Second opinion and self‐efficacy in German skin cancer patients

• Published in: Journal der Deutschen Dermatologischen Gesellschaft 2024-11, Vol.22 (11), p.1499-1507
• Main Authors: Stege, Henner, Schneider, Sara, Forschner, Andrea, Eigentler, Thomas, Nashan, Dorothée, Huening, Svea, Lehr, Saskia, Meiss, Frank, Kaatz, Martin, Kuchen, Robert, Kaehler, Katharina C., Haist, Maximilian, Grabbe, Stephan, Huebner, Jutta, Loquai, Carmen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; decision making; Diagnosis; Female; Germany; Humans; Internal-External Control; Locus of control; Male; Melanoma; Melanoma - psychology; Middle Aged; Motivation; Patients; Physician-Patient Relations; Quality of Life; Referral and Consultation; second opinion; Self Efficacy; Skin cancer; Skin Neoplasms - psychology; Surveys and Questionnaires; treatment
• ISSN: 1610-0379; 1610-0387; 1610-0387
• DOI: 10.1111/ddg.15512

Summary Background The 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 Methods Utilizing 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. Results The 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. Conclusions Overall, 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.