Cancer patient's experiences with german health care system
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Cancer Patients' Experiences with the German Health Care System
Impact of COVID-19 on Cancer Care in Germany
Mental Burden and Treatment Delays
The COVID-19 pandemic has significantly impacted cancer care in Germany, leading to increased mental burden among patients and healthcare workers. A study conducted during the first wave of the pandemic revealed that cancer patients experienced high levels of mental stress due to restricted visits, isolation, and delays in treatment. Similarly, another survey found that 55% of cancer patients reported symptoms of anxiety, and 39% reported symptoms of depression, with those experiencing changes in their care plans being more likely to report depressive symptoms. The pandemic has also led to increased stress among healthcare workers, who have had to cope with their own mental and physical burdens while managing patient care .
Changes in Cancer Care and Follow-Up
The pandemic has necessitated changes in cancer care protocols, with 13% of patients reporting alterations in their treatment or care plans. These changes primarily affected follow-up care, monitoring during treatment, and psychological counseling. The need for more time and effort to organize cancer care was reported by 56% of physicians, highlighting the strain on healthcare resources. Despite these challenges, the majority of patients did not experience changes in their cancer care, although the psychological and social burdens remained high.
Barriers to Accessing Cancer Care
Structural and Individual Barriers
Barriers to accessing cancer screening and treatment services in Germany include both structural inadequacies and individual attitudes. Research indicates that age- and gender-specific barriers significantly impact the utilization of cancer-related medical and psychosocial services. These barriers can lead to delays in diagnosis and treatment, ultimately affecting patient outcomes.
Patient-Reported Experience Measures (PREMs)
The use of patient-reported experience measures (PREMs) in oncology is limited in Germany. A study assessing the feasibility of using the German adaptation of the Danish National Cancer Patient Questionnaire found that while the response rate was high, certain questions did not fully capture the German healthcare pathways, particularly those related to the diagnostic process. This highlights the need for tailored PREMs that accurately reflect the patient experience within the German healthcare system.
Psycho-Oncological Support and Quality of Life
Integrated Psycho-Oncological Care
The integrated cross-sectoral Psycho-Oncology (isPO) program aims to reduce anxiety and depression in newly diagnosed cancer patients by providing psycho-oncological care tailored to individual needs. Initial findings indicate that the program is well accepted, with 79.5% of patients expressing satisfaction with their care and 49.3% reporting improved quality of life. This underscores the importance of continuous psycho-oncological support in improving patient outcomes.
Oncological Social Care Project (OSCAR)
The OSCAR project, which involves monthly structured interviews conducted by specially trained Social Care Nurses, aims to improve the quality of life for cancer patients by addressing medical, personal, and social needs. The project is currently being evaluated to assess its impact on patient-reported outcomes, health literacy, and physician-patient communication. This innovative approach highlights the potential benefits of specialized social support in oncology care.
End-of-Life Care and Patient Satisfaction
Aggressive Treatments and Palliative Care
A retrospective study of cancer patients who died in a German university hospital revealed that aggressive treatments are still common at the end of life, particularly among patients with hematologic malignancies. The study emphasizes the need for timely integration of specialist palliative care to ensure high-quality end-of-life care.
In-Patient Experiences
Patient satisfaction with in-patient cancer care is a crucial measure of hospital quality. A survey of skin cancer patients in a German university hospital found that while overall satisfaction was high, there were areas for improvement, particularly in addressing patients' fears and anxieties and providing support for professional and social rehabilitation. These findings highlight the importance of comprehensive care that addresses both medical and psychosocial needs.
Conclusion
The experiences of cancer patients within the German healthcare system reveal significant challenges, particularly in the context of the COVID-19 pandemic. Mental burden, changes in care protocols, and barriers to accessing services are key issues that need to be addressed. Programs like isPO and OSCAR demonstrate the potential benefits of integrated psycho-oncological and social support in improving patient outcomes. Additionally, there is a need for tailored patient-reported experience measures to accurately capture the patient journey and inform quality improvements in cancer care.
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