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Laryngorhinootologie 2019; 98(03): 175-182
DOI: 10.1055/a-0829-6885
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

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

A group intervention to promote work ability in patients with head and neck cancer
Laura Broemer
1   Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
,
Peter Esser
1   Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
,
Susan Koranyi
1   Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
,
Michael Friedrich
1   Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
,
Katja Leuteritz
1   Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
,
Susanne Wiegand
2   HNO-Universitätsklinik, Universitätsklinikum Leipzig
,
Andreas Dietz
2   HNO-Universitätsklinik, Universitätsklinikum Leipzig
,
Andreas Boehm
3   Klinik für Hals-, Nasen-, Ohrenheilkunde, Städtisches Klinikum Sankt Georg Leipzig
,
Friedemann Pabst
4   Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Plastische Operationen, Städtisches Klinikum Dresden Friedrichstadt
,
Bernhard M. Strauß
5   Institut für Psychosoziale Medizin und Psychotherapie, Universitätsklinikum Jena
,
Orlando Guntinas-Lichius
6   Univ. HNO-Klinik, Jena
,
Anja Mehnert
1   Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
› Author Affiliations
Further Information

Publication History

09/21/2018

12/21/2018

Publication Date:
24 January 2019 (online)

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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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