psychological aspects of oncology patient

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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psychological aspects of oncology patient

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