Integration der Lebensqualitätserfassung in den Versorgungsprozess

108 of 421 patients undergoing radiotherapy for malignancies of abdominal and/or pelvic origin participated in this study about quality of life and its changes over time. METHODS: Patients were asked to answer a battery of questionnaires which included the FACT-G, SDS, SSS, FKV, FBK and FLZ combined with questions about their living situation, radiotherapy side effects and need for additional support. Points in time were the first week of radiation therapy (T1), the end of therapy (T2), six weeks (T3) and six months (T4) after radiation. RESULTS: Participants are younger, less depressed, have a better overall performance status and require less additional support than patients refusing or dropping out of the study. Significant changes show in some scores and subscores as there are the physical and overall qol and the relationship with the doctors (FACT-G), physical, social and overall distress (FBK), active coping-style (FKV) and satisfaction with health status (FLZ). Patients prefer asking for information and speaking with their doctors. One third tends to deny to profit from psychotherapeutic interventions. Factor analysis shows six main domains influencing quality of life : social support, physical and social distress, emotional distress, financial satisfaction, social satisfaction and denying coping strategies. DISCUSSION: Participants belong to a well selectioned group with good physical and psychosocial resources. They require nevertheless additional support and admit in most of the cases to profit of talks with psychologists. It has to be supposed that non-participating patients are even more in need of such help. Cluster analysis supposes that desire for psychological support is specific for distressed and dissatisfied patients. Further evaluation of the economic benefits of individual psycho-oncologic prevention is needed. A short scoring questionnaire using six main items of qol should help physicians to prevue the patients need and aptity for psycho-oncologic interventions as for example individual psychotherapy, group therapy and support of the family and medical staff.