The impact of the COVID-19 pandemic restrictions on the health care utilization of cancer patients.

BACKGROUND: COVID-19 has impacted both society and medical care. While Germany entered the first lockdown in spring 2020, the PIKKO study (Patient information, communication and competence empowerment in oncology) was still active. The intervention modules, patient navigator (PN), services of the Saarland Cancer Society (SCS), psycho-social counseling and different courses, and online knowledge database (ODB) continued to be offered, but in an adapted form. It was the aim of this supplementary survey to identify the restrictions and burdens of the pandemic containment strategies on the PIKKO patients and thus on the PIKKO study itself. Furthermore, this work shows how the PIKKO modules were used during the lockdown. METHODS: All patients in the PIKKO intervention group (IG) were invited to complete a questionnaire, n = 503. Furthermore, utilization of the SCS and log files of the ODB were analyzed. For socio-demographic data and contacts with the PN, data from the regular PIKKO surveys were used. In addition to descriptive statistics, chi²-tests, F-tests and linear regression analyses were performed. RESULTS: 356 patients participated in this supplemental survey. 37.6% reported restrictions. "Restrictions on accompanying persons", "ban on visits to the wards" and "protective mouth-nose-mask" were reported as the greatest burdens. 39.0% expressed fears that the restrictions would have an impact on the course of their disease. Linear regression analyses showed differences in feelings of burden among age groups (more among < 60-year-olds), gender (more among women), children in the household (more with children), and preexisting financial stress (more with financial worries). In April 2020, there was more patient contact with PNs by phone, more SCS psycho-social counseling by phone, adapted SCS course offering, but with significantly fewer participants, and high activity on the ODB. CONCLUSION: Cancer patients in the IG reported restrictions from the pandemic containment strategies and feared an impact on their recovery. However, whether a burden is perceived as heavy depends more on gender, age, or pre-existing burdens than on whether the lockdown affects PIKKO or not. The utilization of counseling, courses or the ODB despite lockdown shows the need for such services, especially in times of crisis. TRIAL REGISTRATION: This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21 Feb 2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703 .

Patient information, communication and competence empowerment in oncology: Results and learnings from the PIKKO study.

PURPOSE: Many concepts for accompanying and supporting cancer patients exist and have been studied over time. One of them was PIKKO (a German acronym for "Patient information, communication and competence empowerment in oncology"), which combined a patient navigator, socio-legal and psychological counseling (with psychooncologists), courses dealing with various supportive aspects, and a knowledge database with validated and easy-to-understand disease-related information. The aim was to increase the patients' health-related quality of life (HRQoL), self-efficacy as well as health literacy and to reduce psychological complaints such as depression and anxiety. METHODS: To this purpose, an intervention group was given full access to the modules in addition to treatment as usual, while a control group received only treatment as usual. Over twelve months, each group was surveyed up to five times. Measurements were taken using the SF12, PHQ-9, GAD, GSE, and HLS-EU-Q47. RESULTS: No significant differences were found in scores on the mentioned metrics. However, each module was used many times and rated positively by the patients. Further analyses showed a tendency higher score in health literacy with higher intensity of use of the database and higher score in mental HRQoL with higher intensity of use of counseling. CONCLUSION: The study was affected by several limitations. A lack of randomization, difficulties in recruiting the control group, a heterogeneous sample, and the COVID-19 lockdown influenced the results. Nevertheless, the results show that the PIKKO support was appreciated by the patients and the lack of measurable effects was rather due to the mentioned limitations than to the PIKKO intervention. TRIAL REGISTRATION: This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21.02.2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703.

Resilience and personality as predictors of the biological stress load during the first wave of the Covid-19 pandemic in Germany.

Since the Covid-19 outbreak, pandemic-specific stressors have potentiated the-already severe-stress load across the world. However, stress is more than an adverse state, and chronic exposure is causally involved in the development of mental and physical disease. We ask the question whether resilience and the Big Five personality traits predict the biological stress response to the first lockdown in Germany. In a prospective, longitudinal, observational study, N = 80 adult volunteers completed an internet-based survey prior to the first Covid-19-related fatality in Germany (T0), during the first lockdown period (T1), and during the subsequent period of contact restrictions (T2). Hair strands for the assessment of systemic cortisol and cortisone levels were collected at T2. Higher neuroticism predicted higher hair cortisol, cortisone and subjective stress levels. Higher extraversion predicted higher hair cortisone levels. Resilience showed no effects on subjective or physiological stress markers. Our study provides longitudinal evidence that neuroticism and extraversion have predictive utility for the accumulation of biological stress over the course of the pandemic. While in pre-pandemic times individuals high in neuroticism are typically at risk for worse health outcomes, extraverted individuals tend to be protected. We conclude that, in the pandemic context, we cannot simply generalize from pre-pandemic knowledge. Neurotic individuals may currently suffer due to their general emotional lability. Extraverted individuals may primarily be socially stressed. Individualized stress management programs need to be developed, and offered in a lockdown-friendly format, to minimize the stress burden caused by Covid-19 or future pandemics and to protect the most severely affected individuals from the development of stress-associated disease.

Erratum zu: Bedeutung der COVID-19-Pandemie für die öffentliche Gesundheit und gruppenpsychologische Aspekte ­ Teil 2 einer (vorläufigen) Übersicht.

[This corrects the article DOI: 10.1007/s00278-021-00505-6.].

[Importance of the COVID-19 pandemic for public health and group psychological aspects-Part 2 of a (preliminary) review]. / Bedeutung der COVID-19-Pandemie für die öffentliche Gesundheit und gruppenpsychologische Aspekte ­ Teil 2 einer (vorläufigen) Übersicht.

Based upon the findings related to the impact of the coronavirus disease 2019 (COVID-19) pandemic on human living conditions and psychological health, in the first part of this review the authors discuss the consequences of the pandemic for public health. It is surprising to see that related to public health but also psychological factors and sequelae of the pandemic, a broad knowledge was already available based upon former pandemics and disasters long before the outbreak of COVID-19. This knowledge has been used very sparsely, if at all, for health political decisions. In view of the social significance of the pandemic and its social impact, findings from group psychology and group dynamics seem to be specifically important for a better understanding of behavior within the population as well as the conceptualization of public health interventions. An increase in psychological disorders was described related to the pandemic. For the treatment of these disorders, a range of psychotherapeutic approaches including evidence-based group psychotherapy are available. Whereas the use of telemedical and digital techniques is increasingly more common within individual psychotherapy, many questions are still open related to online group treatment.

[Indirect and direct psychosocial consequences of the corona pandemic-part 1 of a (preliminary) review]. / Folgen der COVID-19-Pandemie für die psychische Gesundheit und Konsequenzen für die Psychotherapie ­ Teil 1 einer (vorläufigen) Übersicht.

The pandemic triggered by the coronavirus disease 2019 (COVID-19) has, apart from a few positive effects, led to massive and manifold impairments of human living conditions for which this article suggests a taxonomy. According to the severity, these impairments have resulted in a deterioration of the psychological well-being for many people and an increased vulnerability for psychological disorders. This has been confirmed by numerous studies and review articles, which also dealt with the question of factors that positively as well as negatively influencing mental health. This review shows that, e.g. suffering from COVID-19 disease, younger age and female gender as well as a pre-existing psychiatric or somatic disease must be considered as special risk factors. Psychotherapists are confronted with the pandemic in different ways. In view of the societal impact psychotherapists have a special role. In addition, the pandemic raises questions on specific issues and specific groups which must be addressed.

Any progress in Group Psychotherapy and Group Analysis? "The Facts are Friendly" – Clinical, Research and Training Perspectives.

Any progress in Group Psychotherapy and Group Analysis? "The Facts are Friendly" – Clinical, Research and Training Perspectives This article answers questions related to the progress of group psychotherapy from the perspective of a researcher and clinician in a moment when group treatments seem to boom in a training context, related to health political decisions as well as supported by positive research results. Besides remarks on some developments related to group therapeutic approaches, the author suggests a reflection of integrative concepts and a focus on the results of social psychology. Current societal developments, primarily the Covid-19 pandemic, indicate the importance of group psychological issues in the present time. An improvement of the image of group psychotherapy still needs joint efforts on a political, scientific and practical level, and intensifying group psychotherapy training. (English) [ABSTRACT FROM AUTHOR] Fragen zu Fortschritten der Gruppenpsychotherapie werden aus der Perspektive eines Forschers und Klinikers in einer Zeit beantwortet, in der Gruppenpsychotherapie sowohl im Ausbildungskontext, in der Gesundheitspolitik aber auch untermauert durch positive Forschungsergebnisse einen Aufschwung zu verzeichnen scheint. Neben Hinweisen auf einige Entwicklungen gruppentherapeutischer Ansätze wird angeregt, in der Gruppentherapie vermehrt über integrative Konzepte und den Bezug zur Sozialpsychologie nachzudenken. Aktuelle gesellschaftliche Entwicklungen, allen voran die Covid-19-Pandemie, lassen gruppenpsychologische Ansätze aktuell sehr wichtig erscheinen. Eine weitere Imageverbesserung der Gruppentherapie bedarf gemeinsamer Anstrengungen auf politischer, wissenschaftlicher und praktischer Ebene und einer weiteren Intensivierung gruppentherapeutischer Ausbildung. (German) [ABSTRACT FROM AUTHOR] Copyright of Gruppenpsychotherapie und Gruppendynamik: Beiträge zur Sozialpsychologie und therapeutischen Praxis is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The psychology of the COVID-19 pandemic: A group-level perspective

Objective: The coronavirus disease (COVID-19) threatened not only people's physical health but also every aspect of their psychological well-being: from their struggle to avoid contracting the disease, to their coping with the disruption of the normal course of their lives, to the trauma they endured when the virus took the lives of those they loved. The objective of this article is to consider the group-level processes that sustain people's physical and psychological well-being during COVID-19. Method: Applying group dynamic and group therapy theory and research, we explore why COVID-19 spread so rapidly. We also explore how people cope with prolonged social isolation, distress, and social inequities, as well as how people deal with the psychological trauma of the disease, which includes heightened levels of depression, anxiety, substance abuse, and complicated bereavement. Results: Researchers and theorists suggest that human beings are fundamentally social, and the need to gather with others is extremely important, especially during times of distress. The need to belong as well as the importance of reducing loneliness during uncertain times often encourages people to connect, despite recommendations to remain socially distant. Conclusions: Group treatment options developed by group psychotherapists are effective at reducing depression, anxiety, complicated grief, and stress. We conclude by examining the growing impact of online groups and the many ways that these groups help people improve their psychological well-being during the COVID-19 crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved) Impact Statement Highlights and Implications-*Group dynamic theorists and researchers provide important contributions to the understanding of the prevention of COVID-19. Group dynamics explain why some people perceive less of a threat and why some people refuse to wear face masks or social distance. *Group psychotherapy researchers and practitioners describe the importance of group leadership, group cohesion, and the effects of loneliness and social isolation on people coping with COVID-19. *Given the mental and physical health challenges we face with COVID-19, online group and group therapy interventions are becoming more prevalent. The importance of future studies examining the effectiveness of online groups (both support and therapy) are necessary. We also need studies that examine what individual difference variables influence the effectiveness of online group interventions, such as age, race, class, ethnicity, culture, attachment style, and level of isolation. *One of the main implications of this article is that it is critical to examine the group-level factors that influence how we navigate a pandemic. Groups influence how we prevent the transmission of COVID-19, how we sustain ourselves during periods of social isolation, and how we address the effects of complicated bereavement, trauma, illness, social inequities, unemployment, anxiety, and depression. (PsycInfo Database Record (c) 2020 APA, all rights reserved)