title: [Disease specific stress of tumor patients at the beginning of radiotherapy. Effects on psychosocial support requirement].
abstract: OBJECTIVE
  Radiotherapy brings a tumor patient into a special life situation in which different variables play a role of often unknown importance. The goal of this study was to investigate disease specific stress of tumor patients at the beginning of radiotherapy with established psychodiagnostic questionnaires and to evaluate the effect on psychosocial support requirement in order to reduce stress and to improve quality of life and compliance during radiotherapeutical treatment.
  
  
  METHODS
  732 patients were screened, of whom 446 (60.9%) fulfilled the criteria for inclusion (refusals 21.0%, low karnorsky performance status 6.6%, management problems 3.4%, language barriers 3.0%, cognitive restrictions 2.6%, death 2.5%). Disease specific aspects of stress in the questionnaire (Fragebogen zur Belastung von Krebspatienten, FBK), life situation (LS) and self-defined care requirements (BB) (Figure 1) were self-rated by patients with different tumor types before radiotherapy. Medical and sociodemographic data were also documented. We investigated 446 patients (262 male, 184 female; median age 60.0 years) with different diagnoses (Table 1).
  
  
  RESULTS
  Stress was observed mainly due to reduction of efficiency, anxiety and pain on the subscales (Figure 2). Women had a significant higher stress on subscales of pain (p = 0.016) and anxiety (p = 0.009) (Table 2), patients younger than 45 years in the subscale information (p = 0.002) and patients older than 45 and younger than 60 years in the subscale anxiety (p = 0.002) and the total score (p = 0.003) (Table 3). Patients with mamma carcinoma had the highest the stress (Table 4). The maximum percentages of patients under high stress were found for the subscales of efficiency (43%) and anxiety (40%). The support requirement was characterized by the need of more medical information and dialogue with the doctor. We saw a significant correlation of high stress and high care requirement (Tables 5 and 6).
  
  
  CONCLUSIONS
  Psychosocial support should be founded on psychosocial stress diagnostic and self-defined care requirement.
authors.affiliation: Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München. susanne.sehlen@radonc.med.uni-muenchen.de
authors.forename: S
authors.initials: S
authors.lastname: Sehlen
authors.forename: H
authors.initials: H
authors.lastname: Hollenhorst
authors.forename: B
authors.initials: B
authors.lastname: Schymura
authors.forename: M
authors.initials: M
authors.lastname: Firsching
authors.forename: U
authors.initials: U
authors.lastname: Aydemir
authors.forename: P
authors.initials: P
authors.lastname: Herschbach
authors.forename: E
authors.initials: E
authors.lastname: Dühmke
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D011788:Quality of Life; D012737:Sex Factors; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires