The effect of including a 'psychooncological statement' in the discharge summary on patient-physician communication: a randomized controlled trial.

OBJECTIVE: The objective of this study is to determine whether the inclusion of a 'psychooncological statement' (PO-statement) in the discharge summary enhances patient-physician communication about psychosocial issues across the inpatient and outpatient sector. METHODS: A total of 1416 cancer patients were randomly assigned to the intervention (with PO-statement in the discharge summary) or control group (discharge summary without PO-statement). Shortly before discharge from the hospital (T1), patients from the intervention group were screened for psychosocial distress. Based on the electronic clinical documentation system, screening results were subsequently integrated into the discharge summary, which automatically generated a PO-statement. To determine the effect of the PO-statement, patients as well as their primary care physicians (n = 596) were asked during follow-up care (T2) whether psychosocial distress was discussed during the last consultation. RESULTS: Including a PO-statement in the discharge summary did not result in more frequent discussions about psychosocial issues compared with the control group from the patients' and physicians' perspectives. Instead, discussions about psychosocial well-being were significantly associated with women of the patient (p = <0.001) and the physician (p = 0.011), medical discipline (gynecologists; p = 0.002), cancer diagnosis (gynecological cancer; p = 0.002), metastases (p = <0.001), professional training of patients (none, p = 0.026), and psychosocial qualification of physicians (p = 0.018). CONCLUSION: Written information on psychosocial distress in the discharge summary alone does not affect communication.

[Long-term survival of adult cancer patients from a psychosomatic perspective - literature review and consequences for future research]. / Langzeitüberleben von Erwachsenen nach Krebs aus psychosomatischer Sicht-Literaturübersicht und Forschungsdesiderate.

OBJECTIVES: The increasing survival of cancer patients is the result of early detection, improved treatment, and demographic change. This poses urgent questions regarding the stresses and needs for care long-term survivors face. METHODS: A literature survey (PubMed, Scopus) was conducted based on all publications with a psychooncological background from 2004 to 2008 concerning long-term survivors. RESULTS: Of the 164 publications found, 74 referred to breast cancer; 62 % came from the United States and only 4 % from Germany. Although overall quality of life among long-term survivors appears to be good, considerable adverse somatic effects (long-term effects, late consequences, recidivism, second tumors) and mental effects (e.g., fear of recurrence) persist. Somatic and psychosocial determinants of long-term adjustment, health behaviour, health care needs and utilization, and the quality of life of next-to-kin have hardly been studied. The effects of psychotherapy on survival remain controversial. CONCLUSIONS: In light of the growing number of long-term surviving cancer patients, it is necessary to study their strains and needs for care under a lifespan perspective.