Second opinion and self‐efficacy in German skin cancer patients

Author:

Stege Henner1,Schneider Sara1,Forschner Andrea2ORCID,Eigentler Thomas3,Nashan Dorothée4,Huening Svea4,Lehr Saskia5,Meiss Frank5ORCID,Kaatz Martin6,Kuchen Robert7,Kaehler Katharina C.8,Haist Maximilian1ORCID,Grabbe Stephan1,Huebner Jutta9,Loquai Carmen110

Affiliation:

1. Department of Dermatology University Medical Center Mainz Mainz Germany

2. Department of Dermatology University Hospital Tuebingen Tuebingen Germany

3. Department of Dermatology Venerology and Allergology Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität Berlin Germany

4. Department of Dermatology Hospital Dortmund Dortmund Germany

5. Department of Dermatology Medical Center‐University of Freiburg Freiburg Germany

6. Department of Dermatology DRK‐Krankenhaus Rabenstein Chemnitz Germany

7. Institute of Medical Biostatistics Epidemiology and Informatics (IMBEI) University Medical Center Mainz Germany

8. Department of Dermatology Venerology and Allergology University Hospital Schleswig Holstein, Campus Kiel Kiel Germany

9. Klinik für Innere Medizin II Hämatologie und Onkologie Universitätsklinikum Jena Jena Germany

10. Department of Dermatology Klinikum Bremen‐Ost Gesundheitnord gGmbH Bremen Bremen Germany

Abstract

SummaryBackgroundThe global incidence of skin cancer has steadily increased in recent years. Accordingly, patients require information on diagnosis and treatment options while dealing with the perceived impact of the diagnosis. In 2015, the German government enacted legislation under the Social Code (SGB V, § 27b), granting patients the right to obtain a second medical opinion.Patients and MethodsUtilizing a standardized questionnaire, our study aims to explore whether patients diagnosed with skin cancer actively pursue a second medical opinion and to evaluate any potential disruptions to their daily lives. We collected a total of 714 completed questionnaires.ResultsThe majority of those seeking a second opinion were diagnosed with malignant melanoma (96, 58%). Primary motivations for seeking a second opinion included seeking reassurance regarding treatment decisions and obtaining further information. Additionally, seeking a second opinion was correlated with a significantly lower internal locus of control, indicating a belief that their actions are not solely determined by their own abilities. Notably, we observed a greater impairment of daily life among younger participants and those with advanced cancer.ConclusionsOverall, our study shows that second opinions often strengthened the patient‐physician interaction and provided additional reassurance, especially in patients with a weak perception of control. Moreover, we found that the impairment of quality of life and both internal and external locus of control decrease significantly in advanced tumor stages. Hence, it is imperative to identify additional interventions aimed at bolstering internal resilience and locus of control, thereby enhancing patients' capacity to cope with their cancer diagnosis.

Publisher

Wiley

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