Assisted by Deutsche Krebshilfe, the German cancer aid fund, a questionnaire for assessment of quality of life in patients with life-threatening skin tumours and disfiguring tumour sequels was developed at Fachklinik Hornheide between 1986 and 1988. A first step toward determining quality of life and for enhancing treatment-integrated rehabilitative work is the assessment of the subjective distress and problems experienced due to the illness and its treatment. This is the objective of the Hornheider Fragebogen, a questionnaire developed in the framework of the study on the basis of extensive literature search, structured interviews with patients and treating staff. This self-assessment instrument was answered by 131 patients with malignant tumours of the skin, twice during in-patient treatment and a third time some 6 months after discharge. Statistical analysis of the data collected proved the questionnaire to be valid, reliable and practicable. Additionally, it has been possible to draw up a number of significant results of immediate relevancy. It turned out that persons who are unemployed, divorced, or married but separated, as well as persons without school leaving certificate, experienced greater distress and more problems in many dimensions than the other respondents. The questionnaire was viewed as meaningful and as helpful by the patients in order to voice unspecific anxiety and questions. Also, the study entailed positive implications for our rehabilitative work already in this initial testing phase, by enabling us to give more specific support to the patients. The Hornheider Fragebogen, after review and abridgment, consists of 27 problem-oriented questions relating to eight dimensions of life.