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Hintergrund
Lungenkrebsbetroffene sind besonders stark durch psychischen Stress belastet. Gleichzeitig sind die Inanspruchnahmeraten von psychoonkologischer Unterstützung relativ gering. Es ist wenig über die Gründe der (Nicht‑)Inanspruchnahme bekannt.
Fragestellung
Welche emotionalen Herausforderungen erleben Menschen mit Lungenkrebs? Was sind ihre Gründe für die (Nicht‑)Inanspruchnahme psychoonkologischer Unterstützung?
Material und Methode
Es wurden qualitative Interviews mit 20 Lungenkrebsbetroffenen ausgewertet, die im Rahmen der CoreNAVI-Studie durchgeführt wurden.
Ergebnisse
Die Befragten erleben psychischen Stress in Form von Unsicherheiten und Zukunftsängsten. Auch den Druck, schnell von einer Behandlung in die nächste gehen zu müssen und keine Zeit für sich zu haben, nehmen die Betroffenen als belastend wahr. Das offene Sprechen, ohne das persönliche Umfeld belasten zu müssen, sowie konkrete Ratschläge erleben die Nutzer*innen der Psychoonkologie als große Hilfestellung. Die Nichtinanspruchnahme wird durch fehlenden Bedarf und mangelnde Kapazitäten begründet. Zudem werden Vorbehalte gegenüber psychologischer Unterstützung deutlich.
Schlussfolgerung
Betroffene mit Lungenkrebs erleben psychische und emotionale Belastungen auch durch die Vielzahl und Dichte an Therapien. Daraus resultierende fehlende Kapazitäten könnten eine Erklärung für die geringe Inanspruchnahme von psychoonkologischer Unterstützung sein. Eine stärkere Gewichtung der Psychoonkologie gegenüber aufwendigen medizinischen, oft nur geringfügig lebensverlängernden Therapien sowie der Abbau von Vorbehalten gegenüber psychologischer Hilfe sollten in der Versorgungspraxis verstärkt in den Fokus rücken.
Aim The purpose of this study was to examine physical fitness and psycho-cognitive performance and their associations in young and middle-aged workers with primarily physical versus mental work demands. Subjects and methods Healthy young and middle-aged workers (73 men, age = 33 +/- 7 years; 75 women, age = 35 +/- 9 years) were recruited from German small-to-medium-sized enterprises (< 250 employees) and classified into groups with primarily mental (MD) or physical demands (PD) at work. Participants were tested for cardiorespiratory fitness, trunk flexor/extensor muscular endurance, handgrip strength, balance, leg muscle power, perceived stress, cognitive performance, and work ability. Results Ninety-four workers were allocated to the MD (53% females) and 54 to the PD (46% females) groups. The MD group showed significantly better balance, trunk extensor muscular endurance, and cognitive performance (p < 0.035, 0.35 <= d <= 0.55) and less stress compared with the PD group (p < 0.023, d = 0.38). Group-specific Spearman rank correlation analysis (r(S)) revealed significant small-to-medium-sized correlations between physical fitness and cognitive performance (- 0.205 <= r(S) <= 0.434) in the MD and PD groups. Significant small-to-medium-sized correlations were found for physical fitness and stress/work ability (0.211 <= r(S) <= 0.301) in the MD group only. Further, associations of trunk extensor muscular endurance and work ability were significantly higher in the MD group (r(S) = 0.240) compared with the PD group (r(S) = - 0.141; z = 2.16, p = 0.031). Conclusions MD workers showed better physical fitness measures (balance, trunk extensor muscular endurance) and cognitive performance and lower levels of perceived stress compared with PD workers. Small-to-medium-sized associations between physical fitness and psycho-cognitive performance measures indicate that gains in physical fitness may at least partly contribute to psycho-cognitive performance and/or vice versa, particularly in MD workers.
Fluid intelligence (fluid IQ), defined as the capacity for rapid problem solving and behavioral adaptation, is known to be modulated by learning and experience. Both stressful life events (SLES) and neural correlates of learning [specifically, a key mediator of adaptive learning in the brain, namely the ventral striatal representation of prediction errors (PE)] have been shown to be associated with individual differences in fluid IQ. Here, we examine the interaction between adaptive learning signals (using a well-characterized probabilistic reversal learning task in combination with fMRI) and SLES on fluid IQ measures. We find that the correlation between ventral striatal BOLD PE and fluid IQ, which we have previously reported, is quantitatively modulated by the amount of reported SLES. Thus, after experiencing adversity, basic neuronal learning signatures appear to align more closely with a general measure of flexible learning (fluid IQ), a finding complementing studies on the effects of acute stress on learning. The results suggest that an understanding of the neurobiological correlates of trait variables like fluid IQ needs to take socioemotional influences such as chronic stress into account.
Background: The use of psychoactive substances to neuroenhance cognitive performance is prevalent. Neuroenhancement (NE) in everyday life and doping in sport might rest on similar attitudinal representations, and both behaviors can be theoretically modeled by comparable means-to-end relations (substance-performance). A behavioral (not substance-based) definition of NE is proposed, with assumed functionality as its core component. It is empirically tested whether different NE variants (lifestyle drug, prescription drug, and illicit substance) can be regressed to school stressors.
Findings: Participants were 519 students (25.8 +/- 8.4 years old, 73.1% female). Logistic regressions indicate that a modified doping attitude scale can predict all three NE variants. Multiple NE substance abuse was frequent. Overwhelming demands in school were associated with lifestyle and prescription drug NE.
Conclusions: Researchers should be sensitive for probable structural similarities between enhancement in everyday life and sport and systematically explore where findings from one domain can be adapted for the other. Policy makers should be aware that students might misperceive NE as an acceptable means of coping with stress in school, and help to form societal sensitivity for the topic of NE among our younger ones in general.