Psychological help in oncology practice

Inna Mukharovska

doi:10.26766/pmgp.v2i2.19

Abstract

Background The psychological effects of cancer and its treatment on the patients, their families and health care workers point the need to develop psychological measures in oncology practice. Methods The study conducted at the Kyiv City Clinical Cancer Center during 2014-2016 years. In research participated 422 cancer patients: 80 patients on the stage of diagnostic, 187 – primary treatment and 155 – secondary treatment caused by cancer progression, 218 family members: 79 on primary (Gp), 68 – secondary stage of treatment in their relatives (Gs) and 71 in situation of palliative care (Gpal), and 50 oncologists. We used such psychodiagnostic tools as HARD, 5PFQ, SVF120, questionnaire “Type reaction on the disease”, questionnaire of Mezzich. Results Cancer caused significant influence on the mental state of the patients displayed at the personal, behavioral and psychosocial functioning levels. HADS showed the prevalence of anxious versus depressive symptoms (p<0,05), but the structure of symptomatic was similar. In patients on diagnostic stage were higher levels depression and anxiety, p<0,05. Destructive personal patterns found in 12,7% of patients, ineffective coping strategies in 24,6% respondents. In 62,8% cancer patients found maladjusted types of reactions on the disease, in compare with interpsychic disadaptation intrapsychic ones was dominant (p<0,05). The main types of reactions on the disease were anosognostic (13,0±3,4%), anxious-sensitive (11,4±3,2%), ergopathic-anxious (10,4±3,1%), sensitive (7,8±2,7%), anxious (7,6±2,6%) and hypochondriac (6,4±2,4%). Relatives of cancer patients experienced high levels of stress due to diagnosing cancer pathology in a loved one. The high levels of distress recognized in 92,4±2,6% relatives in Gp, 86,8±3,4% in Gs and 91,5±2,8% in Gpal. The rates of emotional exhaustion in oncologists was 16,1±9,1 points, depersonalisation – 6,0±4,5 points, professional achievements – 35,4±7,5 points. In 34% oncologist were present from 1 to 3 components of burnout. Conclusion According to the results psychological help, as important component of cancer management, must be provided not only to the patients, but to the relatives (caregivers) and oncologists because of high levels of distress and emotional burnout. The result of this study could become a basis for creating a new complex program of psychological interventions for these individuals.

Highlights

The psychological effects of cancer and its treatment on the patients, their families, and healthcare workers point the need to develop a program of psychological interventions for use in oncology practice
The research was conducted at the Kyiv City Clinical Cancer Center (2014 – 2016) and had an observational design
On average about 7 family members are Results involved in the assistance of cancer patient

Summary

Materials and Methods

The research was conducted at the Kyiv City Clinical Cancer Center (2014 – 2016) and had an observational design. Psychological and social sis and anticancer therapy selection (G1), 187 - primary (G2). We used Hospital Anxiety and Depression Scale (HADS). On average about 7 family members are Results involved in the assistance of cancer patient. Chronic illness excludes family members from social life, reduces their physical and mental well-being. Work in oncology is associated with high levels of stress due to the interaction with sick people who experience physical and psychological suffering. The study revealed the prevalence of depressive and anxiety disorders in cancer patients. According to the observational data, oncologists Table 1: Severity manifestations of anxiety and depression have showed high levels of emotional exhaustion - 15 - 25%, for the HADS, mean ± SD. Psychological cancer consequences and its treatment effects on a patient, his family members, healthcare professionals need management.

Anxiety Depression

Findings

An important practical challenge is to create a positive