Oncology is a rapidly developing field with a growing number of publications every year. The main goal of this survey was to learn more about the information needs of oncologists and general practitioners. Data were collected using a standardised questionnaire developed in collaboration with the German Cancer Society (Deutsche Krebsgesellschaft) and the German Association of General Practitioners (Deutscher Hausärzteverband). A total of 495 questionnaires could be evaluated. Medical congresses were the preferred source of information for all participants. General practitioners preferred textbooks, while oncologists preferred journals and the Internet (all p < .001). Reasons for a lack of confidence during patient consultation were lack of time (60% of participants), lack of knowledge (61% of general practitioners and 26% of oncologists) and lack of data (>50%). Oncologists felt more confident in searching scientific databases than general practitioners did. Both groups required rapid access to transparent information. For general practitioners, reviews and comments by experts helped to put new information in the context of cancer treatment. Oncologists and general practitioners showed significantly different information needs and different ways to access specific information. In order to better integrate general practitioners while simultaneously serving the needs of oncologists, a database that is up to date, rapidly accessible and does not incur high costs would be helpful.
Complementary and alternative medicine (CAM) is used by many cancer patients by themselves. Therefore, we conducted a survey regarding the association between CAM, self-efficacy, and patient activation in adult cancer patients. A standardized questionnaire, consisted of the ASKU, the PAM 13-D, and a structured questionnaire on CAM usage from our own working group, was distributed to 880 potential participants. Six hundred and thirty-nine (639) patients (male 32.9%, female 63.2%; gynecological cancer 41%, gastrointestinal 19.2%, urogenital 15.6%) took part. 60% of all patients used CAM in the last 3 months (biological 73%, holistic 63%, mind–body methods 62%). Higher self-efficacy was associated with higher interest in CAM (p = 0.03), but not usage of CAM, compared to patients with lower self-efficacy (p = 0.099). Higher patient activation was associated with higher interest in CAM (p = 0.004) and usage of CAM (p = 0.012). Patients with higher activation significantly more often used homeopathy (p = 0.007), prayer (p = 0.002), yoga, etc. (p = 0.032), meditation (p = 0.002), low carb or ketogenic diets (p < 0.001) (but not vegan or other cancer diets). Higher patient activation is associated with higher usage of CAM. Focusing on patient activation as a goal in patient–physician relationship will help patients to adhere to a healthy lifestyle and to actively participate in the whole treatment process.
Zusammenfassung Ziel der Studie Die neue Approbationsordnung für Ärzte in Deutschland fordert verstärkt Hospitationen Medizinstudierender in allgemeinmedizinischen Lehrpraxen. Diese Studie soll einen Überblick geben, in welchem Ausmaß komplementär- und alternativmedizinischen Verfahren in deutschen Lehrpraxen angeboten werden und ob sie den Kriterien evidenzbasierter Medizin entsprechen. Orientierung an letzteren ist eine notwendige Voraussetzung für die Qualifikation zur Lehrpraxis. Methodik Nach systematischer Suche nach anerkannten Lehrpraxen der Fakultäten wurden deren Diagnostik- und Therapieangebote über die Praxis-Webseiten erfasst und unterschieden zwischen evidenzbasierter Komplementärmedizin und Alternativmedizin ohne oder mit umstrittener Evidenzbasierung. Ergebnisse Über die Hälfte der 4102 erfassten Lehrpraxen bot mindestens ein Verfahren aus dem komplementär- und/oder alternativmedizinischen Bereich an. Darunter waren überwiegend durch die Ärztekammer anerkannte Zusatzbezeichnungen. Alternativmedizinische Verfahren wurden in 18,2% der Praxen angeboten. Schlussfolgerung Sammelbegriffe und strittige Evidenzlagen erschweren eine Einordnung der Verfahren. Das Angebot nicht-evidenzbasierter Therapien in Lehrpraxen wirft die Frage nach einem Widerspruch zwischen der Rekrutierung vieler neuer Lehrpraxen und der Qualität der Lehre auf. Eindeutige Angebote der Alternativmedizin sollten zur Disqualifikation als Lehrpraxis führen. Umstrittene Verfahren könnten zumindest im Rahmen der akademischen Lehre und der Facharztweiterbildung in Bezug auf EbM-Kriterien und Kommunikationskompetenz unterrichtet werden, sodass junge Mediziner und Ärzte auf die Gespräche mit den Patienten vorbereitet sind.
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