Maintaining the mental health of Ukrainians in time of war: searching for a mechanism to provide a comprehensive system of psychosocial support and mental health awareness.

OBJECTIVE: Aim: To substantiate the possibilities of developing a comprehensive system of psychosocial support for Ukrainians during and after the war through thedevelopment of an integrated model of psychosocial service provision in the community, which promotes cross-sectoral interaction and expands the possibilities of integrating and scaling up multiple levels of mental health interventions. PATIENTS AND METHODS: Materials and Methods: The article is based on the use of bibliosemantic analysis of scientific works on the topic of mental health and mental health during the war. CONCLUSION: Conclusions: It is emphasised that in developing a comprehensive system of psychosocial support, it is necessary to: ensure accessibility of services for those in need; integrate services into the general health and social protection system; use a multisectoral approach, involving various organisations, institutions and professionals; train professionals to work in war conditions; develop and implement psychoeducation and psychological support programmes; monitor and evaluate the effectiveness of programmes. Particular attention is paid to psychoeducation as a technology that can be used at different levels of psychological intervention by both mental health professionals and other specialists involved in the provision of social services in communities. The spread of the impact of psychoeducational programmes will contribute to the development of community resilience in the face of social and psychological risks provoked by the war. A mechanism for scaling up the capabilities of the Technical Working Group on Mental Health and Psychosocial Support (MHPSS TWG), an association of leading international and Ukrainian NGOs specialising in mental health, established in Ukraine with the support of the WHO and the Ministry of Health of Ukraine, is proposed. The idea of creating a network of Resilience Centres in communities with the aim of forming a comprehensive system of psychosocial support at the state and community levels is substantiated.

Role of life satisfaction, emotional support, and feeling of social isolation on adherence to breast cancer screening recommendations among US women.

BACKGROUND: Psychosocial factors can play important roles in promoting preventive health behaviors. This study aimed to assess how life satisfaction, receipt of emotional support, and feeling of social isolation were associated with adherence to the USPSTF recommendation of breast cancer screening in a nationally representative US population. METHODS: Using data on 71,583 women aged 50 to 74 years, from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey, we estimated multivariable logistic regressions to assess the odds of adherence across different categories of the respective psychosocial constructs. We accounted for various demographic and socioeconomic correlates and checked the robustness of the relationship within income and educational sub-groups. RESULTS: We found that women who were dissatisfied with their life were 52.0% less likely to adhere compared to women who reported to be very satisfied. Similarly, women who rarely/never got emotional support and who always/usually felt socially isolated were 51.6% and 39.9% less likely to adhere, compared to women who always got support and never felt isolated, respectively. These results were robust across different levels of income and educational attainment. CONCLUSION: Our findings demonstrated a strong association between social environment, psychological wellbeing, and adherence to breast cancer screening, and thus suggested scope of potential psychosocial interventions to improve adherence. POLICY SUMMARY: Efforts to improve women's psychosocial wellbeing could facilitate compliance with breast cancer screening recommendations.

Prioritizing the Psychosocial Support Needs of Mothers with Gestational Diabetes: A Delphi Study.

Background: Gestational diabetes is the most common medical complication in pregnancy, and the psychosocial health of women suffering from this condition affects their adherence to treatment and self-efficacy. However, since it is not possible to design interventions dealing with all of these needs, the aim of this study was to prioritize the psychosocial supportive needs of women with gestational diabetes. Materials and Methods: This was a modified Delphi design study involving 22 experts who were selected using purposive and snowball sampling methods. The study was conducted between April 2021 and June 2021. First, the psychosocial needs of diabetic pregnant women were extracted through a qualitative study involving interviews with multidisciplinary specialists and diabetic pregnant mothers (22 participants) and a systematic review of reputable scientific databases. Throughout the two Delphi stages, the questionnaire was classified, quantified, and analyzed. Results: Based on the results of this study, the following are the top priorities when addressing the psychosocial needs of mothers with gestational diabetes: paying attention to and identifying the mother's worries and anxiety, husband and family support for diabetic pregnant women, the inclusion of specialized nutrition counseling services in mothers' treatment plan, timely education of mothers about diabetes and its complications, and proper nutrition for diabetic mothers. Conclusions: The priorities of the supportive needs obtained in this study can be used to design interventions aimed at promoting psychosocial health, reducing stress and anxiety, and improving medication adherence in women with gestational diabetes.

Research Report: Exploring Needs, Impediments and Perspectives for a Digital Mental Health Tool in Psychiatric Settings.

The COVID-19 pandemic brought forth rapid responses and changes in the acceptance of digital health interventions. Digital solutions appear increasingly promising, yet little is known about the peculiarities in the psychiatric context, contrary to other medical branches. The project MeHealth aimed at disclosing specific needs and reservations of patients and professionals in the psychiatric field. Apprehensions towards technology were found to be held on both sides. Cooperating with a psychiatric hospital in Austria, through a transdisciplinary research approach including focus groups and workshops, a framework for an integrated Digital Mental Health Tool was established. The findings leading to the framework show a strong need for patient-empowerment, enhancement of trust in technology and the need for multi-stakeholder cooperation. Digital tools should be designed to enhance the continuity of care and information exchange on behalf of the patient. Learnings were gained, which prove recommendable for future R&D projects on digitalization in the delicate field of psychiatry.

[Children visiting intensive care units and emergency departments : Kids are welcome!] / Besuche von minderjährigen Angehörigen in der Intensiv- und Notfallmedizin : Kinder als Besucher willkommen!

In this white paper, key recommendations for visitation by children in intensive care units (ICU; both pediatric and adult), intermediate care units and emergency departments (ED) are presented. In ICUs and EDs in German-speaking countries, the visiting policies for children and adolescents are regulated very heterogeneously: sometimes they are allowed to visit patients without restrictions in age and time duration, sometimes this is only possible from the age of teenager on, and only for a short duration. A request from children to visit often triggers different, sometimes restrictive reactions among the staff. Management is encouraged to reflect on this attitude together with their employees and to develop a culture of family-centered care. Despite limited evidence, there are more advantages for than against a visit, also in hygienic, psychosocial, ethical, religious, and cultural aspects. No general recommendation can be made for or against visits. The decisions for a visit are complex and require careful consideration.

Development of a Peer Support Mobile App and Web-Based Lesson for Adolescent Mental Health (Mind Your Mate): User-Centered Design Approach.

BACKGROUND: Digital technologies and mobile interventions are possible tools for prevention initiatives to target the substantial social and economic impacts that anxiety, mood, and substance use disorders have on young people. OBJECTIVE: This paper described the design and development of the Mind your Mate program, a smartphone app and introductory classroom lesson enhancing peer support around the topics of anxiety, depression, and substance use for adolescents. METHODS: The development of Mind your Mate was an iterative process conducted in collaboration with adolescents (n=23), experts, school staff, and software developers. The development process consisted of 3 stages: scoping; end-user consultations, including a web-based survey and 2 focus groups with 23 adolescents (mean age 15.9, SD 0.6 years); and app development and beta-testing. RESULTS: This process resulted in a smartphone peer support app and introductory classroom lesson aimed at empowering adolescents to access evidence-based information and tools to better support peers regarding mental health and substance use-related issues. The program contains links to external support services and encourages adolescents to reach out for help if they are concerned about themselves or a friend. CONCLUSIONS: The Mind your Mate program was developed in collaboration with a number of key stakeholders in youth mental health, including adolescents. The resulting program has the potential to be taken to scale to aid prevention efforts for youth mental health and substance use. The next step is to conduct a randomized controlled trial testing the feasibility, acceptability, and efficacy of the program.

"My life became more meaningful": confronting one's own end of life and its effects on well-being-a qualitative study.

BACKGROUND: The perception of being closer to death can be experienced due to old age or life-limiting diseases, and can pose profound existential challenges. Actively confronting death-related issues and existential questions may increase psychosocial comfort and stimulate personal growth, whereas dysfunctional coping may lead to existential distress. To date, research on individual and (semi-)professional approaches to confronting the own end of life and the effects on one's well-being remain scarce. Therefore, the aim of this study was to explore individual strategies and wishes in order to derive ideas for appropriate support concepts. METHODS: Twenty semi-structured interviews were conducted with people over the age of 80 (n = 11) and with a life-limiting disease (n = 10). The interviews were transcribed verbatim and independently coded by two researchers according to Braun and Clarke's thematic analysis approach. RESULTS: While the use of (semi-)professional approaches (e.g., therapeutic support) to confronting existential questions in the shape of one's impending death was rare, individual coping strategies did have a positive impact on psychosocial comfort. There were hardly any significant differences between the participants aged 80 and over and those with a life-limiting disease in terms of individual coping strategies or how they approached the ends of their lives. Both groups reported that theoretical education, preparing for the ends of their lives (e.g., funerals), talking about death-related topics, reflecting on death-related topics, and contemplating death in a spiritual sense had positive effects on their assurance, self-determination and relief. The necessity of confrontation and a desire for low-threshold, accessible and flexible services to meet their existential and spiritual needs were highlighted. CONCLUSIONS: There is both a desire and a need for the addressing of existential questions. Outside of private contexts, however, the participants possessed little awareness of support services that focused on confronting end-of-life issues, and rarely used such services. Efforts to raise awareness for psychosocial and spiritual needs should be implemented within the care system, together with low-threshold support concepts, in order to increase psychosocial well-being. More research evaluating individual approaches to confronting the own end of life are needed to better understand this determinant of well-being and its mechanisms of action. TRIAL REGISTRATION: www.germanctr.de , DRKS-ID: DRKS00020577 .

Trajectories of resilience and related factors in primary caregivers of patients with advanced head and neck cancer: A longitudinal cohort study.

PURPOSE: Primary caregivers (PC) of patients with advanced head and neck cancer (HNC) report stress during caregiving time post-treatment. We sought to identify the trajectories of resilience from initial completion of treatment to 1-year post-treatment in PC of patients with advanced HNC and to determine the factors associated with trajectories of resilience. DESIGN: In this prospective cohort study with convenience sampling, patient-PC dyads were recruited from a medical center in northern Taiwan between August 2015 and July 2020. METHODS: We recruited 120 patient-PC dyads and followed up at treatment completion and 1, 6, and 12 months post-treatment. Generalized estimating equation analysis was performed to identified factors related to resilience. FINDINGS: PCs' overall resilience increased from initial completion of treatment to peak at 1-year post-treatment. Patient factors associated with greater overall resilience included older age, higher performance status, and shorter time since cancer diagnosis; PC factors included reporting more social support, better physical health, and better mental health. CONCLUSIONS: PC mental health was the most important factor in the resilience trajectory of patients with advanced HNC cancer. CLINICAL RELEVANCE: Quantifying the relevant factors of trajectories of resilience will help to identify vulnerable PCs and guide survivorship care in the early stages of the post-treatment period.

Unmet psycho-social needs, coping strategies and psychological distress among people with cancer: Evidence from Pakistan.

OBJECTIVE: To explore the unmet psychosocial needs, coping styles and psychological distress among people with cancer. METHODS: The cross-sectional correlational study was conducted from May to July 2017 at Shifa International Hospital, Islamabad and Hayatabad Medical Complex, Peshawar, Pakistan which comprised of 182 patients diagnosed with cancer. Data was collected using the Supportive Care Needs Survey-Short Form-34, Mini-Mental Adjustment to Cancer Scale and the Hospital Anxiety Depression Scale. Data was analysed using SPSS 23v. RESULTS: It was found that all psychosocial needs were unmet among all participants (100%) who were suffering from cancer. However, health care information needs and psychological needs emerged to be strikingly unmet with 35.61% and 30.7% respectively. Moreover, maladaptive coping styles were highly endorsed than adaptive coping styles. CONCLUSION: This study pointed towards gaps in delivering quality care services in health care settings, inadequate attention and serious psychological health care neglect of people fighting with life threatening disease, indicating a dire need for proper psychological interventions for effective and holistic treatment planning to improve the whole process of illness and recovery.

Effectiveness of self-help workbook intervention on quality of life in cancer patients receiving chemotherapy: results of a randomized controlled trial.

BACKGROUND: A self-help workbook is expected to support cancer patients to cope with physical and psychosocial distress, to facilitate communication with medical staff, and to improve quality of life (QOL). We conducted a randomized controlled trial to evaluate the effectiveness of a self-help workbook intervention on QOL and survival. METHODS: From June 2014 to March 2015, patients with breast, colorectal, gastric, and lung cancer receiving outpatient chemotherapy were randomized into an intervention group (n = 100) or control group (n = 100). Intervention group participants received workbooks originally made for this study, read advice on how to cope with distress, and filled out questionnaires on the workbooks periodically. EORTC QLQ-C30 was evaluated at baseline, at 12 weeks, and at 24 weeks. The primary endpoint was Global Health Status / QOL scale (GQOL). RESULTS: No significant interaction was observed between the intervention and time in terms of GQOL or any of the functional scales. Among the 69 patients who continued cytotoxic chemotherapy at 24 weeks, the intervention was significantly associated with improved emotional functioning scores (P = 0.0007). Overall survival was not significantly different between the two groups. CONCLUSIONS: Self-help workbook intervention was feasible in cancer patients receiving chemotherapy. Although the effect of the intervention was limited, a post-hoc subset analysis suggested that the intervention may improve emotional functioning among patients who receive long-term cytotoxic chemotherapy. TRIAL REGISTRATION: UMIN Clinical Trials Registry, UMIN000012842 . Registered 14 January 2014.

The Peer Support Experience of AYA Hiroba: A Get-together for Adolescents and Young Adults with Cancer

Background: Adolescents and young adults (AYA) with cancer go through various life events during their illness trajectory, and there is often insufficient information on their diseases due to their rarity. Few chances are available for AYA patients to meet and share information with each other. Therefore, at the National Cancer Center Hospital in Japan we hold AYA Hiroba, a monthly get-together for AYA patients to communicate with each other. This study investigated satisfaction and effect with the activity. Methods: We have held the AYA Hiroba activity once a month since May 2016. We asked participants to complete a questionnaire at each session.Results: We held the activity 33 times between May 2016 and May 2019. A total of 130 patients participated, and 97 of them completed the questionnaire, including providing demographic data, since October 2017. The respondent demographics were as follows: sex (male/female), 38/59; median age, 29 years (range 14–39 years); outpatients/inpatients, 31/66; number of sessions attended (1/≥2), 42/55; and cancer type (sarcoma/malignant lymphoma/brain tumor/germ cell tumor/leukemia/melanoma/breast cancer/neuroblastoma/Wilms tumor/lung cancer/cervical cancer/nasopharyngeal cancer/tongue cancer/blank), 45/11/9/7/6/5/3/3/2/1/1/1/1/2). Many attendees perceived the activity favorably: “It was very satisfying” (61.7%), and “It was very helpful” (65%). The feedback was classified into three categories: “interaction with the same generation”, “diversion”, and “getting information”. Discussion: AYA patients have a great need to communicate with each other, and the feedback suggests that AYA Hiroba would be effective in interaction with the same generation, diversion and getting information. Most participants were very satisfied with the program.

[The German Association for Psychiatry, Psychotherapy and Psychosomatics participation compass II : Implementation of social participation for people with mental illnesses]. / Der DGPPN-Teilhabekompass II : Umsetzung sozialer Teilhabe für Menschen mit psychischen Erkrankungen.

For most people living with mental illnesses, participating in society is of existential importance; however, psychosocial care often fails to recognize its significance and therefore rarely includes the patient's interaction with society in the course of treatment. The reasons for this are both substantial and organizational in nature. The endless opportunities for participating in society, current areas as well as ways of taking part in social life even beyond the terms of the social legislative definition are, in addition to institutional variety and regional differences, all too often barriers to providing the very urgently needed support. Further aspects are insufficient knowledge of therapists about established options of rehabilitative treatment and about responsibilities related to participation in specialized training and further education for professional caregivers. The presented compass of participation for social integration of persons with mental illnesses starts at this point: it provides guidelines for psychiatric and psychotherapeutic practitioners, general practitioners as well as for physicians working in residential or day care institutions with a psychiatric and psychotherapeutic background. Both this article and planned online versions should help professionals to timely and successfully assist people, particularly those with severe mental illnesses, to navigate the broad spectrum of services for social and vocational integration in Germany.

Harnessing Reddit to Understand the Written-Communication Challenges Experienced by Individuals With Mental Health Disorders: Analysis of Texts From Mental Health Communities.

BACKGROUND: Mental disorders such as depression, bipolar disorder, and schizophrenia are common, incapacitating, and have the potential to be fatal. Despite the prevalence and gravity of mental disorders, our knowledge concerning everyday challenges associated with them is relatively limited. One of the most studied deficits related to everyday challenges is language impairment, yet we do not know how mental disorders can impact common forms of written communication, for example, social media. OBJECTIVE: The aims of this study were to investigate written communication challenges manifest in online mental health communities focusing on depression, bipolar disorder, and schizophrenia, as well as the impact of participating in these online mental health communities on written communication. As the control, we selected three online health communities focusing on positive emotion, exercising, and weight management. METHODS: We examined lexical diversity and readability, both important features for measuring the quality of writing. We used four well-established readability metrics that consider word frequencies and syntactic complexity to measure writers' written communication ability. We then measured the lexical diversity by calculating the percentage of unique words in posts. To compare lexical diversity and readability among communities, we first applied pairwise independent sample t tests, followed by P value adjustments using the prespecified Hommel procedure to adjust for multiple comparison. To measure the changes, we applied linear least squares regression to the readability and lexical diversity scores against the interaction sequence for each member, followed by pairwise independent sample t tests and P value adjustments. Given the large sample of members, we also report effect sizes and 95% CIs for the pairwise comparisons. RESULTS: On average, members of depression, bipolar disorder, and schizophrenia communities showed indications of difficulty expressing their ideas compared with three other online health communities. Our results also suggest that participating in these platforms has the potential to improve members' written communication. For example, members of all three mental health communities showed statistically significant improvement in both lexical diversity and readability compared with members of the OHC focusing on positive emotion. CONCLUSIONS: We provide new insights into the written communication challenges faced by individuals suffering from depression, bipolar disorder, and schizophrenia. A comparison with three other online health communities suggests that written communication in mental health communities is significantly more difficult to read, while also consisting of a significantly less diverse lexicon. We contribute practical suggestions for utilizing our findings in Web-based communication settings to enhance members' communicative experience. We consider these findings to be an important step toward understanding and addressing everyday written communication challenges among individuals suffering from mental disorders.

Predictors of post-traumatic growth in stroke survivors.

PURPOSE: The development of post-traumatic growth was studied longitudinally within 14 months poststroke. The predictions of two models of post-traumatic growth were examined. METHOD: Forty-three stroke survivors were investigated at two time points (i.e., time 1 and time 2), six months apart. Each completed the Post-traumatic Growth Inventory, Rumination Scale, Impact of Events Scale, Multidimensional Scale of Social Support, the Barthel Index and the COPE scale. RESULTS: Post-traumatic growth was evident four to five months after stroke, increasing significantly over the next six months at which point levels resembled those reported in cross-sectional stroke studies. Active and denial coping and rumination at time 1 were positively associated, and age was negatively associated, with post-traumatic growth at time 2, but acceptance coping was not associated. Neither active coping nor rumination mediated the effect of social support on post-traumatic growth as predicted. As predicted, rumination mediated the relationship between post-traumatic stress and post-traumatic growth. Exploratory stepwise regression demonstrated rumination and active coping at time 1 accounted for 45% of variance in post-traumatic growth at time 2. CONCLUSIONS: Post-traumatic growth can develop soon after stroke. Deliberate rumination is a key factor in post-traumatic growth. Both active coping and denial coping were associated with post-traumatic growth demonstrating the psychological complexity of poststroke adjustment. Implications for rehabilitation Therapists can expect stroke survivors to show post-traumatic growth in the first months after stroke. Therapists should look to promote post-traumatic growth and positive adjustment through working with survivors to increase active coping (attempts to deal effectively with the impact of stroke) and rumination (cognitive processing of the impact of the stroke). Since denial coping was also associated with posttraumatic growth, stroke survivors who maintain overly optimistic views about the severity and impact of their stroke are likely to benefit from therapists continually facilitating capacity for growth and well-being.

Variables asociadas al funcionamiento social en usuarios de hogares y residencias protegidas / Variables associated with the social performance of users in supported housing

RESUMEN Objetivo: Determinar las variables asociadas al funcionamiento social de usuarios que viven en hogares y residencias protegidas, en particular las características personales y clínicas de los residentes, factores del dispositivo residencial y de las áreas de salud a las que pertenecen. Material y método: Estudio descriptivo y correlacional cuya muestra estuvo compuesta por 122 residentes y 30 cuidadores de 15 hogares y 6 residencias protegidas. Se evaluó el desempeño social usando la Escala de Habilidades Básicas de la Vida Diaria que consta de 4 subescalas: autocuidado, habilidades domésticas, habilidades comunitarias, actividad y relaciones sociales. Para analizar los datos se utilizó un modelo lineal mixto. Resultados: En las subescalas de autocuidado, habilidades comunitarias y actividades y relaciones sociales, la varianza depende fundamentalmente de las características personales, en tanto en las habilidades domésticas el 47,6% corresponde a características del dispositivo y del área sanitaria. El nivel de restrictividad, el tiempo de permanencia en el dispositivo, el diagnóstico, la edad de los residentes y el apoyo social percibido fueron variables predictoras del funcionamiento social. Conclusión: El funcionamiento social de usuarios que viven en hogares y residencias está determinado, principalmente, por características individuales, sin embargo, variables del dispositivo y del área sanitaria tienen influencia dependiendo del tipo de habilidad social.

ABSTRACT Objective: Determine the variables associated with the social performance of users living in supported housing, in particular the personal and clinical characteristics of the residents, factors of the centre and of the health areas to which they belong. Method: Descriptive and correlational study whose sample consisted in 122 residents and 30 caregivers of 15 supported housing and 6 residential housing. Social performance was assessed through the Basic Everyday Living Skills Scale, which consisted of four sub-scales: self-care, domestic skills, community skills and activity and social relationships. In order to analyze the data, a mixed linear model was used. Results: In the sub-scales of self-care, community skills and activities and social relations the variance depends primarily on the personal characteristics. On the other hand, in the domestic skills 47.6% corresponds to centre characteristics and health area. The level of restrictiveness, time of residence in the facility, diagnosis of the users, age of residents and social support received corresponded to the statistically significant variables on the prediction of the social performance. Conclusion: Social performance of the users who live in supported housing is mainly determined by individual characteristics. However, variables of the centre and health area have a different weight depending on the type of social skill.

Longitudinal Changes in Psychological States in Online Health Community Members: Understanding the Long-Term Effects of Participating in an Online Depression Community.

BACKGROUND: Major depression is a serious challenge at both the individual and population levels. Although online health communities have shown the potential to reduce the symptoms of depression, emotional contagion theory suggests that negative emotion can spread within a community, and prolonged interactions with other depressed individuals has potential to worsen the symptoms of depression. OBJECTIVE: The goals of our study were to investigate longitudinal changes in psychological states that are manifested through linguistic changes in depression community members who are interacting with other depressed individuals. METHODS: We examined emotion-related language usages using the Linguistic Inquiry and Word Count (LIWC) program for each member of a depression community from Reddit. To measure the changes, we applied linear least-squares regression to the LIWC scores against the interaction sequence for each member. We measured the differences in linguistic changes against three online health communities focusing on positive emotion, diabetes, and irritable bowel syndrome. RESULTS: On average, members of an online depression community showed improvement in 9 of 10 prespecified linguistic dimensions: "positive emotion," "negative emotion," "anxiety," "anger," "sadness," "first person singular," "negation," "swear words," and "death." Moreover, these members improved either significantly or at least as much as members of other online health communities. CONCLUSIONS: We provide new insights into the impact of prolonged participation in an online depression community and highlight the positive emotion change in members. The findings of this study should be interpreted with caution, because participating in an online depression community is not the sole factor for improvement or worsening of depressive symptoms. Still, the consistent statistical results including comparative analyses with different communities could indicate that the emotion-related language usage of depression community members are improving either significantly or at least as much as members of other online communities. On the basis of these findings, we contribute practical suggestions for designing online depression communities to enhance psychosocial benefit gains for members. We consider these results to be an important step toward a better understanding of the impact of prolonged participation in an online depression community, in addition to providing insights into the long-term psychosocial well-being of members.

Effectiveness, acceptance and satisfaction of guided chat groups in psychosocial aftercare for outpatients with prostate cancer after prostatectomy.

BACKGROUND: Physical and psychological symptoms associated with prostate cancer and its treatment can cause patients to feel distressed. Furthermore, patients still experience a range of unmet support needs. Online interventions have the potential to fill a gap in cancer care by augmenting the limited available mental health services. OBJECTIVE: The main goal of the study was to evaluate the effectiveness of guided chat groups in psychosocial aftercare for outpatients with prostate cancer. Additionally, the participants' satisfaction with and acceptance of the intervention was measured and evaluated. METHODS: A quasi-experimental design was used to analyze the research questions. 18 prostate cancer patients followed five web-based chat-group sessions. 26 patients received treatment as usual. The guided chat group enabled patients to exchange concerns, problems and support with fellow patients. The intervention group and control patients had to fill in self-reported questionnaires before the intervention and at a follow-up. Outcome measures include distress, anxiety, depression, anger, need for help, quality of life (QoL), fear of progression (FoP) and coping with cancer. To analyze the effectiveness of the chat groups, an analysis of covariance was conducted. RESULTS: The analysis of covariance revealed one significant difference between the two groups for the outcome anger. The difference had a large effect size (η2 = 0.160) with higher scores for the intervention group. Further differences with a medium effect size were found for coping with cancer, the physical component of quality of life and depression. The intervention group scored higher on all three outcomes.Additionally, participants reported that the atmosphere in the chat sessions was confidential and believed that the chat program worked as a bridge between inpatient treatment and daily life. CONCLUSIONS: Intervention participants reported poorer results for the primary and secondary outcomes in comparison to the control group patients at follow up, which indicates that web based chat groups may not be an effective way to decrease prostate cancer perceived distress even if the intervention participants seem to accept the intervention.

My Personal Journey With Ovarian Cancer Treatment: Caring and Chemotherapy Tips.

Six years ago, I was diagnosed with stage IIIA ovarian low malignant cell potential cancer. It was the most shocking situation I have ever experienced. I didn't realize I had any symptoms, except occasional back pain, which I attributed to starting a new workout program. I had scheduled an abdominal computerized tomography (CT) scan for recurrent microscopic hematuria, which my internist wanted to check. I was told I would hear the results in two days. Two hours after my CT scan, while I was eating ice cream and watching television, an on-call genitourinary doctor (who I did not personally know) called to tell me the good news-that I had kidney stones, thus the microscopic hematuria. However, the bad news was that I had ovarian cancer that had spread to my omentum. He said he would call my gynecologist right away.

[Psychotherapeutic treatment of traumatized refugees in Germany]. / Psychotherapeutische Versorgung traumatisierter geflüchteter Menschen in Deutschland.

Traumatic experiences resulting from war and violence can lead to a broad spectrum of psychological and somatic stress responses. The psychological strain of traumatized refugees is frequently aggravated by specific post-migration stressors. The current healthcare provision in Germany is characterized by many restrictions. The different residence permits are associated with a limited access to medical and psychotherapeutic services. In addition, there are several barriers limiting access of this group of patients to the healthcare system (e. g. low level of training of mental healthcare staff, language barriers and lack of financing for interpreters). Empirical studies have shown that traumatized refugees profit from existing trauma-focused and evidence-based interventions. Treatment is associated with particular challenges and issues (e. g. use of interpreters, migration and culture-specific as well as legal aspects). Specialized treatment centers for traumatized refugees use a multidisciplinary treatment approach, which includes psychotherapeutic, medical and social work interventions as well as assistance with the residential status and integration programs.