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8/2/2019 Psychological Aspects of Oncology Patient
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Psychological Aspects of
Oncology PatientContributing Factors &Intervention
Elham Abd El-Kader Fayad
Professor of Psychiatric & Mental Health Nursing
3/5/2006
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For oncology client the following
areas should be examend:
Adjustment and quality of life. Symptoms control.
Immune function.Disease progression
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Studies of quality of life &
psychological adjustment focuses
the attention on several questions
Which patient are most vulnerable
to psychological difficulties?
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What challenges emerge for patients
with different sites of disease at
different phases of treatment?
Disabilities? Tumor site? Choice oftreatment & time since diagnosis?
This plays an obvious role in shaping
psychological responses to cancer.
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Symptoms Control
Nausea, vomiting, pain, fatigue
& hot flashes are among thesymptoms that have been
targeted for adjectivepsychological interventions.
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Interest in symptoms control helped
set the stage for closerinterdisciplinary collaboration in the
clinic, introducing an alternative to the
more traditional practice of referringmedical symptoms to medical
specialists & psychological problems
to mental health specialists.
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Immune Function &Disease Outcome
Psychological factors contributing
to disease progression.
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Growing evidence suggests that
social isolation, associated with all-cancer mortality after controlling
for traditional risk factors.
Social support may have differential
effects on survival.
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Psychological factors suchas: stress, pessimism, or
isolation affect the medical
treatment.
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Stress and psychological factorsinfluence health behaviors
contributing to poor diet,diminished appetite, disrupted
sleep, limited exercise, increase
cigarette smoking, andintensified substance abuse.
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Associated Common
Psychological Symptoms
Certain psychological symptoms arecommon to clients diagnosed with
cancer these include anger,
depression, anxiety, helplessness, and
hopelessness
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Anger
Clients with cancer
diagnosis typically
demonstrate behaviors thatare indicative of anger.
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These behaviors reflect
feelings of helplessness and
frustration about the illness
and the effects the illnesshas on daily functioning.
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Behaviors likely to be
exhibited include demanding
types of action, loud
verbalization, slamming ofitems, and social withdrawal.
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Depression
Clients with cancer diagnosis
typically demonstrate symptoms
of depression related to
disruption of daily functioning.
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Signs associated with
depression include feelings ofhelplessness/hopelessness, flat
affect, poor eye contact,
disrupted eating/sleeping
patterns, absence of motivation
and compliance, and decreasedenergy level.
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Anxiety Oncology clients typically
demonstrate feelings andbehaviors of anxiety.
This reflects feelings of real orimagined threat to body image.
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Anxiety results in autonomicnervous system stimulation
with increased heart rate,increased respirations,
increased visual acuity,
diaphoresis, shortness of
breath, and restlessness.
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Helplessness/Hopelessness
Oncology clients demonstratefeelings of
helplessness/hopelessness.
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Helplessness relates to feelings
of powerlessness associated
with being unable to changewhat is happening, while
hopelessness relates to feelings
of despondency and loss of
optimism.
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This is reflected in feelings of
loss of control (feeling that anevent can be managed) and
individuality and increased
dependency on others.
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Associated Psychiatric Symptoms
Psychosis is the inability of
a client to understand and
know reality or cope withdemands of daily living.
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Psychotic symptoms that may bedemonstrated in clients with
selected medical illness diagnoses
include evidence of delusions and
hallucinations, thought process
disruption, and difficulty in caringfor oneself.
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Assessment
The nurse uses various
resources to collect
psychological, biological, andsocial data.
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Subjective and objective
symptoms,
family/significant otherreports, and diagnostic
reports are considered inthe assessment phase.
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Psychological Assessment
Elicits clients emotional
reaction & coping abilities
and support resources.
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A stress appraisal should be
done with identification ofthe source of stress, number
of stressors, and duration of
stressors.
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Depression symptomsassessment should be completed
with notation of time of initialsymptoms, duration of
symptoms, and physical
appearance.
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Identification of coping behaviorsis part of the psychological
assessment and includes
assessment of adaptive and
maladaptive behaviors that reflect
a clients ability to identifyproblems and analyze feelings
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The assessment phase
should also includeidentifying the emotional
stage of the illness.
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Clients often progressively
move through stages of illness
and interventions should be
planned according to the
emotional stage.
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These Stages include
Denial of the illness and associated
limitations.
Anger at loss of control andassociated limitations.
Bargaining, with a plea for anotherchance and a seeking of new
answers/treatments.
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Depression when grieving
occurs due to loss or anticipated
loss.
Acceptance/adaptation when
conflicts are resolved and theclient participates in care.
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Management
In cancer illness:
Client experiences feelings ofhelplessness & hopelessness.
In addition, feelings of depression,
anger, and hostility are
experienced.
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The clients response will be
affected by coping skills,
developmental/lifespan level,
spiritual, cultural, biological,and psychosocial factors.
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Interventions for clients with
cancer should include use of
empathy and compassion; a focus
on aspects of the clients life that
were positive, spiritualityassessment and reinforcement;
support of family and significant
others; and allowing client dignity,
client control, and use of pain
management.
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