Anxiety, posttraumatic stress, and fear of cancer progression in patients with melanoma in cancer aftercare.

UNLABELLED: Several studies have described mental distress and anxiety in patients with melanoma. The findings of these studies varied from patients with a quality of life similar to the general population and those with increased mental distress. In the present study, we investigated anxiety, posttraumatic stress, and fear of cancer progression to gain a detailed picture of the burdens of these patients. PATIENTS AND METHODS: 70 patients with malignant melanoma who attended cancer aftercare were surveyed using the psychometric instruments Hospital Anxiety and Depression Scale (HADS), Posttraumatic Symptom Scale (PTSS-10), and Fear of Progression Questionnaire (FoP-Q). The questionnaires were evaluated and an analysis of the single items carried out. RESULTS: The scores for the three anxiety parameters were low, but 7% of the patients presented an increased HADS score, and 17% an increased PTSS-10 value. An analysis of the items showed that patients feared physical disabilities more than mental distress or lack of social support. CONCLUSION: Most of the patients perceived themselves as stable, and relied on the assistance of their families. However, a small group of patients suffered from clinically relevant anxiety; these patients should be given the support indicated for their specific distress.

Communication Skills Trainings: Subjective Appraisal of Physicians from Five Cancer Centres in North Rhine, Germany.

BACKGROUND: Physician-patient communication is an essential component of high-quality health care provision for cancer patients. To date, communication skills training programmes have not been systematically implemented in oncology and have low physician participation rates. METHODS: As a part of a needs assessment a written questionnaire was used to explore needs and preferences (structural conditions and content) regarding communication skills training programmes for physicians working in oncology settings in 5 university hospitals in North Rhine, Germany. RESULTS: 207 physicians took part in the survey. Analyses revealed positive attitudes and high willingness to attend such training programmes, with a preference for short trainings that are compatible with clinical practice. Suggested topics included breaking bad news, conversations about death and dying and dealing with difficult emotions. CONCLUSION: Communication skills training approaches should not only pay attention to evidence regarding their efficacy, but also take into consideration physicians' needs and preferences. Further research is required on the subject of barriers to participation in such training programmes.