Norbert Schäffeler

University of Tübingen | EKU Tübingen · Department of Psychosomatic Medicine

Cancer patients suffer from severe distress. About one third show mental comorbidities. Nevertheless, there is no common agreement on how to measure distress or identify patients in need for psychooncological services using screening questionnaires. A sample of N = 206 patients with confirmed breast cancer, being inpatient for surgical treatment, f...

HintergrundEine bedarfsgerechte integrierte Mitbehandlung psychischer Belastungen und Störungen gehört zu den Herausforderungen einer modernen Krebsmedizin. Ohne standardmäßiges Screening auf psychischen Distress bleibt ein großer Teil der versorgungsbedürftigen Krebspatienten unerkannt. Mit der verpflichtenden Einführung von Distress-Screenings in...

Abstract To identify distressed patients in oncology using screening questionnaires is quite challenging in clinical routine. Up to now there is no evidence based recommendation which instrument is most suitable and how to put a screening to practice. Using computer based screening tools offers the possibility to automatically analyse patient’s dat...

Zusammenfassung Die Diagnose des Mayer-Rokitansky-Küster-Hauser Syndroms (MRKHS), eine seltene Variante der weiblichen Geschlechtsentwicklung, wird meist in der Pubertät gestellt. Die Verunsicherung im Selbstbild, die Unmöglichkeit schwanger zu werden führen häufig zu deutlicher Belastung. Obwohl eine psychosomatische Begleitung in der Literatur ko...

Objective Patients with cancer experience significant psychosocial distress. Stressors include interpersonal difficulties like loneliness, isolation, thwarted belongingness, communication impediments, and conflicts. Interventions are required that address their specific psychosocial needs. Interpersonal Psychotherapy (IPT) is a promising concept fo...

Objective The purpose of this study was to review the existing quantitative and qualitative evidence regarding how mindfulness‐based interventions (MBIs) help cope with cancer‐related challenges and increase affected patients' perceived self‐efficacy. Methods A systematic literature search was conducted on PubMed, PsycInfo, PubPsych, and CINAHL. Q...

Background: e-Health interventions are increasing in the field of organ transplantations; however, the literature lacks evidence regarding needs, attitudes, and preferences of organ recipients and donors during the course of an organ transplantation. Methods: In a cross-sectional study, 70 subjects were assessed using self-rated and validated quest...

Cancer causes psychological distress. Approximately one-third of all patients with cancer suffer from distress requiring psycho-oncological treatment. Examining factors contributing to their distress can inform approaches to counteracting them. Among such factors, resilience is considered to be a psychological adaptive capacity resulting from compl...

The possibility of positive psychological changes after cancer, namely, posttraumatic growth, is a growing field of research. Identifying personality traits and coping strategies related to posttraumatic growth may help find vulnerable individuals as well as promote helpful coping strategies to help more patients make positive changes at an early s...

Background In patients with anorexia nervosa (AN), gastrointestinal (GI) symptoms are common and usually improve during or after nutritional rehabilitation. It is unclear when exactly GI symptoms change in the timecourse of treatment and to which extent. In this study, we analyzed the timecourse of GI symptoms and their relation to disease-specific...

Serious games convey information and use interactive components to reinforce and train behaviours. A serious game addressing nutrition, physical activity and stress coping—the Kids Obesity Prevention Program (KOP)—was previously evaluated for efficacy in children. This study aimed at evaluating the KOP-game regarding: (i) its acceptance and efficac...

Background: Psychiatric disorders are common but underdiagnosed in cancer survivors. Research suggests that tumor type has an effect on the prevalence of clinically relevant depression, anxiety, comorbid anxiety-depression and posttraumatic stress disorder (PTSD). Aim: To identify studies that examined the prevalence of clinically relevant level...

Background The coronavirus disease 2019 (COVID-19) pandemic has led to major health-related concerns in the population. Several risk factors for a severe course of COVID-19 disease have been identified, with obesity taking an important role. However, it is unclear whether this association is only known in the expert world or whether individuals als...

Zusammenfassung Funktionelle gastrointestinale Erkrankungen wie das Reizmagen- (funktionelle Dyspepsie, FD) und das Reizdarmsyndrom (RDS) sind stressassoziiert. Die seit 2020 grassierende COVID-19-Pandemie hat Ängste und Stress in der Bevölkerung ausgelöst. Distanzierende Maßnahmen zur Bekämpfung der Pandemie beeinflussen die psychische Gesundheit....

Objectives Female genital malformations may be present in the form of individual entities, they may involve neighboring organs or they may occur in the context of complex syndromes. Given the anatomical structures of the vulva, vagina, uterus and uterine appendages, the clinical picture of malformations varies greatly. Methods This S2k-guideline w...

Objectives Female genital malformations may take the form of individual entities, they may involve neighboring organs or they may occur in the context of complex syndromes. Given the anatomical structures of the vulva, vagina, uterus and adnexa, the clinical picture of malformations may vary greatly. Depending on the extent of the malformation, org...

Objectives Female genital malformations may take the form of individual entities, they may involve neighboring organs or they may occur in the context of complex syndromes. Given the anatomical structures of the vulva, vagina, uterus and adnexa, the clinical picture of malformations may vary greatly. Depending on the extent of the malformation, org...

Background: Due to the COVID-19 pandemic, the healthcare system in general and psychosomatics in particular were forced to change counseling-specific services and break up established structures. At the beginning of 2020, phone as well as videotelephonic counseling options had to be quickly established. Methods: Patients (n = 278) of the department...

Background: The COVID-19 pandemic made it necessary to change established structures of medical counseling services and quickly establish digital counseling formats to ensure continuity of care. In this context, we offered telephone and video-telephonic counseling in addition to traditional face-to-face counseling in the office. Methods: Patient...

Objective Hopelessness and depression are strongly associated with suicidality. Given that physical and psychological outcomes can be altered with hope, hope is a therapeutic goal of increasing importance in the treatment of brain tumor patients. Moreover, it is not yet understood which factors affect the perception of hope in brain tumor patients....

Background: Immune checkpoint inhibitors (ICI) provide effective treatment options for advanced melanoma patients. However, they are associated with high rates of immune-related side effects. There are no data on the distress of melanoma patients during their ICI treatment. We, therefore, conducted a prospective longitudinal study to assess distre...

The Mayer-Rokitansky-Küster-Hauser-syndrome (MRKHS) is characterized by a congenital uterine and vaginal aplasia. A large body of literature reports that a diagnosis of MRKHS has a variety of psychological effects on patients and doubts about female identity. The aim of the underlying study was to detect the patient-reported physical and mental hea...

Der Bereich des „Patient Empowerment“ befasst sich mit dem ergänzenden, aber auch eigenständigen Beitrag der PatientInnen zur Genesung – nicht als Konkurrenz, sondern als Ergänzung und Erweiterung zu dem Leistungsspektrum der Medizin. Initial wurde der Begriff etwa um das Jahr 2000 populär, insbesondere wurde dieser früh von Patienteninitiativen im...

Objective Attachment anxiety and avoidance are known risk factors for the development of unmet needs and poor well-being among patients with chronic diseases. Few studies have addressed this in individuals with cancer. We aimed to explore the relationship between supportive care needs, attachment styles and distress in women with breast and gynecol...

Introduction Although a high percentage of patients with cancer experience severe psychological distress, few of them receive psycho-oncological care, largely due to barriers on the side of patients and healthcare providers that pose great challenges to delivering such care. In response, low-threshold, self-guided eHealth interventions can enable p...

Uterus transplantation (UTx) can provide a route to motherhood for women with Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS), a congenital disorder characterized by uterovaginal aplasia, but with functional ovaries. Based on our four successful living-donor transplantations and two resulting births, this analysis presents parameters relevant to st...

Background:The Mayer-Rokitansky-Küster-Hauser syndrome, MRKHS, is a rare (orphan) disease characterized by theaplasia or hypoplasia of the uterus and the vagina. In women's health research, little is known as to how much careprovision for patients with MRKHS takes into account their socio-demographic together with their clinical characteristics.Thi...

Background Health games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses 3 core topics of nutrition, physical activity, and stress coping. It is the first serious game that extensively targets the dietary energy density principle (DED-P) in relatio...

Hintergrund: Weißer Hautkrebs, der von den Patienten oft nicht als Krebserkrankung verstanden wird, gilt als weniger gefährlich als der schwarze Hautkrebs und wird i.d.R. mittels operativer Exzision des betroffenen Areals kurativ behandelt. Bislang gibt es keine belastbare Studie, welche die Belastung der Patienten bei den oft mehrfachen Operatione...

BACKGROUND Health games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses three core topics of nutrition, physical activity and stress coping. It is the first serious game which extensively targets the dietary energy density principle (DED-P) in rel...

Organ preservation after a clinical complete response to radiochemotherapy is currently one of the most discussed topics in the management of rectal cancer. However, the patient’s perspective has only been poorly studied so far. In this multicenter study, we examined 49 patients with locally advanced rectal cancer. The willingness to participate in...

In rural areas, breast cancer-affected patients still do not receive sufficient psycho-oncological care that addresses their specific needs. As a partial solution, telemedicine and web-based applications (eHealth) can add value to their psycho-oncological care as part of self-management regardless of personnel resources, geographical distance from...

Objective: To report our experience with the screening and selection of potential recipients and living donors of our uterus transplantation (UTx) program. Design: Part of an observational program. Setting: University hospital. Patient(s): Patients with absolute uterine factor infertility (AUFI). Intervention(s): Screening by e-mail and telephone,...

Objective: We investigated how individuals with normal weight (NW) versus individuals with obesity (OB) visually explore human bodies varying in BMI. Methods: 16 OB (BMI 37.5 ± 7.7 kg/m²) and 35 NW (BMI 21.5 ± 1.6 kg/m²) visually explored 35 natural photographs and 25 avatars depicting male and female bodies ranging from normal weight to obesity...

Zusammenfassung Einleitung Während einer Krebserkrankung stellen sich Fragen nach Lebenssinn in neuer Prägnanz. Studien zeigen, dass ein Großteil der Patienten spirituelle Bedürfnisse äußern und Religiosität/ Spiritualität eine wichtige Ressource in der Krankheitsbewältigung sein kann. Bislang liegen zur Entwicklung psychischer Belastung und der Ro...

Purpose: Current S3-guidelines recommend routine distress assessment for all cancer patients. Up to now there is no gold-standard which screening instrument should be used. In previous studies we’ve been able to show a poor accordance of recommended instruments among themselves. This study investigates the accordance with a psycho-oncological exter...

Hintergrund: Um eine bestmögliche psychoonkologische Versorgung zu gewährleisten wird in der seit 1/2014 gültigen S3-Leitlinie Psychoonkologie ein frühestmögliches Screening aller Krebspatienten gefordert. Auf der Grundlage dieser Belastungsmessung sollen behandlungsbedürftige Patienten identifiziert und ihnen eine psychoonkologische Begleitung/ Be...

Background: Over the last decade, a growing body of studies regarding the application of eHealth and various digital interventions has been published and are widely used in the psycho-oncological care. However, the effectiveness of eHealth applications in psycho-oncological care is still questioned due to missing considerations regarding evidence-...

In this chapter we report results from a study on a digital health communication campaign initiated by Children’s Healthcare of Atlanta. This campaign has triggered a highly controversial discussion in the USA, because it used obese children and showed them in online media talking about being stigmatized. Our research is based on the assumption tha...

Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients’ psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are ass...

9514 Background: There is limited data about the impact of melanoma on the psychological burden of patients. Despite some known predictors for distress like female gender or younger age, melanoma stages have not been found being related to distress in melanoma patients and there is no data concerning distress in melanoma patients under systemic tre...

Objective and method: A systematic literature search was conducted to assess the chances and limitations of video games to combat and prevent childhood obesity. This search included studies with video or computer games targeting nutrition, physical activity and obesity for children between 7 and 15 years of age. Results: The study distinguished...

BACKGROUND Over the last decade, a growing body of studies regarding the application of eHealth and various digital interventions has been published and are widely used in the psycho-oncological care. However, the effectiveness of eHealth applications in psycho-oncological care is still questioned due to missing considerations regarding evidence-ba...

Questions of meaning and purpose in life are becoming relevant during cancer. Studies have shown that most patients have spiritual needs and that religion/spirituality can be an important ressource in coping with illness. So far, only few studies examine the psychosocial burden and the role of spiritual needs during the treatment process of patient...

Background Access to highly specialized health care services and support to meet the patient’s specific needs is critical for health outcome, especially during age-related transitions within the health care system such as with adolescents entering adult medicine. Being affected by an orphan disease complicates the situation in several important res...

”Transition programs” domain items ordered according to their gap and priority scores (including original German version). (DOCX)

”Patient participation” domain items listed according to their gap and priority scores (including original German version). (DOCX)

”Needs of and offers to parents and relatives” domain items listed according to their gap and priority scores (including original German version). (DOCX)

”Online-Portal” domain items ordered according to their gap and priority scores (original German version; for English version, see main body). (DOCX)

“Tailored information offers” domain items ordered according to their gap and priority scores (original German version; for English version, see main body). (DOCX)

In rural area cancer‐affected patients still do not receive a psychooncological care which addresses specific needs. On the results of a representative cross‐sectional needs assessment (N = 733), we developed amanualfor a psycho‐oncological web‐based intervention (Make It TrainingMindfulness and s kill bas ed d istress reduc tion in oncology). The...

Current German S3‐guidelines recommend routine distress assessment for all cancer patients. There is no gold‐standard regarding which screening instrument should be used. We've been able to show that the accordance of recommended instruments used for psycho‐oncological treatment indications is poor and their correlation with patients' subjective ne...

Hintergrund Die S3-Leitlinie Psychoonkologie fordert ein routinemäßiges Distress-Screening aller Tumorpatienten, um belastete Patienten gezielt einer weiteren Diagnostik bzw. psychoonkologischen Behandlung zuzuweisen. Bislang gibt es jedoch noch keinen Konsens, welches Instrument hierfür als Goldstandard eingesetzt bzw. wie der Wunsch der Patienten...

Introduction In health services research, there is a special emphasis on the transition from adolescence into adulthood. During this transition period, adolescents change from pediatric to adult medical care. This process must be carefully structured, particularly when special medical care is required. Challenges and difficulties become apparent pa...

Understanding the intermediate- and long-term psychological consequences of genetic testing for cancer patients has led to encouraging research, but a clear consensus of the psychosocial impact and clinical routine for cancer-affected BRCA1 and BRCA2 mutation carriers is still missing. We performed a systematic review of intermediate- and long-term...

Die aktuelle S3-Leitlinie Psychoonkologie empfiehlt ein flächendeckendes wiederholtes Screening zur Erfassung von Distress bei Tumorpatienten. Evidenzbasierte Empfehlungen, welches Instrument zur psychoonkologischen Indikationsdiagnostik am geeignetsten ist, fehlen bislang. Im Zeitalter digitaler Dokumentationssysteme erscheint eine Umstellung von...

Zur Erfassung der Belastung von Tumorpatienten wird in den S3-Leitlinien Psychoonkologie ein Routine-Screening gefordert. Dadurch sollen belastete Patienten identifiziert und gezielt psychoonkologischen Versorgungsangeboten zugewiesen werden. Dieser Prozess gestaltet sich in der Praxis häufig schwierig, die Evidenzlage für ein Screening an sich als...

Background Current S3-guidelines recommend routine distress assessment for all cancer patients. Up to now there is no gold-standard which screening instrument should be used. We’ve been able to show that the accordance of recommended instruments used for psycho-oncological treatment indications is poor and their correlation with a subjective need i...

Hintergrund: Etwa ein Drittel der Krebspatienten leidet komorbid an einer psychischen Störung. Um Risikopatienten rechtzeitig zu identifizieren, werden in der aktuellen S3-Leitlinie Psychoonkologie diverse Instrumente empfohlen. Ferner soll der psychosoziale Unterstützungswunsch erfasst werden. Nach bisherigem Forschungsstand wurde jedoch deutlich,...

Hintergrund Zur Erfassung der Belastung von Tumorpatienten wird in den S3-Leitlinien Psychoonkologie ein Routine-Screening gefordert. Dadurch sollen belastete Patienten identifiziert und gezielt psychoonkologischen Versorgungsangeboten zugewiesen werden. Durch kürzer werdende Liegezeiten steht hierfür in vielen Organkrebszentren inzwischen nur noch...

Fragestellung Die routinemäßige Belastungsmessung bei Tumorpatienten wird in den S3-Leitlinien Psychoonkologie gefordert. Auf der Grundlage des Hornheider Screening Instruments (HSI) sowie des subjektiven Bedarfs wurden psychoonkologische Behandlungspfade definiert. Bislang ist nicht evaluiert, wie gut diese Behandlungspfade den Bedarf der Patiente...

Hintergrund Insbesondere während Chemotherapie scheint in der klinischen Praxis eine hohe krankheitsbedingte Belastung onkologischer Patienten evident. Bislang ist über die Entwicklung der Belastungen im Behandlungsverlauf jedoch nur wenig bekannt. Methoden In der Universitäts-Frauenklinik Tübingen wurde die Belastung von N=48 MammaCa-Patientinne...

Deficits of care exist during the transitional period, when young people with ongoing needs of support to achieve their physical, social, and psychological potential are entering adulthood. This study aims to develop a patient oriented, structured provisional model to improve transitional care for adolescents with Mayer-Rokitansky-Kuester-Hauser-Sy...