[Oncological Rehabilitation and Development of Strategies in Crisis Situations Using the Example of the Covid 19 Pandemic in 2020 by Using a Patient and Staff Survey Results of Pandemic Care]. / Onkologische Rehabilitation und Entwicklung von Strategien in Krisensituationen am Beispiel der Covid-19-Pandemie im Jahr 2020 unter Berücksichtigung einer Patienten- und Mitarbeiterbefragung.

INTRODUCTION: Cancer is a life-threatening disease often with curative therapy approaches, high risk of relapse and distressing symptoms, which require immediate, quality-assured care throughout the entire therapy process including rehabilitation, even in a pandemie. METHODS: We started to develop a pandemic plan to maintain oncological rehabilitation in February 2020. With the involvement of the whole clinic staff we developed protection scenarios with the aim of achieving Covid-19-free clinics. Schedules were developed and implemented based on the epidemiological bulletins of the RKI (Robert Koch Institute, Germany) of 2017 (influenza infection) and 2020 (Covid-19). The effects of these measures were evaluated by means of a patient and employee survey. RESULTS: The challenges of the pandemic have been successfully implemented. Both the patient and employee surveys showed a high level of acceptance of the measures. For example, 98.5% of patients stated that the continuation of rehabilitation was important for their health, even in the pandemic situation. At the same time, 87% felt safe. 88% of all employees (MA) and 93% of MA in the risk group stated that the protective measures were introduced at the right time. At the same time, 76% of all employees and 84% of the employees in the risk group agreed with the additional burden. In spite of the high risk potential in the clinics (immunocompromised patients, patients from different districts with different levels of exposure), an outbreak of SARS-CoV-2 could be avoided in the clinics. CONCLUSION: The timely roll-out of adapted pandemic rules in rehabilitation clinics enables the continuation of high-quality oncological rehabilitation even in pandemic times and thus contributes to a stabilisation of the supply chain for cancer diseases. A high level of acceptance of the measures among patients and hospital staff was evaluated.

Cancer patients and the Internet: a survey of the 'Quality of Life' Working Groups of the Arbeitsgemeinschaft für Internistische Onkologie and the Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie.

BACKGROUND: Patient-reported outcomes, such as quality of life (QoL) assessment, are becoming more important as endpoint in clinical trials and for decision making regarding new anticancer product approvals. Nevertheless, numerous obstacles exist regarding the implementation of QoL assessment in the daily practice of medical oncologists. Regular, computerized or internet home-based QoL assessments could be a step forward. METHODS: Using a 15-item paper questionnaire, we conducted a survey among 1580 cancer patients regarding their willingness to use internet QoL assessment, and collected personal data and information about current disease and performance status. RESULTS: Younger patients (i.e. ≤65 years) significantly more often had internet access (78% versus 36%; χ(2) test, p < 0.001). Moreover, the availability of internet access correlated with higher education levels. 55% of all polled patients are willing to use an internet-based QoL assessment tool, regardless of the type of internet access, whereas almost two-thirds (n = 600; 65%) of patients with their own internet access would be willing to use it for providing statements about QoL. Of these, especially younger patients in good health status with higher education degrees indicated their willingness to use such tools. CONCLUSION: These data may serve as a basis for identifying patient groups willing to participate in pilot projects to evaluate the implementation of internet-based regular assessment of QoL in cancer.

[Course of psychosocial distress and health-related quality of life in patients at different age groups during cancer rehabilitation]. / Verlauf der psychosozialen Belastung und gesundheitsbezogenen Lebensqualitat bei Patienten verschiedener Altersgruppen in der onkologischen Rehabilitation.

OBJECTIVES: This study investigates psychosocial distress and health-related quality of life in younger (up to 40 years), middle-aged (up to 50 years), and elderly cancer patients (up to 60 years). METHODS: 637 patients (94%women, 75% breast-cancer patients) completed validated questionnaires measuring distress, anxiety, depression, fear of progression, and quality of life at the beginning (T0) and the end (T1) of a cancer rehabilitation program (T0/T1 response rate: 72 %) as well as at 1-year follow-up (T2) (n = 485, T2 response rate: 76 %). RESULTS: Patients in the different age groups did not differ significantly in psychosocial distress at T0 except for fear of progression, which is lower among the younger age group. Elderly patients have a significantly lower physical quality of life. At the beginning of the rehabilitation program, patients in all age groups were significantly more anxious compared to population-based normative values, whereas higher depression was found only in younger and middle-aged patients. Patients in all age groups have a significantly lower quality of life compared to population-based normative values. In particular, large effect sizes were found for physical functioning domains. Patients in all age groups improve significantly in psychosocial distress and quality of life over time; however, significant interaction effects between age group and time were not observed in psychosocial distress and quality of life. CONCLUSIONS: Age differences are predominantly observed in physical quality-of-life dimensions rather than in psychosocial distress. This finding should be considered for the development of rehabilitation services.