Refine
Has Fulltext
- no (3)
Document Type
- Article (3) (remove)
Is part of the Bibliography
- yes (3)
Keywords
- distress (3) (remove)
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.
Background: As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization.
Methods: The clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis.
Discussion: This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines
This case report addresses the problem of underreporting negative results and adverse side effects in animal testing. We present our findings regarding a hyperphagic mouse model associated with unforeseen high mortality. The results outline the necessity of reporting detailed information in the literature to avoid duplication. Obese mouse models are essential in the study of obesity, metabolic syndrome and diabetes mellitus. An experimental model of obesity can be induced by the administration of gold thioglucose (GTG). After transcending the blood-brain barrier, the GTG molecule interacts with regions of the ventromedial hypothalamus, thereby primarily targeting glucose-sensitive neurons. When these neurons are impaired, mice become insensitive to the satiety effects of glucose and develop hyperphagia. In a pilot study for optimising dosage and body weight development, C57BL/6 mice were treated with GTG (0.5 mg/g body weight) or saline, respectively. Animals were provided a physiological amount of standard diet (5 g per animal) for the first 24 hours after treatment to prevent gastric dilatation. Within 24 hours after GTG injection, all GTG-treated animals died of gastric overload and subsequent circulatory shock. Animals developed severe attacks of hyperphagia, and as the amount of provided chow was restricted, mice exhibited unforeseen pica and ingested bedding material. These observations strongly suggest that restricted feeding is contraindicated concerning GTG application. Presumably, the impulse of excessive food intake was a strong driving force. Therefore, the actual degree of suffering in the GTG-induced model of hyperphagia should be revised from moderate to severe.