Zusammenfassung:Hintergrund: Personalisierte Krebstherapien in Form einer Epidermal Growth Factor Receptor-Antikörpertherapie (EGFR-Antikörpertherapie) haben sich bei bestimmten soliden und metastasierten Tumoren als Therapieoption etabliert. Toxische Hautreaktionen zählen zum charakteristischen Nebenwirkungsspektrum dieser Therapien. Ziel: Erfassung des Ausmaßes, in welchem therapieinduzierte Hautreaktionen auf die Lebensqualität von onkologischen PatientInnen im Rahmen einer EGFR-Antikörpertherapie Einfluss nehmen, sowie die Erhebung des individuell wahrgenommenen Unterstützungsbedarfs der PatientInnen. Methode: Embedded Design mit quantitativem Schwerpunkt (Fragebogenerhebung, n = 32) und Auswertung ergänzender qualitativer Daten (Interviews, n = 5). Ergebnisse: Physische Manifestationen der Hautreaktionen (etwa Hautirritationen und Juckreiz) schränken die Lebensqualität der PatientInnen am stärksten ein, während damit verbundene emotionale und funktionelle Beeinträchtigungen deutlich seltener angegeben werden. Hautreaktionen werden von den PatientInnen nicht als prioritäre und stark belastende Problematik angesehen, sondern vielmehr als ein Teilaspekt der Gesamtsymptombelastung. Dennoch zeigen sich deutliche Zusammenhänge zwischen den Auswirkungen der Hautreaktionen auf die Lebensqualität und insbesondere dem allgemeinen physischen und psychologischen Unterstützungsbedarf. Schlussfolgerungen: Die Auswirkungen von toxischen Hautreaktionen auf die Lebensqualität der PatientInnen sind begrenzt, sie bedürfen dennoch gezielter, unterstützender, in das allgemeine Symptommanagement integrierter Interventionen. Schlüsselwörter: Hautreaktionen, Unterstützungsbedarf, EGFR-Antikörpertherapie, Krebs Skin toxicities and unmet supportive care needs of patients with cancer undergoing EGFR-inhibitor therapy Abstract:Background: Targeted therapies, such as the EGFR (epidermal growth factor receptor) inhibitor therapy, are being used to treat patients with various solid and metastatic tumours. Skin toxicities are a common side effect of this therapy. Aim: The aim of this study was to assess the effects of skin toxicities on quality of life of patients with cancer undergoing EGFR inhibitor therapy, as well as their unmet supportive care needs. Method: Embedded design. A standardised quantitative survey was administered and analysed. In addition, memos and audiotaped material of insightful conversations with the patients after survey administration were included in the analyses. Results: Among the three domains of the effects of skin toxicities on quality of life, physical symptoms (e. g. itching skin, rash) were most frequently reported to impair quality of life, while associated emotional and functional impairments were less frequently reported. Patients don't consider the management of skin toxicities to be a priority during their treatment, skin toxicities are rather perceived in context of the total symptom burden. Yet, we observed significant correlations between the assessed quality of life and unmet supportive care need...

The study explored how family care is developed and maintained in families in cases where more than one family member is involved in care. A total of 43 family carers in Austria participated in this qualitative study. Family care is a process of ongoing communication, in which responsibilities, coordination and conditions are negotiated among the family members involved. Three distinct care network types emerged from the data, which differ in terms of the individual perception of roles and responsibilities, and the distribution of care. Responsibilities for one another, awareness of being a family carer and the availability of resources are preconditions for the composition of these networks.

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Background In nursing homes, food is part of the care provided to residents, causing it to be strictly organised within the institutional framework. Moreover, once food has been integrated into the institutional logic, structural and economic aspects regarding organisation of food and eating may dictate individual and social needs, as a theoretical perspective informed by Goffman’s notion of the ‘total social institution’ suggests. This paper describes nursing home residents’ practices of dealing with meal requirements in two Austrian nursing homes, to understand how food integrates into the daily routine and how the institutional setting influences the social and material arrangement of food. Methods An ethnographic design was chosen to gain an in-depth understanding. Two urban nursing homes were studied over 21 months (approx. 800 h of participant observation and ethnographic interviews collected). Data analysis took place iteratively, following Grounded Theory strategies. Results As the thick descriptions resulting from this procedure show, observing everyday practices of eating in nursing homes reveals complex dimensions of residents being subject to institutional logics, and also demonstrates that residents develop elaborate strategies to deal with the institutional circumstances. Conclusion A better understanding of the resulting tensions between the restrictions of living in a formal organisation and the agencies of residents described, may contribute to better understanding the effects of structural constraints and to designing more flexible processes.

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