P19.04 Psychosocial counseling in neuro-oncology - analysis of topics and needs of brain tumor patients

Abstract

Objective: In the field of neuro-oncology an increasing focus is being directed towards the psychosocial needs of patients diagnosed with brain tumors. However, it remains challenging to establish psycho-oncological therapies and interventions that meet the specific needs of these patients. Therefore, the aim of this study was to identify major concerns and burdens of brain tumor patients on the basis of our clinical experience. Methods: This retrospective chart analysis included 53 patients attending supportive psycho-oncological counseling at the Department of Neurosurgery, University of Münster between 2010 and 2014. All patients were counseled by the same therapist, a neurosurgeon with specialization in psycho-oncology. Notes were analyzed based on qualitative content analysis. With regard to physical and psychological symptoms, coping strategies and further concerns mentioned by the patients, thematic categories were established. Notes were then assigned to the categories to analyze their frequency distribution and identify the patients’ main concerns. Results: The cohort had a mean age of 48 years. 30 (56.6%) were female. 23 (43.4%) were diagnosed with high grade glioma, 16 (30.2%) with low grade glioma, 10 (8.9%) with a benign brain tumor and 4 (7.5%) had cerebral metastasis. The median number of consultations per patient was 4 (range 1 - 47). During their first consultation, 36 (67.9%) patients listed their physical symptoms and limitations. 40 (75.5%) suffered psychological symptoms, often accompanied by a depressive disorder. The majority of patients expressed issues related to questions concerning meaning of and priorities in life (71.7%), medical topics and questions (62.3%) and death and mortality (56.6%). Furthermore, the following concerns were primarily mentioned: the shock of being diagnosed with a brain tumor, work and occupation, loss of roles and tasks in daily life, family conflicts, reduced mobility, excessive demand and reduced capacity. Concerning coping modes, more patients showed appropriate strategies (including an active attitude toward the disease; 39.6%) than inappropriate strategies, comprising resignation (20.8%) and rumination (18.9%). Concerning psychological symptoms and topics of conversations, there were no significant differences among patients regardless of the dignity of tumor (p= n.s.). Conclusion: These results provide an insight into major concerns and issues that patients diagnosed with a brain tumor are frequently dealing with. Therefore, they can serve as an important basis for the development of psychosocial intervention concepts. No significant differences between the diagnosis groups were found. This suggests that, regardless of prognosis and tumor natural history, the burdens of patients diagnosed with a brain tumor are similar and all patients, despite of their diagnosis, might benefit from psychosocial support.