Psychosocial Situation Research Articles

Burnout syndrome in Primary Health Care.

The labor situation is considered essential for social follow-up; however, the contradiction between its importance and the psychic changes it can cause to workers should be considered. To check the presence of burnout syndrome in Primary Health Care workers in a municipality in the interior of the state of São Paulo and to check the association with the sociodemographic and labor data of these workers. Exploratory cross-sectional and quantitative study with 74 workers and developed from July to October 2020. Data were collected using an instrument for sociodemographic and labor characterization and for measurement of the syndrome, the Oldenburg Burnout Inventory already validated in Brazil. Descriptive statistics, frequency, percentage, measures of central tendency and dispersion were used; Fisher's exact test was applied to check the association between the studied variables and the burnout syndrome, considering the significance level of p < 0.05. The obtained data were discussed using the existing literature. Among the participants, 20.3% had no changes, 18.9% showed distance, 16.2% had exhaustion, and 44.6% had burnout syndrome. There was statistical significance for the variable unit of work (p < 0.014). The importance of studying labor mental health in Primary Health Care is because of the constant exposure of workers to psychosocial risk situations in social settings and their instabilities. Knowledge of the conditions allows for intervention actions in the environments and makes it possible to face the problems.

Comparison of the Psychological Impact of COVID-19 on Self-Employed Private Healthcare Workers with Respect to Employed Public Healthcare Workers: Three-Wave Study during the COVID-19 Pandemic in Spain

(1) Background: Coronavirus disease, also called COVID-19, is a worldwide pandemic with a major impact on all aspects of the individual (health status, psychological, and economic aspects, among others). The perception of health professionals in this situation has been influenced by their economic and psychosocial situations. On the economic level, self-employed workers have no state subsidies, with the added disadvantage of not having sufficient means to cope with contagion. This could potentially have an impact on their health and indirectly on their family members, creating additional stress. The aim of this study was to determine whether there are differences in the level of anxiety of health professionals working in private practice compared to healthcare workers working in public institutions during the first three waves of COVID-19. (2) Methods: A cohort study on 517 subjects comparing anxiety between a group of health workers and a group of health professionals working in the public sector at three key moments during the pandemic was performed. (3) Results: Statistically significant differences were found between self-employed private health professionals compared to those working as public health workers. The perception of impact was worse in the self-employed; however, a higher level of anxiety was evident in public employees in all assessed domains (cognitive, physiological, and motor, p = 0.001). (4) Conclusions: There were significant changes when comparing the first phase between both groups; employed public healthcare workers manifested a sense of lower risk of COVID-19 contagion than privately employed professionals, who had a higher level of anxiety. In the second and third waves, negative feelings improved for both groups, and the fear of showing anxiety to the patient decreased over the course of the waves.

The psychosocial situation of families caring for children with rare diseases during the COVID-19 pandemic: results of a cross-sectional online survey

BackgroundThe COVID-19 pandemic is affecting many areas of life and has posed additional strains on the highly vulnerable group of caregivers of children with rare diseases (RDs). The psychosocial situation of the family caregivers deserves more attention, both in research and practice. The current study explores the distress level of caregivers of children with RDs, their psychosocial information needs, and caregiver-reported health-related quality of life (HRQoL) of children with RDs in times of the COVID-19 pandemic.MethodsData from a cross-sectional online survey conducted within the German CARE-FAM-NET project (children affected by rare diseases and their families-network) between March and August 2020 were examined. The study sample included 149 family caregivers, mostly mothers (83.2%) of 167 children with RDs. The survey assessed demographic and disease-related characteristics, distress and everyday problems of caregivers (Distress Thermometer for Parents; scale 0–10), psychosocial information needs (self-developed items; scale 0–100), and caregiver-reported HRQoL of the children with RDs (DISABKIDS Chronic Generic Measure, short-form; scale 0–100). Using descriptive statistics, we analyzed the psychosocial situation of families during the COVID-19 pandemic. We further conducted correlation analysis to investigate interrelations.ResultsThe distress level among caregivers was high (M = 6.84, SD = 2.43); 89.6% reported clinical distress (≥ 4). Everyday problems (e.g., sleep problems, fatigue, being out of shape, fears, feeling tense or nervous, and worry) were frequent. Caregivers reported a wide range of psychosocial information needs. In about half of the children (49.5%), caregiver-reported HRQoL was low, while average HRQoL (M = 58.7, SD = 19.5) was comparable to parent-reported norm data of children with severe clinical conditions. Distress correlated positively with psychosocial information needs (r = 0.40), and negatively with the caregiver-reported HRQoL of the children (r = − 0.46).ConclusionsThis study indicates a high psychosocial burden on family caregivers of children with RDs during the early COVID-19 pandemic, characterized by high distress levels and wide-ranging everyday problems, unmet psychosocial information needs, and reduced caregiver-reported HRQoL in children with RDs. The findings highlight the ongoing need for target group-specific, low-threshold support services (e.g., websites) during and after the pandemic.

Improving Care for People Living With Dementia and Diabetes: Applying the Human-Centered Design Process to Continuous Glucose Monitoring.

People with Alzheimer's disease or related dementias and diabetes mellitus (ADRD-DM) are at high risk for hypoglycemic events. Their cognitive impairment and psychosocial situation often hinder detection of hypoglycemia. Extending use and benefits of continuous glucose monitoring (CGM) to people with ADRD-DM could improve hypoglycemia detection, inform care, and reduce adverse events. However, cognitive impairment associated with ADRD presents unique challenges for CGM use. This commentary proposes applying the human-centered design process to CGM, investigating design solutions or interventions needed to integrate CGM into the health care of patients with ADRD-DM. With this process, we can identify and inform CGM designs for people with ADRD-DM, broadening CGM access, increasing detection and treatment of the silent threat posed by hypoglycemia.

QOL-23. TOWARDS PATIENT-REPORTED OUTCOME ASSESSMENT IN THE MOLECULAR TUMOR BOARD – CANCER PATIENTS UNDER TARGETED THERAPY: APP-BASED ASSESSMENT OF PATIENT-REPORTED OUTCOMES (TRACE)

Abstract Comprehensive genomic profiling and biomarker-based therapeutic strategies are currently used in clinical trials and in innovative health care systems including the center for personalized medicine network. Systematic assessments of patient-reported outcomes are warranted to gain insight into the perspective of patients and their relatives during biomarker-based therapies. In the present study, we focused on health-related quality of life (HRQoL), psychosocial situation, and physical symptoms in patients treated at the Center for Personalized Medicine Tübingen. First, we retrospectively evaluated symptom burden of n=265 (neuro-)oncological patients in the Molecular Tumor Board (MTB). Sixty percent of patients reported at least 1 neurological symptom, and psychosocial burden/unmet needs were high (overall 156/265; 59%, patients with malignant tumors n=86/106; 81%, Fisher’s exact, p &amp;lt; 0.0001). We therefore developed an app by 14 expert rounds and pretesting including validated assessments of HRoL, symptom und psychological burden and tested it in a pilot study. We conducted a structured interview with users 3 months afterwards to assess the app’s usability and feasibility. The interview was transcribed and analyzed according to a qualitative content analysis. So far, a total of 10 patients and caregivers have been enrolled in this pilot study. They reported that (i) the app is compatible with their daily routine (median 9.3, range 0-10), that (ii) they are more aware of their health status, which was rated as positive, and that (iii) completing app-based questionnaires was easier compared to paper questionnaires. Two patients reported technical problems, which were resolved timely. The pilot study proved feasibility and acceptance of the app. The app might optimize symptom burden assessment, adapted to the patients’ profiles. The next step is to prospectively compare HRQoL before and after start of targeted therapy in a multicenter study.

Stress among healthcare workers during the COVID-19 pandemic and the determinant factors: a cross-sectional study

BACKGROUND During the COVID-19 pandemic, there has been an increase in workload, as well as greater vigilance and compliance at work. Healthcare workers must perform their duties while facing the fear of COVID-19, which can trigger and/or aggravate stress. This study aimed to obtain the determinant factors of stress among healthcare workers during the pandemic by emphasizing the change in the psychosocial situation at the hospital.&#x0D; METHODS This cross-sectional study was conducted from January to March 2021 using an online questionnaire consisting of personal and occupational questionnaires, as well as the validated stressor and stress questionnaires using validity and reliability tests (Cronbach’s alpha 0.8 and 0.9). For the multivariate analysis, multiple logistic regression was used to identify the determinant factors (p&lt;0.05). Data were analyzed using SPSS software version 20 (IBM Corp., USA).&#x0D; RESULTS Determinant factors of the occurrence of moderate–severe stress were the alteration of stressors including age (aOR = 1.9), working hours (aOR = 1.9), work zone (aOR = 2.7), limited facilities and resources (aOR = 6.2), risk of disease transmission (aOR = 0.3), and personal work demands (aOR = 2.1).&#x0D; CONCLUSIONS In addition to the younger age, the determinant factors of the incidence of moderate–severe stress in healthcare workers during the COVID-19 pandemic at the hospitals were work-related conditions. However, they remained controllable to prevent stress among healthcare workers in the peak load work situations such as a pandemic.

How Did Corona Crisis Managers in Germany Make Sense of the Psychosocial Situation?

Alongside its immediate consequences for physical health, the current Coronavirus pandemic and the associated containment measures have led to multiple psychosocial consequences for the population. While virus containment is the main motive of crisis management, there is, so far, little evidence on how crisis management actors consider findings about the psychosocial state of the German population. This paper therefore examines the role of psychosocial consequences within the work of crisis management organizations during the Corona pandemic in Germany. Against the theoretical background of the sensemaking concept, 14 qualitative interviews were conducted with decision-makers from municipal and state administrations, public health departments, aid organizations, and critical infrastructure organizations. Our results indicate that crisis managers perceive aspects related to the psychosocial situation as relevant, but in a very selective way. They use different and often non-scientific sources to acquire knowledge about the psychosocial consequences. In sum, these aspects do not play a major role in decision-making processes. We argue that the perception and processing of psychosocial consequences depend in particular on the organizational context such as goals, plausibility assumptions, identity conceptions, and problem frames. In order to extend theoretical models of psychosocial crisis management, more detailed knowledge of sensemaking processes in crisis management organizations is necessary.

Associations between Psychological Variables, Knowledge, Attitudes, Risk Perceptions and Health Behaviours towards COVID-19 among Adolescents

There is currently little scientific evidence available that allows us to understand patterns of knowledge, risk perception, attitudes, and behaviours among adolescents in relation to COVID-19. This study aims to analyse the relationship between knowledge about COVID-19, risk perception, and psychological variables and the adherence to preventive measures among the adolescent population. It is a descriptive cross-sectional study, which included adolescents between the ages of 12 and 18 (n = 354). The questionnaire was sent to several secondary schools chosen by convenience sampling and following a non-probabilistic snowball sampling. Descriptive, univariate, and multivariate analyses were carried out in order to determine whether knowledge about COVID-19, risk perception, tolerance of frustration, planning and decision-making, family functionality, self-efficacy, self-esteem, and social skills are related to preventive measures. The adoption among adolescents of behaviours which protect them against COVID-19 depends on knowledge about the disease, the perception of the risk it poses to them, as well as their tolerance of frustration and planning and decision-making abilities. The relationship between the individual variables among adolescents with the adoption of behaviours which protect them against COVID-19 has been confirmed. The development of intervention and communication strategies that take the psychosocial situation of adolescents into account will help to increase the adoption of protective health behaviours in the context of a pandemic.

미혼모 가정 아동의 심리 발달에 대한 고찰과 치료적 제언

Objectives The purpose of this study is to examine the psychological development of children of single mothers through psychodynamic theory and to provide therapeutic suggestions. Methods For this purpose, first, the psychosocial experiences of single mothers were analyzed. Second, the psychological development of children of single mothers was analyzed based on Freud's psychoanalytic theory, Object Relations theory, and Attachment theory. Third, PCIT (Parent-Child Interaction Therapy) was proposed as an alternative intervention to promote the healthy psychological development of children of single mothers. Results Single mothers have physical, psychological, and social vulnerabilities for raising their children alone in the absence of a partner. From the perspective of psychodynamic theory, the psychosocial situation of single mothers acts as a limiting point for their children's psychological development. Therefore, it is necessary to understand the uniqueness of psychological development of children of single mothers, and psychosocial interventions supplementing for their vulnerabilities are required. Conclusions Finally, the implications were introduced, and follow-up studies were suggested based on these findings.

Prospective Associations of Lifetime Post-traumatic Stress Disorder and Birth-Related Traumatization With Maternal and Infant Outcomes.

ObjectiveMany women experience traumatic events already prior to or during pregnancy, and delivery of a child may also be perceived as a traumatic event, especially in women with prior post-traumatic stress disorder (PTSD). Birth-related PTSD might be unique in several ways, and it seems important to distinguish between lifetime PTSD and birth-related traumatization in order to examine specific consequences for mother and child. This post-hoc analysis aims to prospectively examine the relation of both, lifetime PTSD (with/without interpersonal trauma) and birth-related traumatization (with/without postpartum depression) with specific maternal and infant outcomes.MethodsIn the prospective-longitudinal Maternal in Relation to Infants' Development (MARI) study, N = 306 women were repeatedly assessed across the peripartum period. Maternal lifetime PTSD and birth-related traumatization were assessed with the Composite International Diagnostic Interview for women. Maternal health during the peripartum period (incl. birth experience, breastfeeding, anxiety, and depression) and infant outcomes (e.g., gestational age, birth weight, neuropsychological development, and regulatory disorders) were assessed via standardized diagnostic interviews, questionnaires, medical records, and standardized observations.ResultsA history of lifetime PTSD prior to or during pregnancy was reported by 25 women who indicated a less favorable psycho-social situation (lower educational level, less social support, a higher rate of nicotine consumption during pregnancy). Lifetime PTSD was associated with pregnancy-related anxieties, traumatic birth experience, and anxiety and depressive disorders after delivery (and in case of interpersonal trauma additionally associated with infant feeding disorder). Compared to the reference group, women with birth-related traumatization (N = 35) indicated numerous adverse maternal and infant outcomes (e.g., child-related fears, sexual problems, impaired bonding). Birth-related traumatization and postpartum depression was additionally associated with infant feeding and sleeping problems.ConclusionFindings suggest that both lifetime PTSD and birth-related traumatization are important for maternal and infant health outcomes across the peripartum period. Larger prospective studies are warranted.ImplicationsWomen with lifetime PTSD and/or birth related traumatization should be closely monitored and supported. They may benefit from early targeted interventions to prevent traumatic birth experience, an escalation of psychopathology during the peripartum period, and adverse infant outcomes, which in turn may prevent transgenerational transmission of trauma in the long term.

Decision Making in the Context of Paediatric Solid Organ Transplantation Medicine.

This manuscript aims to outline ethical, legal, and psychosocial key situations in the context of transplantation under special consideration of children. Besides being particularly vulnerable, children as minors by law are not meant to consent to whatever medical procedure is applied to them. Rather their next-of-kin and medical staff are to decide. In the context of transplantation thus it needs to be reflected under which circumstances a child can become an organ donor or receive an organ. This essay will not provide answers to current questions in transplantation medicine but provide an overview of present European practices and juxtapose divergent courses of action which are based on an assumed similar social-cultural background. Data are drawn from a systematic comparison of the various national organ transplantation laws and tissue acts. Ethical reflections are based on a thematically targeted literature search using PubMed Central and PhilPapers databases.

Gemeinsamkeiten und Unterschiede in der spezialisierten ambulanten Palliativversorgung von Erwachsenen sowie Kindern und Jugendlichen: Ergebnisse aus Fokusgruppendiskussionen mit Leistungserbringer*innen

BackgroundIn Germany, people with life-limiting conditions and complex symptoms are eligible for specialized outpatient palliative care (SOPC). Requirements, delivery and goals of SOPC have been laid down by the Federal Joint Committee in a nationwide guideline. The guideline emphasizes the need to consider the special needs of children and adolescents with life-limiting conditions. A specification of these needs has so far been missing. The focus group discussion presented here aimed at investigating similarities and differences between the specialized outpatient palliative care of adults (SOPC for adults) on the one hand, and children and adolescents (SOPPC) on the other hand, from the perspective of health care professionals in order to further define specifics of SOPPC. MethodIn three focus group discussions a total of 11 nursing and 8 medical professionals from SOPC for adults and SOPPC engaged in face-to-face discussions on the similarities and differences of both care forms. Discussions were designed openly and stimulated with three guiding questions only. Focus group discussions were audio-recorded, transcribed verbatim and analyzed by thematic analysis supported by the software MAXQDA. ResultsWithin the following six themes, similarities as well as key differences between SOPC and SOPPC were identified: the participants discussed diseases, coverage area and locations, therapy goals, the psychosocial care situation, the role of relatives and end-of-life care. From the participants’ perspective different underlying diseases constitute a main difference that causes further differences in the expertise required. Furthermore, SOPC for adults and SOPPC differ in the dimension of areas covered by one team, the number of patients per team and the reasons for SOPC visits. Differences in terminal care and the mourning process within the team became evident. Some similarities existed regarding goal-setting, psychosocial care and the role of relatives, but concrete patterns and the importance of these aspects differed because a particularly complex and emotional communication is required when a child is dying. ConclusionFrom the perspective of health care professionals, SOPC for adults and SOPPC differ with regard to underlying diseases as well as care patterns such as collaboration with relatives and their need for psychosocial support. Therefore, the care for children, adolescents and young adults with life-limiting conditions and pediatric diseases all over Germany should be delivered within the frame of an independent care structure by teams whose members possess specific pediatric expertise.

“Protect, test, vaccinate”: dealing with Covid-19 in outpatient psychiatric care

IntroductionCurbing the spread of the coronavirus and stabilizing the overall psychosocial situation requires compliance with preventive measures: “Protect, test, vaccinate”.ObjectivesPopulation groups with psychosocial problems which are difficult to reach and have a high risk of infection, morbidity and mortality as well as unfavorable help-seeking behavior and generally lower vaccination rates need support.MethodsIn the outpatient psychiatric facilities of the Psychosocial Services in Vienna (PSD-Wien), specific concepts to support “protect, test, vaccinate” were implemented to protect patients and employees. Information about the benefits and risks of vaccination, relieving fears and support in registering and attending vaccination appointments were of special significance.ResultsAnalyzes of selected data from 1,319 patients at PSD-Wien show (period: 1st half of 2021) that these measures made it possible to achieve a significantly higher vaccination willingness in people with severe mental illnesses (84 %) than in the general Austrian population (based on the date of examination, currently approximately 60 %). The same applies to vaccination rates: at least 47 % have received a partial vaccination, of which about half have already received both partial vaccinations.ConclusionsHigh vaccination willingness and rates as well as the necessary protection (wearing masks, keeping distance, complying with hygiene rules) and regular testing must not be a phenomenon of privileged population groups. Psychosocial support is needed so that the trilogy “Protect, test, vaccinate” becomes possible for everyone, including people with severe mental illnesses. Social psychiatry is not just about mental health, but also about physical health care and prevention.DisclosureNo significant relationships.

THE EFFECT OF THE COVID-19 PANDEMIC ON THE EDUCATION AND PSYCHOSOCIAL STATUS OF SECONDARY SCHOOL STUDENTS: THE CASE OF ISTANBUL

In the Covid-19 pandemic, which has affected the whole world, education has been suspended in Turkey as of March 16, 2020, and then it has been decided to switch to online (distance) education. The transition to distance education during the pandemic process has affected children's physical, cognitive, psychosocial and all other developmental areas, and various changes have occurred in the content and functioning of the education provided. The purpose of this research is to examine the impact of the Covid-19 pandemic on the education and psychosocial status of secondary school students. This research is a qualitative study. Individual in-depth interview technique was used as the data collection method. In this context, face-to-face and online in-depth interviews lasting 30-60 minutes were conducted with 12 secondary school students studying in Istanbul, in line with the semi-structured questionnaire, with the consent of their families. The data obtained from the interviews were deciphered and evaluated with descriptive analysis and content analysis. MAXQDA computer software was used to analyze the data. Among the participant statements, four main themes and 23 codes were formed: "online education, social life, routines (activities of daily living) and mood". As a result of the analyzes made, it was seen that the educational experiences and psychosocial situations of the students were generally negatively affected by the pandemic process.Students studying at secondary school level in Istanbul participating in the research; They stated that they want to go out of the house and go back to their lives before the pandemic, that they wake up later in the mornings during the distance education process, and that they eat irregularly compared to before the pandemic. In addition, they stated that their study patterns and coursework changed, the efficiency of the lessons decreased, they had problems in the lessons due to technological inadequacies and their stress levels increased due to these problems, they spent more time with their families during the pandemic process and they experienced distraction from their siblings at home. It is recommended to switch to face-to-face training by taking the necessary precautions.

Validation of the psychometric properties of a "Modified Version of the Hornheider Screening Instrument" (HSI-MV) using a sample of outpatient and inpatient skin tumor patients.

The basis for adequate psycho-oncological care is the identification of patients with psychosocial support needs. The German Working Group for Psychooncology also recommends the Hornheider Screening Instrument (HSI) for this purpose. The question, "Is anyone in your family particularly burdened by the hospital stay?" is intended to capture disease-related family stress. But is this item equally suitable for outpatients and inpatients? The study objective was to examine how replacing the original item affects the test performance of this modified version of the HSI and the frequency of psychosocial stress. 92 outpatients and 98 inpatients with skin tumors assessed their psychosocial situation using different questionnaires. Compared to inpatients, less than half as many outpatients answered the item in the affirmative. If the question was replaced by: "Is someone in your family particularly burdened by your disease or the course of the disease?" this setting-related difference did not arise. The "Alternative item" and the "Modified version of the HIS" (HSI-MV) proved to be superior to the original item and the original HSI with regard to all examined criteria. The HSI-MV can be used as a reliable and valid instrument for the systematic assessment of psychosocial care needs in outpatient and inpatient settings. Depending on care capacity, a threshold of ≥5 or ≥4 is appropriate. In addition to screening, the desire for support should be enquired.

On prophets and disciples: the case of Osho.

In times of crisis, prophets tend to emerge in different realms including that of religion. This paper undertakes a Jungian analysis of the phenomenon presented between spiritual leader Osho and his disciples in the 1970s and 1980s, as an example of the risks entailed in the type of group process where leader and followers inadvertently identify with the collective archetypes of prophet and follower. Psychosocial situations that predispose the appearance of prophets are analysed, and cases of collective suicides in recent decades are recalled. The paper also highlights the intervention of another psychological phenomenon: the conflict between the ethics of individuals versus that of groups, since large groups produce a decrease in responsibility and individual ethics.

Children with cancer and their families after active treatment: analyses of biopsychosocial needs and implications for healthcare – a study protocol

IntroductionPatients and families affected by paediatric cancer experience psychosocial burden not only during active treatment but also during follow-up care. Use of health services during follow-up treatment should be organised...

Crime against a minor and dissociative phenomenon due to the combined effect of toxic consumption by the offender

The casuistry deals with an aggressor with a long history of the combined consumption of toxic substances of cocaine and alcohol, who perpetrated the murder of a minor under 13 years of age. The victim was assaulted while she was going down the stairs of a block of flats and was taken, against her will, to the aggressor's home.&#x0D; Regardless of the motive for the assault, the perpetrator restrained the victim, choked her with a dog leash until she asphixiated. Subsequently, he gave her multiple postmortem puncture wounds with a knife, one of which was a grave stab into the left ear (breaking the knife, with the blade remaining inside the auditory organ) and another wound in the left chest. In the autopsy, the introduction of a ballpoint pen into the minor's trachea was also appreciated.&#x0D; The aggressor, who was evaluated directly by the writer, stated that, although aware of his conduct "because he was told a posteriori of the consequences of his actions", he maintained that he had no recollection of the alleged events.&#x0D; Likewise, he stated that he was in a critical and/or adverse psychosocial situation due to the recent death of his mother and that, due to this, the pattern of use and abuse of toxic substances (cocaine and alcohol) had increased.

The impact of cancer on the mental health of patients parenting minor children: A systematic review of quantitative evidence.

To provide an overview of quantitative data on the impact of cancer on the mental health of patients parenting minor children. We focused on mental health outcomes, their levels and prevalence, and applied measurement tools. MEDLINE, CINAHL, PsycInfo and Web of Science were searched up to March 2021. We included quantitative studies, published in a peer-reviewed journal and reporting outcomes on the mental health (e.g., depression, anxiety) of cancer patients parenting minor children (≤ 21years). Study quality was assessed based on the National Institute for Health assessment tool for observational studies. This study is registered on PROSPERO (CRD42019141954). A total of 54 articles based on 36 different studies were included in this systematic review. Studies differ markedly regarding study and sample characteristics (e.g., outcome measures, sample size, parental health status). Depression and anxiety levels range from normal to abnormal, according to applied measurement tools. 7%-83% of parents with cancer have depression scores indicating probable depression and 19%-88% have anxiety scores indicating anxiety disorder. This review reveals the dimension of mental burden affecting cancer patients parenting minor children. To identify, address and timely treat potentially arising mental health problems and support needs, affected parents should be closely monitored by healthcare professionals and referred to specialized support offers, if necessary. In the context of a comprehensive patient- and family-oriented care, it is highly relevant to integrate mental health (including parental) issues routinely into oncological care by proactively asking for the patient's psychosocial situation and the family status.

Salivary testosterone, testosterone/cortisol ratio and non-verbal behavior in stress

The relationship between hormone release and non-verbal communication under stress conditions is still not sufficiently explored. The aim of the present study was to test the hypothesis that salivary testosterone concentrations and testosterone/cortisol (T/C) ratios correlate positively with assertive behavior representing a non-aggressive form of dominance during an acute stress situation. As a stress model, a socially evaluated cold pressor test was investigated in healthy men. The non-verbal behavior was analyzed according to the ethological coding system for interviews described by Troisi (1999). Salivary testosterone concentrations did not change throughout the stress test. The T/C ratios decreased significantly over time only in subjects showing high stress perception. The duration of affiliative and the frequency of flight behavior was higher in subjects with high stress perception compared to those with low stress perception. A significant positive correlation between the duration of prosocial behavior and values of T/C ratios was found in the whole sample. The area under the curve values of testosterone positively correlated with the duration of assertive behavior in the group with high stress perception and negatively in the other group. Our findings allow suggesting that the changes in non-verbal behavior during acute psychosocial stress situations may be more pronounced in subjects showing high stress perception. Obtained results motivate further research on a better understanding of the consequences of the lack of sense of full facial expressions, such as wearing face masks, on the balance between hormones and non-verbal behavior under stress conditions.