Psychosocial aspects of cancer

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Psychosocial aspects of cancer
Introduction
A patient with cancer and their families face challenges during the life cycle.
Psychological crisis often due to emotionally paralyzing diagnosis.
Facing greatest fear of loss of control
1.     Role adjustments

·        The ability to fulfil the usual role and responsibility will change.
·        Changed role may manifest as separateness, increased concern and kindness, distancing and avoidance.
·        It creates a feeling of incompetence and discomfort labelled "indifferent", which creates frustration
Management
·        Help the patient with cheering encouragement.
·        Focus on physical wellbeing of the patient in addition to sexual health and sexual relationship.
·        Maintain positive self-concept.
·        Help adjusting in altered social relationship,
·        Handle physical discomfort
·        Help complying with the prescribed regimen.
·        Help in dealing with social stigma of illness or disability.
2.     Emotional response and ability to cope
·        Patients experiences multiple types of distresses.
·        DABDA
·        Response depends how the patient kept informed about the disease.
Management
Develop skills to deliver information in truthful yet gentle manner that can maintain a hope and sense of reassurance.
Inform the diagnosis in an empathic and appropriate manner.
Provide privacy and adequate time, assess understanding of patient, arrange review, discuss treatment options, provide resource information.
3.     Anxiety
·        Occurs at different point of disease
·        Can be adjustment disorder with anxiety mood, generalized anxiety disorder, panic disorder, phobias etc.
·        Often experience tension, feeling upset, nervousness, and inability to sleep.
Management:
·        Anxiety can be when waiting for procedures and tests, results and diagnosis, anticipating major treatment, on completion of treatment, learning of relapse, during advanced illness..
·        Respond to the concerns shown by the patients and family.
·        Respond to their stories with concern and empathy, respect and a lack of blame and emphasize the strengths exhibited by them.
4.     Depression
·        Occurs due to disease related tests, treatments, side effects and medications.
·        Severity of the disease, site of the disease, lack of social support, fear of uncontrolled pain Management: Aggressive treatment of depression
5.     Facing cancer with spouse
·        Can offer opportunity for growth and understanding in relationship.
·        But it also can confuse, frustrate and distance a couple from one another.
·        Can powerfully challenge the relationship rules, boundaries and family organization of the  couple.
Management
·        Understand and strengthen the spouse.
·        Because spouse knows, what the ill partner requires during the crisis.
·        Listening, staying emotionally responsive, offering physical closeness, respecting the need of ill spouse.
6.     Interpersonal difficulties
·        Interpersonal difficulties involve intimacy, marriage and reproduction.
·        Cause distress among partners
·        Creates negative aspects in marital relationship
Management
·        Possible changes in the reproduction to be explained.
·        Kept informed early (before beginning the treatment) about the possible sterility effects so planning can be done for sperm banking or embryo preservation.
7.     Workplace challenges and discriminations
·        Include job discriminations, demotions, firing, unwanted transfers, social isolation and animosity.
·        Due to myths about the terminal disease.
Management
·        Prepare the patient for possibility of such reaction.
·        Educate the employers
·        Enforcement of law
·        Assist in investigations and claims if necessary




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Psychosocial aspects of cancer
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