How to identify patients in need of psychological intervention.

The identification of skin cancer patients in need of psychosocial intervention is a necessary prerequisite to relieving their distress and specifically supporting their coping strategies. The influence of early support even on prognosis has been shown in melanoma patients. Only a few patients ask for support themselves. The workload of doctors and nurses limits their ability to identify patients in need of support. Conducting interviews during daily hospital routine is time-consuming and cannot be implemented adequately. The screening of psychosocial risk patients needs to be based on standardized instruments. They should be easy to implement during the every-day routine. The Hornheide questionnaire with 27 items, the short form of the questionnaire with 9 items, and the Hornheide Screening Instrument (HSI) with 7 interview questions have been developed to achieve this aim in skin cancer patients. The Hornheide questionnaire offers a differentiated analysis of distress, and facilitates an accurate intervention according to the individual distress of the patient. The short form does not provide a differentiated analysis of distress. Its advantage is the speedy identification of patients at psychosocial risk. The HSI is for use during the anamnestic interview. In correlation with reduction of hospitalization time the HSI is most practicable for routine clinical implementation.