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
COMMENTS