Background: Peripartum depression and anxiety disorders are highly prevalent and are correlated with adverse maternal and neonatal outcomes. Antenatal care in Germany does not yet include structured screening and effective low-threshold treatment options for women facing peripartum depression and anxiety disorders. Mindfulness-based interventions (MBIs) are increasingly becoming a focus of interest for the management of such patients. Studies have shown a decrease in pregnancy-related stress and anxiety in expectant mothers following mindfulness programs. Objective: The aim of this study was to explore the clinical effectiveness of a 1-week electronic course of mindfulness on prenatal depression and anxiety in hospitalized, high-risk pregnant women. We hypothesized that participating in a 1-week electronic MBI (eMBI) could alleviate symptoms of depression and anxiety during the hospital stay. Methods: A prospective pilot study with an explorative study design was conducted from January to May 2019 in a sample of 68 women hospitalized due to high-risk pregnancies. After enrolling into the study, the participants were given access to an eMBI app on how to deal with stress, anxiety, and symptoms of depression. Psychometric parameters were assessed via electronic questionnaires comprising the Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI-S), and abridged version of the Pregnancy-Related Anxiety Questionnaire (PRAQ-R). Results: We observed a high prevalence of peripartum depression and anxiety among hospitalized high-risk pregnant women: 39% (26/67) of the study participants in the first assessment and 41% (16/39) of the participants in the second assessment achieved EPDS scores above the cutoff value for minor/major depression. The number of participants with anxiety levels above the cutoff value (66% [45/68] of the participants in the first assessment and 67% [26/39] of the participants in the second assessment) was significantly more than that of the participants with anxiety levels below the cutoff value, as measured with the STAI-S. After completing the 1-week electronic course on mindfulness, the participants showed a significant reduction in the mean state anxiety levels (P<.03). Regarding pregnancy-related anxiety, participants who completed more than 50% of the 1-week course showed lower scores in PRAQ-R in the second assessment (P<.05). No significant changes in the EPDS scores were found after completing the intervention. Conclusions: Peripartum anxiety and depression represent a relevant health issue in hospitalized pregnant patients. Short-term eMBIs could have the potential to reduce anxiety levels and pregnancy-related anxiety. However, we observed that compliance to eMBI seems to be related to lower symptoms of pregnancy-related stress among high-risk patients. eMBIs represent accessible mental health resources at reduced costs and can be adapted for hospitalized patients during pregnancy.

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 stage. The aim of this systematic literature review is to provide an overview of the quantitative data on coping strategies and personality traits associated with posttraumatic growth in patients with cancer and cancer survivors as well as the methods used in included studies. A systematic literature search was conducted using five databases (PubMed, PubPsych, PsycInfo, Web of Science, and PSYNDEXplus). The 70 reports of included studies assessed posttraumatic growth using questionnaires in a sample of patients with cancer or survivors. In addition, associations with a personality trait or coping strategy had to be examined cross-sectionally or longitudinally. All 1698 articles were screened for titles and abstracts by two authors, after which disputed articles were reviewed by a third author. Afterwards, articles were screened for full texts. Most studies had a cross-sectional design and used a sample of patients with breast cancer. Coping strategies have been researched more than personality factors. The personality traits of resilience, hardiness, dispositional positive affectivity, and dispositional gratitude seem to be related to posttraumatic growth, while the Big Five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, neuroticism) have been less researched and/or seem to be unrelated. The use of social support, religious coping, positive reframing, and reflection during illness as coping strategies seems to be related to posttraumatic growth. The findings can be used for the development of interventions. Future studies should investigate associations longitudinally.

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 gynecological cancer. Methods: Using a cross-sectional paper-pencil (n = 157) and online survey (n = 614), a total of 771 patients with breast or gynecological cancer completed a set of validated questionnaires. From September 2013 to January 2014, consecutive inpatients and outpatients of the university hospital Tuebingen were included in the study. Further, participants were recruited through social media, patient internet platforms, self-help group leaders and patient networks. We used the Supportive Care Needs Survey (SCNS-SF-34) with the need dimensions: health system, patient care, psychological, physical, and sexual needs, as well as the Experiences in Close Relationships-Revised Questionnaire, and the Distress Thermometer. A multiple linear regression model was used to analyze the influence of attachment styles (anxiety and avoidance) on the SCNS-SF-34 dimensions. A moderation analysis was used to explore the influence of the interaction between attachment anxiety and distress for all SCNS-SF-34 dimensions. Results: Attachment anxiety was a significant determinant and led to higher unmet supportive care needs in all dimensions, whereas attachment avoidance was not significant. Distress did moderate the relationship between attachment anxiety and psychological and health system needs and led to a higher unmet needs development. For the other SCNS-SF-34 dimensions, distress was not confirmed as a moderator. Conclusion: Our findings highlight attachment anxiety as a risk factor for the development of unmet supportive care needs and potentially impaired psychological adjustment to cancer. Further studies are needed to elucidate the interactions between attachment styles, distress and supportive care needs among cancer patients.

(1) Background: Booster vaccinations for SARS-CoV-2 convalescents are essential for achieving herd immunity. For the first time, this study examined the influencing factors of vaccination willingness among SARS-CoV-2 infected individuals and identified vaccination-hesitant subgroups. (2) Methods: Individuals with positive SARS-CoV-2 PCR results were recruited by telephone. They completed an online questionnaire during their home isolation in Germany. This questionnaire assessed the vaccination willingness and its influencing factors. (3) Results: 224 home-isolated individuals with acute SARS-CoV-2 infection were included in the study. Vaccination willingness of home-isolated SARS-CoV-2 infected individuals with asymptomatic or moderate course was 54%. The following factors were associated with significantly lower vaccination willingness: younger age, foreign nationality, low income, low trust in vaccination effectiveness, fear of negative vaccination effects, low trust in the governmental pandemic management, low subjective informativeness about SARS-CoV-2, support of conspiracy theories. (4) Conclusions: The vaccination willingness of home-isolated SARS-CoV-2 infected individuals with asymptomatic or moderate symptomatic course was low. Motivational vaccination campaigns should be adapted to individuals with acute SARS-CoV-2 infection and consider the vaccination-hesitant groups. Vaccination education should be demand-driven, low-threshold, begin during the acute infection phase, and be guided for example by the established 5C model (“confidence, complacency, constraints, calculation, collective responsibility”).

Objective: The SARS-CoV-2 pandemic has led to pronounced health changes, especially for those infected and psychologically burdened. This cross-sectional study examined the stress experience and coping strategies during home isolation of SARS-CoV-2 infected individuals and analyzed differences regarding psychological burden.Methods: SARS-CoV-2 infected respondents were recruited by telephone and completed an online survey during their home isolation. This questionnaire assessed sociodemographic aspects, somatic factors, psychological burden (depressive symptoms, anxiety, and somatic symptom disorder), perceived stress and coping behavior during the home isolation.Results: Out of 838 SARS-CoV-2 infected individuals during the study period, 648 were contacted and 224 home-isolated respondents were included in the study. Disgrace, social restrictions, job fear, health concerns, and infectiousness could be explored as stressors during the home isolation. Fifty-four percent experienced psychological burden. SARS-CoV-2 infected and home-isolated individuals with psychological burden perceived significant stressors more strongly (p < 0.001, r = 0.5) and coped significantly less (p < 0.001, r = 0.3) with their infection and home isolation compared to SARS-CoV-2 infected individuals without psychological burden.Conclusion: SARS-CoV-2 infected individuals with psychological burden experienced higher stressors and were unable to cope adaptively with home isolation. Therefore, a general and standardized screening procedure for psychological burden should be established. SARS-CoV-2 infected individuals with psychological burden should receive targeted support with professional help in the areas of stress experience and coping skills during their home isolation and beyond to avoid long-term consequences.

Zusammenfassung: Die Identifizierung belasteter onkologischer Patienten mithilfe von Screening-Instrumenten stellt in der Praxis eine große Herausforderung dar. Bislang fehlen evidenzbasierte Empfehlungen, welches Instrument am geeignetsten ist, sowie zur Implementierung eines Screenings. Die Nutzung computerbasierter Instrumente eröffnet neben automatisierter Auswertung und Information psychoonkologischer sowie medizinischer Behandler die Möglichkeit eines reaktiven Fragebogens. Welche Faktoren die Behandlungsentscheidung in der Psychoonkologie unterstützen können ist bislang wenig untersucht.Methode Frauen mit Brustkrebs und gynäkologischen Tumoren, die sich zur stationären operativen Behandlung in der Universitäts-Frauenklinik befanden, wurden konsekutiv in die Studie eingeschlossen (n=103). Bei Aufnahme erfolgte ein computerbasiertes Screening zur Belastungsmessung (ePOS-react). Hierbei wird abschließend auf dem Computer basierend auf der im Screening ermittelten Belastung eine Behandlungsempfehlung gegeben: i) psychoonkologische Beratung/Behandlung, ii) psychoonkologischer Kurzkontakt/Informationsgespräch, iii) kein Angebot. Die Patienten konnten sich für eine der 3 Optionen entscheiden (Behandlungswunsch). Am ersten postoperativen Tag wurde ferner ein klinisches Interview (Psychoonkologischen Basisdiagnostik, PO-Bado) zur Fremdbeurteilung des Behandlungsbedarfs durchgeführt.Ergebnisse 68,9% folgten der Behandlungsempfehlung, 22,3% wünschten ein „intensiveres“ (z. B. Beratung anstelle von empfohlenem Kurzkontakt) und 8,7% ein weniger „intensives“ als das empfohlene Angebot. Die Übereinstimmung zwischen Fremdbeurteilung und screeningbasierter Behandlungsempfehlung liegt bei 72,8%. Die Übereinstimmung zwischen Fremdbeurteilung und Behandlungswunsch der Patientinnen liegt bei 58,3%. Letztere ist niedriger, da sich 29,1% einen psychoonkologischen Kurzkontakt wünschten, für welche aus Sicht der Fremdeinschätzung keine akute Behandlungsindikation bestand.Diskussion Die direkte Rückmeldung des Screening-Ergebnisses in Form einer Behandlungsempfehlung während des computerbasierten Screenings und anschließende Abfrage eines Behandlungswunsches der Patientinnen führt zu einem Anstieg von Kurzkontakten zur persönlichen Informationsvermittlung. Dies erhöht zwar nicht die Genauigkeit hinsichtlich der Fremdbeurteilung, führt jedoch zu einer höheren Transparenz im Zugang zu psychoonkologischer Behandlung und kann damit Patientenautonomie und Adhärenz stärken.