Die Bedeutung der Arzt-Patient-Kommunikation für die psychische Belastung und die Inanspruchnahme von Unterstützungsangeboten bei Krebspatienten

Zusammenfassung

Eine schlechte Arzt-Patient-Kommunikation hat in der Behandlung von Krebspatienten negative Auswirkungen auf das psychische Befinden der Patienten und verursacht hohe gesundheitsökonomische Kosten. In diesem Review wird der aktuelle Forschungsstand zur Bedeutung der Kommunikation für die psychische Belastung und die Zufriedenheit onkologischer Patienten sowie für die Inanspruchnahme psychosozialer Dienste dargestellt. Besondere Berücksichtigung finden dabei die kommunikativen Präferenzen und Bedürfnisse der Patienten. Für eine gelungene Kommunikation scheint die Passung von patientenseitigen Präferenzen und ärztlichem Verhalten maßgeblich zu sein. Allerdings sind diese von verschiedenen Faktoren abhängig, verändern sich im Krankheitsverlauf und werden im Praxisalltag nur unzureichend berücksichtigt. Deshalb ist es wichtig, die patientenseitigen Präferenzen wiederholt zu erfassen und im Gespräch zu berücksichtigen. Aufgrund einer häufig fehlenden theoretischen Basis sollte die künftige Forschung stärker theoriegeleitet sein. Diesbezüglich wird ein Modell zum Einfluss patientenbezogener Präferenzen auf die Arzt-Patient-Kommunikation, das Wissen über und die Inanspruchnahme von psychosozialen Angeboten unter Berücksichtigung der psychischen Belastung der Patienten entwickelt und vorgeschlagen.

Abstract

A poor doctor-patient-communication in cancer care has negative effects on psychological well being and causes high economic costs. This review analyses the current literature on the impact of communication on distress, satisfaction and utilization of psychosocial services among cancer patients with regard to patients' communication preferences. Crucial to a successful communication seems to be the match of patients' preferences and actual physician's behaviour. However, preferences depend on various factors and can change during the illness trajectory. As preferences often remain unconsidered in everyday practice, they should be assessed repeatedly. For the lack of theoretical foundation, future research should be designed according to theoretical assumptions. In this respect we developed and suggest a model on the impact of patients' preferences on physician-patient-communication, knowledge and use of psychosocial treatment offers that particularly considers psychosocial distress of cancer patients.

Key words

physician-patient-communication - distress - cancer - psychosocial care

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