Aufklärung zur Strahlentherapie: Patientenerwartungen und Auswirkung auf das Erleben der Strahlenbehandlung

This study deales with patient education in radiotherapy. It was a cohort study with repeated measurements (before and after counseling and at the end of therapy). The cohort consisted of cancer patients undergoing ambulatory radiotherapy at the university hospital Marburg. From a cohort of n=137 consecutive patients a total of n=63 completed the study. We used mainly stadardized questionnaires. Our study sample was not significantly different froim the rest of the cohort with regard to basic demographic (age/gender) and clinical criteria (diagnosis and therapeutic approach). Almost 50% had already collected some information about radiotherapy before attending the clinic. Main sources of information were physicians, relatives and friends. The intenet was not used very often. Main concerns of the patients were illness (49 %), side-effects (22%). Most patients associated neutral, 32% positive (cure and hope) and 29 % negative (cancer, fear) aspects with radiotherapy. 25% indicated that gaining information was the most important aim in the talk with the radiotherapist, for 19 developing trust was the most important issue. Emotional aspects such as reducing anxiety, calming down or giving hope were mentioned considerably less often. In 84% of the cases gaining information and developing trust was achieved. 73% were very, 27 only moderately satisfied with doctor-patient-communication. Recall for technical information (duration of therapy, side-effects) was very good. Concerning chances of cure aim of the therapy many patients had unrealistic ideas. 84 % expected that radiotherapy would cure them, although 60% had a curable disease. Comparing the quality of life of our sample before therapy with norm data showed that the patient sample was considerably impaired. Particulary strong differences were found with regard to role functioning, social functioning, fatigue and sleeplessness. Correlations indicated that overall satisfaction with the counseling was inversely correlated with side-effect-scores, loss of appetite and feelings of panic and loneliness during the course of therapy. In other words: The better the counseling the less detrimental effects of radiotherapy. We also were interested in more specific evaluations of the counseling such as getting information and trust. The feeling of being well informed was significantly correlated with low scores in side-effects, no loss of appetite and no feelings of panic. Trust was significantly correlated with little side-effects, no loss of appetite and no feelings of panic. In order to rule out influence of confounding variables (such as age, gender, diagnose) hierarchical regession analyses were performed. In all cases the decisive variable for explaining the variance was the evaluation of counseling. Comparing curative and palliative patients we found that for the latter gaining trust was the most important aim during the consultation. Effects of satisfaction with the doctor-patient-communication were less obvious, but a good communication could help to reduce loneliness during therapy.