Cancer is associated with a variety of stresses and strains. According to the National Cancer Plan, all cancer patients and their relatives should receive needs-based, psycho-oncological care. Regular screening for psychosocial stress across all relevant treatment sectors is prescribed to determine individual care needs. So far, actual implementation has fallen short of these goals.
The feelBack project aims to establish digital stress screening instead of the paper questionnaires used to date. In addition to structuring the survey processes more effectively, this also makes it possible to avoid data loss and could contribute to increasing the screening rate (e.g. by making it available as an app on mobile devices). In the future, digitalisation processes in this area could sustainably improve sectoral networking in psycho-oncological care, e.g. through targeted, patient-determined data transfer between treatment centres. Finally, research areas and centre certifications could benefit from the greater availability of structured data.
As part of a randomised controlled pilot study, the feasibility and acceptance of a digital stress screening was examined in direct comparison to the standard paper questionnaire. In addition, the survey was used to determine the respondents' interest in and acceptance of a cross-sectoral data exchange of screening results. From May to November 2020, 60 people seeking advice at the outpatient psychosocial cancer counselling centre in Ulm were included in the survey. Since August 2021, the survey has been expanded to include a further 90 inpatients treated at Ulm University Hospital (Internal Medicine I). The digital application is based on the feelBack app developed as part of the project, which contains the validated and internationally recognised Distress Thermometer*.
Work on the feelBack project will continue via a cost-neutral extension. The aim is to publish the extended results. In addition, the challenges with regard to the desired interfaces will be addressed so that cross-sectoral summarisation of data can be implemented in real care. In addition, further optimisations in the area of user-friendliness and systematisation of the feelBack app will be undertaken.

* NCCN 1.2005 Distress Management Guideline. National Comprehensive Cancer Network.

Schobel, J., Volz, M., Hörner, K., Kuhn, P., Jobst, F., Schwab, J. D., Ikonomi, N., Werle, S. D., Fürstberger, A., Hoenig, K., Kestler, H. A. (2021). Supporting Medical Staff from Psycho-Oncology with Smart Mobile Devices: Insights into the Development Process and First Results. MDPI International Journal of Environmental Research and Public Health, 18, 5092. https:// doi.org/10.3390/ijerph18105092

CCCU - Comprehensive Cancer Centre Ulm, Dr Peter Kuhn, Head of Clinical Cancer Registry

Franz Jobst, Head of Strategic IT Development, Ulm University Hospital

Centre for Information and Communication (ZIK), Department of University Medicine Ulm

Biberach Health Department, Dr Monika Spannenkrebs, Head of Department

AOK - The health insurance company Ulm-Biberach

Prof Dr Hans Kestler,
Head of the Institute for Medical Systems Biology,
University of Ulm

11/2018 - 12/2022

Oncological patients (N = 60) were randomly assigned to one of two treatment arms
HTI (Hypnosystemic Interventions) vs CBI (Cognitive-Behavioural Interventions), each with three individual sessions or a waiting group. The participants in the HTI group learnt how to use individual inner mental images to activate resources via self-hypnosis, while the participants in the CBI group learnt supportive methods for mindfulness and self-care via psychoeducation. During the waiting period, the patients in the waiting group were cared for as usual (CAU). Changes in dealing with stress and anxiety were evaluated at three measurement points using standardised questionnaires. The extent of psychosocial stress and the ability to cope with stress were analysed using linear regression models with mixed effects at several levels, including diagnosis and duration of illness. The initial results indicate that the short-term programme makes an effective contribution to the psychosomatic support of tumour patients and can be integrated into medical oncological therapy at a low threshold. The catamnestic data is currently being analysed. A workshop report entitled "What can we achieve in three sessions?" was published in the journal Suggestions 2019. A publication in an international journal for psychosomatics and a manualisation are in preparation.

In order to improve the quality of life of tumour patients and strengthen their individual ability to cope with the disease, a short-term psycho-oncological programme was developed and evaluated to provide support during outpatient medical therapy in the day clinic.

2017 - 2021

the CCCU,
of the Clinic for Internal Medicine III and the
Clinic for Gynaecology and Obstetrics
at Ulm University Hospital

Partial funding:
German Society for Hypnosis and Hypnotherapy e.V

Cancer is not only a great burden for the patient themselves, but also for their relatives. The partner, who is the patient's most important resource, is particularly affected. Cancer confronts the partner with a multitude of new tasks and far-reaching adjustments. This demanding support service and their own everyday tasks mean that many partners feel overwhelmed and report psychological problems. However, the existing support services for relatives of cancer patients are rarely utilised by the partners.

As part of this research project, an online psycho-oncological intervention for partners of cancer patients is being developed and its effectiveness tested. The online intervention is based on elements of cognitive behavioural therapy and specific psycho-oncology content. It consists of six weekly lessons, four optional additional lessons and a refresher lesson. Each lesson is accompanied by feedback from a therapist. The partner also has the option of using an SMS coach.

The aim of the intervention is to reduce psychological stress, such as depression and anxiety, as well as to improve the partner's quality of life. Because it is independent of time and place, an online intervention is particularly suitable for partners of cancer patients who have a busy schedule. In addition, the online intervention lowers the threshold of utilisation for stressed partners who make less use of conventional face-to-face therapies (e.g. male partners).

A randomised controlled feasibility study was conducted from 04/2019 to 07/2020 to investigate the feasibility and acceptance of the PartnerCARE online training. 60 partners were randomly assigned to the training group (direct access to PartnerCARE) and the waiting list group (access to PartnerCARE after a 4-month waiting period). Online questionnaires were completed at three time points (baseline (T0), 2 months (T1) and 4 months (T2) after randomisation). The study showed good feasibility and high acceptance of the training (73.3% completed the training, positive individual feedback from participants). In addition, there were initial promising trends with regard to the effectiveness of the training. Detailed information on this can be found in the publications Bodschwinna et al. (2022a) and Bodschwinna et al. (2022b).

The findings of the pilot study will be used to improve the content of the PartnerCARE training programme and make it more attractive and interactive for participants. To this end, whiteboard videos will be created and exemplary dialogue situations between partner and patient will be filmed and incorporated into the online training.

The PartnerCARE online training course has undergone a feasibility and acceptance test and was subsequently optimised in the further development phase to PartnerCARE 2.0. There are now plans to investigate the effectiveness of PartnerCARE in a randomised controlled effectiveness study.

PartnerCARE is a cooperation project between the Clinic for Psychosomatic Medicine and Psychotherapy (Ulm University Hospital), the Comprehensive Cancer Centre Ulm and the Psychosocial Cancer Counselling Centre Ulm with the Department of Clinical Psychology and Psychotherapy (Ulm University).

Bodschwinna D., Lorenz I., Bauereiss N., et al. PartnerCARE-a psycho-oncological online intervention for partners of patients with cancer: study protocol for a randomised controlled feasibility trial. BMJ Open 2020;10:e035599. doi: 10.1136/bmjopen-2019-035599 https://bmjopen.bmj.com/content/10/10/e035599

M.Sc. Daniela Bodschwinna has been awarded the Helmut Wölte Prize 2021 for the PartnerCARE project. https://helmut-woelte-stiftung.de/

PartnerCARE is a psycho-oncological online training programme for partners of cancer patients. The project is a collaboration between the Department of Psychosomatic Medicine and Psychotherapy at Ulm University Hospital and the Department of Clinical Psychology at Ulm University with the Comprehensive Cancer Centre Ulm (CCCU) under the direction of Dr Klaus Hönig and Prof Dr Harald Baumeister. The innovative online training programme provides partners of people with cancer with a low-threshold and flexible offer of psychosocial support. The results of the project will help to close the gap in psychosocial care for relatives of cancer patients in the long term.

The PartnerCARE online training programme has undergone a feasibility and acceptance test and is currently in the further development phase. In the coming year, the effectiveness of PartnerCARE is to be investigated in a randomised controlled effectiveness study.

2017 - ongoing

Prof Dr Harald Baumeister

Note: Recruitment for the pilot study has now been completed
, so PartnerCARE
is not currently available