Dokument: Der Einfluss der Diagnose auf die psychoonkologische Belastung bei neuroonkologischen Patienten: Eine retrospektive Querschnitts-Analyse.

Titel:Der Einfluss der Diagnose auf die psychoonkologische Belastung bei neuroonkologischen Patienten: Eine retrospektive Querschnitts-Analyse.
Weiterer Titel:The influence of the diagnosis on the psycho-oncological burden in neuro-oncological patients: a retrospective cross-sectional analysis.
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=64480
URN (NBN):urn:nbn:de:hbz:061-20240119-105103-7
Kollektion:Dissertationen
Sprache:Deutsch
Dokumententyp:Wissenschaftliche Abschlussarbeiten » Dissertation
Medientyp:Text
Autor: Obermayr, Sarah [Autor]
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Dateien vom 21.12.2023 / geändert 21.12.2023
Beitragende:Prof. Dr. Rapp, Marion [Gutachter]
Prof. Dr. Bielfeld, Alexandra [Gutachter]
Stichwörter:Gliom, Glioblastom, Psychoonkologie, QoL, Lebensqualität, Belastung, EORTC, HADS,
Dokumententyp (erweitert):Dissertation
Dewey Dezimal-Klassifikation:600 Technik, Medizin, angewandte Wissenschaften » 610 Medizin und Gesundheit
Beschreibungen:Trotz maximaler onkologischer Behandlung ist die kurative Therapie eines Glioms weiterhin
nicht möglich. Aufgrund der palliativen Gesamtsituation hat sich ein umfassenderer Blick
auf die Erkrankung entwickelt und die Lebensqualität ist als Therapieziel in den Fokus der
Forschung und Klinik gerückt. Die Belastungen der Erkrankung interagieren mit der
Lebensqualität der Patienten, wobei abhängig von der neuropathologischen Gliom Diagnose
und Graduierung deutliche Differenzierungen hinsichtlich Therapie, Überlebenszeit,
Symptomausprägung oder Erkrankungsalter bestehen
In der aktuellen Literatur gibt es wenige Daten über den Einfluss der neuropathologischen
Diagnose auf die Lebensqualität und Belastung der Patienten. In dieser Arbeit wurden die
psychoonkologischen Aspekte von 62 Gliom Patienten mit der prognostisch günstigsten
Diagnose eines Gliom WHO-Tumorgrad 2 (Gliom_2) und 161 Gliom Patienten mit der
prognostisch ungünstigsten Diagnose eines Glioblastom WHO-Tumorgrad 4 (GBM)
verglichen. Als Messinstrumente wurden der Karnofsky Performance Status (KPS), das
Distress Thermometer (DT), die Hospital Anxiety and Depression Scale (HADS) und die
Lebensqualitätsfragebögen der European Organisation for Research and Treatment of
Cancer (EORTC) verwendet. Zusätzlich wurden patienten- und tumorspezifische Angaben
als mögliche Einflussfaktoren erhoben.
In der vorliegenden Arbeit zeigen sich GBM-Patienten einer signifikant höheren Belastung
ausgesetzt. Insbesondere Depressionen können signifikant ausgeprägter nachgewiesen
werden. Des weiteren kann bei der Primärdiagnose bereits eine signifikant niedrigere
körperliche Konstitution bei Glioblastom Patienten im Vergleich zu Gliom_2 Patienten
festgestellt werden. Korrelierend zeigen sich die motorischen Aspekte des EORTC-QLQC30-
BN20 Fragebogens bei Glioblastom Patienten eingeschränkt. Diese Ergebnisse
bestätigend, zeigt sich darüber hinaus die globale Lebensqualität bei GBM-Patienten als
bedeutend geringer im Vergleich zu Gliom_2 Patienten. Frauen geben in der Kohorte eine
größere kommunikative Einschränkung als Männer an. Ein weiterer negativer Einflussfaktor
auf Depression, Angst und die globale Lebensqualität ist eine vorbekannte psychische
Erkrankung.
Diese Arbeit weist eindeutige Unterschiede in der psychoonkologischen Belastung sowie
der Lebensqualität zwischen GBM und Gliom_2 Patienten nach. Ergänzend ist es in der
Studie gelungen, die jeweils vulnerablen Lebensqualitätsaspekte zu benennen. Ein
Screening der Gliom Patienten in der klinischen Routine stellt sich somit als unerlässlich
heraus, um die individuelle Lebensqualität in der Therapie zu berücksichtigen.

Despite maximum oncological treatment, curative therapy of glioma is still not possible.
Due to the palliative overall situation, a more comprehensive view of the disease has
developed and quality of life as a therapeutic goal has become the focus of research and
clinical practice. The burden of the disease effects with the quality of life of the patients,
whereby depending on the neuropathological glioma diagnosis and grading, there are clear
differentiations regarding therapy, survival time, symptom severity or age of onset.
In the current literature, there are few data on the influence of the neuropathological
diagnosis on the quality of life and burden of the patients. In this study, the psycho
oncological aspects of 62 glioma patients with the most prognostically favourable diagnosis
of a glioma WHO tumour grade 2 (Glioma_2) and 161 glioma patients with the most
prognostically unfavourable diagnosis of a glioblastoma WHO tumour grade 4 (GBM) were
compared. The Karnofsky Performance Status (KPS), the Distress Thermometer (DT), the
Hospital Anxiety and Depression Scale (HADS) and the Quality-of-Life Questionnaires of
the European Organisation for Research and Treatment of Cancer (EORTC-QLQ-C30
BN20) were used as measurement instruments. In addition, patient- and tumour-specific data
were collected as possible influencing factors.
In the present study, GBM patients are exposed to a significantly higher burden. In particular,
depression was found to be significantly more pronounced. Furthermore, a significantly
lower physical constitution can already be determined in glioblastoma patients compared to
glioma_2 patients at primary diagnosis. Correlatively, the motor aspects of the EORTC
questionnaire were found to be limited in glioblastoma patients. Confirming these results,
the global quality of life was also found to be significantly lower in GBM patients compared
to glioma_2 patients. Women than men reported greater communication impairment in the
cohort. Pre-existing mental illness showed to be another negative factor influencing
depression, anxiety and global quality of life.
This work demonstrates clear differences in psycho-oncological burden as well as quality of
life between GBM and glioma_2 patients. In addition, the study succeeded in identifying the
respective vulnerable quality of life aspects. Therefore Screening of glioma patients in
clinical routine is essential in order to take the individual quality of life into account in the
therapy.
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Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:19.01.2024
Dateien geändert am:19.01.2024
Promotionsantrag am:13.07.2023
Datum der Promotion:14.12.2023
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