level. CRF occurs in the context of cancer and/or its therapy and correlates with limitations in everyday life functioning, quality of life, and survival time. Up to now, medical care in Germany is inadequate. German wide institutions are lacking, which are specialised in identifying treatable factors influencing CRF as well as in counselling of adequate, evidence-based treatments. Since 2013, the Bavarian Cancer Society (BCS) implemented a nationwide health care structure with ten psychosocial cancer counselling centers in Bavaria. At these locations, the BCS offers for cancer patients with CRF special consultation hours with well-founded diagnostic and guidance. During the conception and further development of the consultation hour, all relevant guidelines have been considered. All consultation hours are directed by physicians with oncological and psycho-oncological experience. All of them took part in an extensive CRF training. The aim of this prospective, multicentre, observational study is the evaluation of the actual state of the TF-consultation including the analyses of offer and need for TF-consultation hours, of patient-reported TF before TF-consultation and ten weeks later, of realization of the recommended interventions to reduce TF as well as the analysis of strengths and potentials for improvement of the current system. The results will help to implement a German wide care structure.

[Specific Contribution of Psychosocial Cancer Counselling Centers - Perspectives of the Person Seeking Advice and the Referring Professional]. / Zum spezifischen Versorgungsbeitrag psychosozialer Krebsberatungsstellen ­ Sichtweisen der Ratsuchenden und Zuweisenden.

AIM: The aim of the study is to look at the specific contribution of outpatient cancer counselling centers (OCCC) from the perspective of both the person seeking advice and the referring health care professionals. METHODS: Qualitative design by means of guideline-based face-to-face interviews with cancer patients/relatives and individual telephone interviews with referring health care professionals. RESULTS: A total of 43 persons seeking advice and 30 referring health care professionals were interviewed. With regard to the contents of counselling, psycho-oncological support and help for self-help in combination with social-legal information about additional support services are perceived as central features. In the group of referring physicians, however, there seems to be some uncertainty about what OCCCs (can) provide. CONCLUSION: On the one hand, the results point to a specific core of the services offered by OCCCs, and on the other hand to ambiguous perceptions on the part of the respondents. They may contribute to further sharpening the profile of OCCC and to clarifying their place in the health care system.

[Surveys as Quality Management Measures in Psychosocial Cancer Counselling Centers]. / Nutzerbefragung als Qualitätssicherungsmaßnahme in psychosozialen Krebsberatungsstellen.

AIM: The aim of the present survey was to describe and evaluate experiences of German psychosocial cancer counselling centers with user surveys as a quality management measure. METHODS: Representatives of various psychosocial cancer counselling centers were asked to prepare an experience report on user surveys. Nine field reports were presented and discussed in summary by the working group "Cancer Counselling Centers" of the Working Group Psychooncology of the German Cancer Society (PSO). Special attention was paid to the short questionnaire KBS-N (Cancer Counselling Centre Questionnaire) recommended by the working group. RESULTS: All psychosocial cancer counselling centers reported positive experiences with user surveys, which, however, represent an effort in terms of personnel and logistics. In addition to the KBS-N, more detailed questionnaires were also used. The surveys were conducted either continuously or on a random basis over a limited period of time. Those seeking advice were usually asked at a defined time directly after the initial interviews or after the end of the counselling sequence. The response rate was higher (85-95%) when the questionnaire was handed out personally after the initial consultation than for postal delivery and return (47-89%). All counselling centers reported positive feedback on the counselling services provided. Isolated points of criticism were related in particular to organizational framework conditions. CONCLUSION: After weighing up the costs and benefits, an active follow-up survey of those seeking advice using the short questionnaire KBS-N appears to be a practicable quality assurance measure, at least over a limited period of time. More detailed user surveys require more effort and are therefore more suitable for use in research that go beyond quality assurance.