The role of a clinical psychologist in the system of medical and psychological support of cancer patients at radiation therapy stage (аnalytical review of literature and own clinical data)

Abstract

Background. Being diagnosed with cancer is a dramatically stressful condition for a human. Radiation therapy (RT), which is an essential of combination antineoplastic treatment, can cause physical and emotional state changes. Realizing these changes is an additional stress factor that results in impaired life quality of a cancer patient as well refusal to undergo further treatment. At present, there is no distinct system of providing psychological aid for cancer patients in Ukraine.
 Purpose. To carry out analysis and generalization of research literature data in terms of providing psychological aid for cancer patients at RT stage and to present own findings of psychological study enrolling 55 female patients diagnosed with endometrial cancer at RT stage at SO «Grigoriev Institute for Medical Radiology and Oncology» within the period from 2015 to 2018.
 Materials and methods. The literature review involved available contributions obtained via literature search in domestic (Vernadsky National Library of Ukraine) and foreign databases (Scopus, Web of Science Core Collection, PubMed, BMC, ScienceDirect, Wiley Online Library, RNB). Fifty-five patients with endometrial cancer of stage I–II (T1b-c N0 M0 – T2a -b N0 M0) underwent clinical and laboratory examination. The diagnosis of adenocarcinoma was confirmed by means of a histologic study. All patients underwent panhysterectomy and postsurgery course of distant gamma-therapy on “РОКУС-АМ” device by split fractionation. Fifteen patients were provided with psychological correction at RT stage. In order to assess life quality, SF-36 (Health Status Survey) was used. An assessment of the severity of psychosomatic disorders in patients with endometrial cancer was made by means of EORTC QLQ-C30 survey.
 Results. The paper analyzes psychological aid provided to oncology patients at radiation therapy stage in Ukraine and overseas. It presents the peculiarities of patients’ psychological responses during irradiation and possible consequences of higher mental function impairment. The targets of psychological correction and factors influencing life quality of a patient have been considered as well as the effectiveness of psychotherapeutic interventions outcomes of different approaches has been provided. The study states that, currently, medical and psychological follow-up of cancer patients does not consist only in reassuring talk and drug correcting of their psychological state aimed to reduce distress, anxiety and depression level, but also in psychocorrection, psychoeducation, the access to psychotherapeutic groups, individual psychotherapy. The efficiency of applying own developed schemes of medical and psychological correction of emotional state of women with EC is presented, the use of which has made it possible to reduce the manifestations of sleep disorders, cognitive function and fatigue.
 Conclusions. Following a differentiated strategy when choosing methods of psychological aid for oncology patients and their families at radiation therapy stage via psychocorrection of emotional, cognitive and behavioral spheres, psychoeducation or psychotherapeutic interventions will make it possible to significantly improve their psychological status and quality of life.