Eine Gruppenintervention zur Förderung der Arbeitsfähigkeit für Patienten mit Kopf-Hals-Tumoren

Zusammenfassung

Einleitung Trotz hoher Belastung nimmt ein Großteil der Patienten mit Kopf-Hals-Tumoren keine psychosoziale Versorgung in Anspruch. Diese Patienten haben darüber hinaus ein höheres Risiko als andere Krebspatienten, nicht wieder in den Beruf zurückzukehren. Daher wurde eine Gruppenintervention entwickelt, die sich an Patienten mit Kopf-Hals-Tumoren richtet und deren Arbeitsfähigkeit, Lebensqualität, Selbstwirksamkeit und psychisches Wohlbefinden fördern soll.

Material und Methoden In einem randomisiert-kontrollierten Design erhalten die Patienten eine Gruppenintervention oder eine sozialrechtliche Beratung. Eingeschlossen werden männliche Patienten mit Kopf-Hals-Tumoren mit hoher psychischer und arbeitsbezogener Belastung. Die Gruppenintervention besteht aus acht Sitzungen. Die Gruppen werden von einer Psychotherapeutin und einem ehemals Betroffenen eines Kopf-Hals-Tumors (sogenannter Peer) geleitet. Die Umsetzbarkeit und Akzeptanz der Intervention wurde anhand einer Pilotgruppe getestet. Die Teilnehmer der Pilotgruppe evaluierten jede Sitzung und wurden nach Abschluss der Intervention in halbstrukturierten Interviews zur Intervention befragt.

Ergebnisse Von 113 Patienten persönlich angesprochenen Patienten nahmen zehn Patienten an einem Screening-Gespräch teil. Davon nahmen vier Patienten an der Pilotgruppe teil. Die Patienten gaben an, dass sich die Gruppenintervention gut mit ihrem Alltag vereinbaren ließe und dass sie die Gruppe insgesamt positiv wahrgenommen hätten. Drei Patienten betonten die Wichtigkeit des Peers.

Diskussion Vor allem der Peers als Identifikationsfigur ist von zentraler Bedeutung. Zur Verbesserung der Rekrutierungszahlen sollen Einschlusskriterien erweitert und der Teilnahmeaufwand reduziert werden.

Abstract

Introduction Despite high distress the majority of head and neck cancer patients does not use any psycho-oncological counselling or psychotherapeutic support. Additionally, patients with head and neck cancer have an increased risk of not returning to work compared to other cancer patients. Therefore, we have developed a group intervention program which aims at improving work ability in patients with head and neck cancer as well as their quality of life, self-efficacy and psychological well-being.

Material and Methods In a randomized controlled trial head and neck cancer patients either receive a group intervention or socio-legal counselling. Male head and neck cancer patients with elevated levels of psychological and work-related distress are included. The group intervention consists of eight sessions. Groups are led by both a psychotherapist and a former head and neck cancer patient (peer). Feasibility and acceptability of the group intervention were tested by means of a pilot group. Each session was evaluated by pilot group participants. Semi-structured interviews were used to assess relevance of content and practicability.

Results 113 patients were personally addressed, of which four patients participated in the pilot group. Patients reported that the intervention fit very well with their daily life and expressed satisfaction with it. Three patients emphasized the importance of the peer.

Discussion The presence of the peer as identification figure seems to be of crucial importance. To increase recruitment numbers inclusion criteria will be modified and participation costs will be reduced.

Schlüsselwörter

Gruppenintervention - Psychoonkologie - Kopf-Hals-Tumor - Arbeitsfähigkeit - Berufsrückkehr

Key words

group intervention - psychooncology - head and neck cancer - work ability - return to work

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