BackgroundThe diagnosis and treatment of cancer are associated with psychological distress that often leads to a significant reduction in emotional and physical well-being and quality of life. Early detection of psychological distress is therefore important. This study aims to assess the psychological distress of inpatient cancer patients using routine clinical data. Furthermore, variables and problems most strongly associated with psychological distress should be identified.Materials and MethodsN = 1,869 inpatients were investigated (mean age = 60.89 years; 35.94% female) using the National Comprehensive Cancer Network Distress Thermometer and problem checklist to assess distress as well as multiple possible problem areas. Visceral oncological cancer (31.6%) was the most common tumor diagnosis, followed by skin cancer (26.2%) and urological cancer (21.7%).Results65.9% of the sample experienced high levels of distress (Distress Thermometer ≥ 5). Female sex, stage 4 of disease, and visceral and head and neck cancer emerged as risk factors for high distress. A younger age (<65 years) was significantly correlated with higher distress. The most frequently self-reported problems were fears (50.1%), worry (49.9%), and fatigue (49.1%). Patients with all 3 of these problems had 24 times higher risk [odds ratio (OR) = 23.9] for high levels of distress than patients without these problems. Women reported significantly more practical, emotional, and physical problems than men. Younger (<50 years) and middle-aged patients (50–64 years) reported increased levels of practical, family, and emotional problems compared with older patients (≥65 years).DiscussionAlmost two-thirds of the sample reported high levels of distress. The most frequently reported problem areas were emotional and physical problems. These results can help to identify patients with high risk for psychological distress and, therefore, be used to optimize psychosocial and psycho-oncological care for patients with cancer.

BackgroundThe Self-Image Scale is a self-report measure originally developed for use in women with cancer. Two subscales assess appearance satisfaction (self-acceptance) and perceptions of partners' acceptance of their appearance (partner-acceptance). This study aimed to increase the Self-Image Scale's utility by 1) confirming the two-factor structure of the German version of the Self-Image Scale, 2) testing measurement invariance across sex and age groups and validity, and 3) gathering general population normative data. MethodsConfirmatory factor analysis methods were used to examine the proposed two-factor model in a random sample of adults from the general German population (N = 1367). Measurement invariance, scale reliability, and validity were assessed. ResultsThe original factor structure and measurement invariance across sexes and age groups were supported. Women showed significantly lower self-acceptance than men. Adolescent and young adult women showed higher self-acceptance than senior women. For both sexes, partner-acceptance lowered across successive age cohorts. Internal consistencies were good. ConclusionsResults support the use of the German version of the Self-Image Scale in research and clinical practice. Research directions include validation in further diseases, collecting normative data across countries, and dyadic research, particularly exploring partner-acceptance across the life span.

Background and AimsThe relationship between postoperative atrial fibrillation (POAF) and 25-hydroxyvitamin D [25(OH)D] concentration as well as vitamin D supplementation has been discussed controversially. The relation of pre-operative vitamin D status and POAF remains unclear.Methods and ResultsWe analysed the risk of POAF in a prospective, observational cohort study of n = 201 patients undergoing coronary artery bypass graft surgery (CABG) with 25(OH)D concentration. The median age was 66.6 years, 15.4% were women. The median (25th/75th percentile) vitamin D concentration at baseline was 17.7 (12.6/23.7) ng/ml. During follow-up we observed 48 cases of POAF. In age, sex, and creatinine-adjusted analyses, 25(OH)D was associated with an increased risk of POAF, though with borderline statistical significance [odds ratio (OR) 1.85, 95% confidence interval (CI) 0.87–3.92, p-value 0.107], in further risk factor-adjusted analyses the results remained stable (OR 1.99, 95% CI 0.90–4.39, p-value 0.087). The subgroup with vitamin D supplementation at baseline showed an increased risk of POAF (OR 5.03, 95% CI 1.13–22.33, p-value 0.034).ConclusionIn our contemporary mid-European cohort, higher 25(OH)D concentration did not show a benefit for POAF in CABG patients and may even be harmful, though with borderline statistical significance. Our data are in line with a recent randomised study in community-based adults and call for further research to determine both, the clinical impact of elevated 25(OH)D concentration and vitamin D supplementation as well as the possible underlying pathophysiological mechanisms.

Zusammenfassung Ziel Ziel der Studie war die Validierung des 13-Item Pathological Buying Screener (PBS, [1]) in einer klinischen Stichprobe. Methodik Der PBS wurde von 413 therapieaufsuchenden Patient/innen ausgefüllt (pathologisches Kaufen n=151, pathologisches Glücksspiel n=59, Alkoholabhängigkeit n=60, andere psychische Erkrankungen [Angststörung, Depression, Essstörung, somatoforme Störung] n=143). An den Daten der Gesamtstichprobe wurden die Faktorenstruktur des PBS mit einer konfirmatorischen Faktorenanalyse und die Reliabilität mittels Cronbachs α getestet. Aussagen zur Diskriminationsfähigkeit des PBS wurden anhand von Gruppenvergleichen getroffen. Die Gruppe mit pathologischem Kaufen beantwortete weitere Fragebögen, um über Korrelationsanalysen die konvergente und divergente Validität des PBS zu untersuchen. Von einigen Patient/innen dieser Gruppe (n=29) lagen PBS-Summenwerte vor und nach Psychotherapie vor, die zur Einschätzung der Änderungssensitivität des Fragebogens herangezogen wurden. Basierend auf einer Receiver Operating Characteristic (ROC) Analyse mit PBS Daten der Patient/innen mit pathologischem Kaufen und aus einer früheren Bevölkerungsstichrobe [1] wurde ein PBS-Schwellenwert für pathologisches Kaufen ermittelt. Ergebnisse Sowohl das Ein-Faktor als auch das Zwei-Faktor Modell mit den Subskalen „Kontrollverlust/Konsequenzen“ (10 Items) und „Exzessives Kaufverhalten“ (3 Items) zeigten eine gute Modellpassung. Die beiden Subskalen waren stark interkorreliert (r=0,92). Eine hierarchische Regressionsanalyse mit einem anderen kaufsuchtspezifischen Fragebogen (abhängige Variablen) ergabe keine Hinweise auf eine eigene inkrementelle Validität der Subskala „Exzessives Kaufverhalten“. Für den PBS-Summenwert sind eine gute konvergente, divergente und diskriminative Validität gegeben. Der empfohlene PBS-Cut-off Wert von ≥29 [1] ist mit einer hohen Sensitivität (98%) und Spezifität (94,7%) verbunden. Schlussfolgerung Der PBS bildet Kaufsuchtsymptome reliabel und valide ab und eignet sich für die Anwendung im klinischen Bereich.